MEDICATION USE DURING PREGNANCY IN THE NETHERLANDS- A POPULATION-BASED STUDY
Author(s)
Houben E1, Bezemer I1, Hukkelhoven C2, Steegers E3, Herings R1
1PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands, 2Perined, Utrecht, The Netherlands, 3Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
OBJECTIVES: The objective of this study was to assess medication use during pregnancy in a population-based setting in the Netherlands. METHODS: A cross-sectional analysis was conducted using pharmacy dispensing records linked to pregnancy records. Community pharmacy dispensing records were obtained from the Out-patient Pharmacy Database of the PHARMO Database Network (PHARMO) – a population-based network of electronic healthcare databases combining data from different healthcare settings in the Netherlands. Pregnancy records were obtained from the Perinatal Registry of the Netherlands (Perined) – a nationwide registry containing maternal and neonatal characteristics and data on perinatal care. Pregnancies between 1999 and 2015 of women registered in Perined as well as PHARMO were included in the study. Use of unsafe medication was defined according to 5 categories of the Dutch classification of medication in pregnancy: A) medication with pharmacological effects that (A1) should be monitored when used or (A2) should be (temporarily) avoided; B) medication with teratogenic effects that (B1) should be monitored when used or (B2) should be (temporarily) avoided and C) medication with unknown risks due to insufficient experience. RESULTS: The PHARMO-Perined cohort included 475,332 pregnancies of 343,783 women (mean (±SD) age at delivery 30.3 (±4.8) years, 81% with Dutch ethnicity). A total of 335,017 (70%) pregnancies were identified during which women were dispensed medication at least once. Among all pregnancies, 137,893 (29%) were exposed to unsafe medication with the highest use for medication in category C (79,416 pregnancies, 58%) followed by category A2 (48,584 pregnancies, 35%), category A1 (38,084 pregnancies, 28%), category B2 (13,094 pregnancies, 9%) and category B1 (1,952 pregnancies, 1%). CONCLUSIONS: Nearly one third of all pregnancies were exposed to medication not indicated as safe. Future interventions in the Netherlands should focus on the prevention of unsafe medication use during pregnancy.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PIH31
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Prescribing Behavior, Treatment Patterns and Guidelines
Disease
Reproductive and Sexual Health