Provision of Potentially Teratogenic Medications to Female Veterans of Childbearing Age

Bibliographic Data

ID9103869
AuthorsEleanor Bimla Schwarz (0000-0002-9912-8236, University of Pittsburgh, corresponding author), Lisa S Longo (Veterans Health Administration), Xinhua Zhao (0000-0003-0772-8240, VA Pittsburgh Healthcare System), Roslyn A Stone (VA Pittsburgh Healthcare System), Francesca Cunningham (0000-0001-7924-8372, Medication Management (United States)), Chester B Good (0000-0003-4388-4558, University of Pittsburgh)
Year2010
Volume48
Issue9
Pages834-842
Publication date2010-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181e57946
PMID20706159
OpenAlexW2031661258
LanguageEN
Citations received3
References cited12

BACKGROUND: Certain medications increase the risk of birth defects whether used during pregnancy or immediately preconception. OBJECTIVES: To describe dispensing of potentially teratogenic medications (Food and Drug Administration classes D or X) to female Veterans treated by the Veterans Affairs (VA) Healthcare System, and assess whether documented provision of family planning services is more common when potentially teratogenic medications are prescribed. RESEARCH DESIGN: We examined all 2,634,441 prescriptions filled in fiscal year 2007 or 2008 by 78,232 female Veterans, aged 18 to 45, who made >or=2 visits to VA clinics within the year prior to medication dispensing from VA pharmacies. MEASURES: : Medications dispensed, contraceptive counseling, and pregnancy testing. RESULTS: Prescriptions for potentially teratogenic medications were filled by 48.8% of female Veterans who received medications from a VA pharmacy. Women who filled prescriptions for potentially teratogenic medications were only slightly more likely to have documented family planning services (eg, contraception, contraceptive counseling, or pregnancy testing) than women who filled class C, but not class D or X, prescriptions (55.7% vs. 51.8%). Women filling only class A or B prescriptions were least likely to have documented family planning services (35.9%). Among women dispensed potentially teratogenic medications, family planning services were significantly more likely to be documented for women who were >or=25 years (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.57-3.11), unmarried (OR, 1.30; 95% CI, 1.23-1.35), non-White (OR, 1.17; 95% CI, 1.09-1.26), seen at a women's clinic (OR, 1.96; 95% CI, 1.88-2.05), received a retinoid medication (OR, 7.72; 95% CI, 3.02-19.7), or had serious mental illness (OR, 1.26; 95% CI, 1.18-1.34). CONCLUSIONS: Medications that may cause birth defects if used during pregnancy are dispensed frequently to female Veterans by VA pharmacies without documented receipt of contraceptive counseling or pregnancy testing

Confidence interval · Drug · Drug class · Environmental health · Family medicine · Family planning · Medical prescription · Odds ratio · Population · Pregnancy · Psychiatry · Veterans Affairs · Internal Medicine · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Nursing · Pharmacological Effects and Toxicity Studies · Pharmacy · Pregnancy and Medication Impact