Abstract
Background: Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. Objective: To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs filled by women of reproductive age. Design: Description of prescriptions filled in 2001. Setting: A large health maintenance organization in northern California in 2001. Patients: 488 175 women age 15 to 44 years who filled a total of 1 011 658 class A, B, D, or X prescriptions. Measurements: Medications dispensed, contraceptive counseling, and pregnancy testing. Results: A class D or X prescription was filled by 1 of every 6 women studied. Women who filled a prescription for class D or X medications were no more likely than women who filled prescriptions for safer, class A or B medications to have received contraceptive counseling, filled a contraceptive prescription, or been sterilized (48% vs. 51% of prescriptions). There was little variation by clinical indication in rates of contraceptive counseling with class D or X prescriptions, except for isotretinoin. Women who filled a class D or X prescription were only slightly less likely to have a pregnancy documented within 3 months than women filling a class A or B prescription (1.0% vs. 1.4% of prescriptions). Limitations: International Classification of Diseases, Ninth Revision, codes underestimate contraceptive counseling. Documentation of a positive pregnancy test after filling a prescription may overestimate medication use in early pregnancy. Women who filled several prescriptions are overrepresented in prescription analyses. Conclusion: Prescriptions for potentially teratogenic medications are frequently filled by women of childbearing age without documentation of contraceptive counseling.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 370-376 |
| Number of pages | 7 |
| Journal | Annals of Internal Medicine |
| Volume | 147 |
| Issue number | 6 |
| DOIs | |
| State | Published - Sep 18 2007 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Internal Medicine
Cite this
Documentation of contraception and pregnancy when prescribing potentially teratogenic medications for reproductive-age women. / Schwarz, Eleanor; Postlethwaite, Debbie A.; Hung, Yun Yi; Armstrong, Mary Anne.
In: Annals of Internal Medicine, Vol. 147, No. 6, 18.09.2007, p. 370-376.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Documentation of contraception and pregnancy when prescribing potentially teratogenic medications for reproductive-age women
AU - Schwarz, Eleanor
AU - Postlethwaite, Debbie A.
AU - Hung, Yun Yi
AU - Armstrong, Mary Anne
PY - 2007/9/18
Y1 - 2007/9/18
N2 - Background: Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. Objective: To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs filled by women of reproductive age. Design: Description of prescriptions filled in 2001. Setting: A large health maintenance organization in northern California in 2001. Patients: 488 175 women age 15 to 44 years who filled a total of 1 011 658 class A, B, D, or X prescriptions. Measurements: Medications dispensed, contraceptive counseling, and pregnancy testing. Results: A class D or X prescription was filled by 1 of every 6 women studied. Women who filled a prescription for class D or X medications were no more likely than women who filled prescriptions for safer, class A or B medications to have received contraceptive counseling, filled a contraceptive prescription, or been sterilized (48% vs. 51% of prescriptions). There was little variation by clinical indication in rates of contraceptive counseling with class D or X prescriptions, except for isotretinoin. Women who filled a class D or X prescription were only slightly less likely to have a pregnancy documented within 3 months than women filling a class A or B prescription (1.0% vs. 1.4% of prescriptions). Limitations: International Classification of Diseases, Ninth Revision, codes underestimate contraceptive counseling. Documentation of a positive pregnancy test after filling a prescription may overestimate medication use in early pregnancy. Women who filled several prescriptions are overrepresented in prescription analyses. Conclusion: Prescriptions for potentially teratogenic medications are frequently filled by women of childbearing age without documentation of contraceptive counseling.
AB - Background: Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. Objective: To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs filled by women of reproductive age. Design: Description of prescriptions filled in 2001. Setting: A large health maintenance organization in northern California in 2001. Patients: 488 175 women age 15 to 44 years who filled a total of 1 011 658 class A, B, D, or X prescriptions. Measurements: Medications dispensed, contraceptive counseling, and pregnancy testing. Results: A class D or X prescription was filled by 1 of every 6 women studied. Women who filled a prescription for class D or X medications were no more likely than women who filled prescriptions for safer, class A or B medications to have received contraceptive counseling, filled a contraceptive prescription, or been sterilized (48% vs. 51% of prescriptions). There was little variation by clinical indication in rates of contraceptive counseling with class D or X prescriptions, except for isotretinoin. Women who filled a class D or X prescription were only slightly less likely to have a pregnancy documented within 3 months than women filling a class A or B prescription (1.0% vs. 1.4% of prescriptions). Limitations: International Classification of Diseases, Ninth Revision, codes underestimate contraceptive counseling. Documentation of a positive pregnancy test after filling a prescription may overestimate medication use in early pregnancy. Women who filled several prescriptions are overrepresented in prescription analyses. Conclusion: Prescriptions for potentially teratogenic medications are frequently filled by women of childbearing age without documentation of contraceptive counseling.
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UR - http://www.scopus.com/inward/citedby.url?scp=34548792291&partnerID=8YFLogxK
U2 - 10.7326/0003-4819-147-6-200709180-00006
DO - 10.7326/0003-4819-147-6-200709180-00006
M3 - Article
C2 - 17876020
AN - SCOPUS:34548792291
VL - 147
SP - 370
EP - 376
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
SN - 0003-4819
IS - 6
ER -