2023-03-01 カーディフ大学
◆イギリスの研究者たちは、7090人の妊娠中の女性を調査し、5年以内に妊娠していた34人の女性をインタビューした。医療従事者が妊婦に薬剤を処方する際、母親の利益と胎児への潜在的な害のバランスをとる必要があるが、女性の個々の状況が考慮されておらず、決定に十分に参加していないことが分かった。
◆この問題は、重篤な妊娠中の吐き気、妊娠痛、精神衛生状態に対する医薬品の必要性に関連していた。医療従事者が胎児の害を恐れて薬剤の使用を拒否するケースが多く見られ、女性の健康だけでなく、精神的な健康にも影響を与えている。
◆妊娠中には薬剤の使用に関する国家の指針があるが、研究によれば、女性たちが適切な医薬品を手に入れるためには、より多くの取り組みが必要とされている。
<関連情報>
- https://www.cardiff.ac.uk/news/view/2706378-womens-health-at-risk-from-reluctance-to-prescribe-medicine-during-pregnancy
- https://bmjopen.bmj.com/content/13/3/e067987
英国における妊娠中の市販薬と処方薬に関する女性の経験:アンケート自由記述回答およびナラティブ・インタビューから得られた知見 Women’s experiences of over-the-counter and prescription medication during pregnancy in the UK: findings from survey free-text responses and narrative interviews
Julia Sanders,Rebecca Blaylock,Caitlin Dean,Irene Petersen,Heather Trickey,Clare Murphy
BMJ Open Published March 1, 2023.
DOI:http://dx.doi.org/10.1136/bmjopen-2022-067987
Abstract
Objectives To explore women’s experiences of over-the-counter and prescription medication advice and use during pregnancy.
Design A study design consisting of an online survey and nested in-depth interviews with a subsample of participants. We analysed data from survey free-text responses and in-depth interviews using thematic analysis. Quantitative survey data is published elsewhere.
Setting The UK.
Participants Women were eligible if living in the UK, aged 16–45 years, were pregnant or had been pregnant in the last 5 years regardless of pregnancy outcome. A total of 7090 women completed the survey, and 34 women who collectively had experienced 68 pregnancies were subsequently interviewed.
Results Medication prescribing and use during pregnancy was common. The prescribing, dispensing and taking of some advised medications were restricted through women’s or prescribers’ fear of fetal harm. Lack of adherence to national prescribing guidance, conflicting professional opinion and poor communication resulted in maternal anxiety, avoidable morbidity and women negotiating complex and distressing pathways to obtain recommended medications. In contrast, some women felt overmedicated and that pharmacological treatments were used without exploring other options first.
Conclusion Increased translation of national guidance into practice and greater personalisation of antenatal care are needed to improve the safety, efficacy and personalisation of prescribing in pregnancy.
