Multiple Information Sources and Consequences of Conflicting Information About Medicine Use During Pregnancy: A Multinational Internet-Based Survey
Multiple Information Sources and Consequences of Conflicting Information About Medicine Use During Pregnancy: A Multinational Internet-Based Survey
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DOI：
10.2196/jmir.2939
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发表时间：
2014-02-01
影响因子：
7.4
通讯作者：
Enlund, Hannes
中科院分区：
文献类型：
--
作者：
Hameen-Anttila, Katri;Nordeng, Hedvig;Enlund, Hannes
背景：孕妇可获得各种各样的药物信息来源。当使用多个信息源时，存在信息将变化甚至冲突的风险。目的：这项多国研究的目的是分析孕妇使用多个信息源的程度和冲突信息的后果，并调查哪些产妇的社会人口学、生活方式和医学因素与这些目标相关。方法：在两个月的时间里，在5个区域（东欧、西欧、北方、美洲、澳大利亚）孕妇使用的1至4个互联网网站上提供了一份匿名的互联网调查问卷。共获得7092份回复（n=5090名孕妇; n=2002名婴儿小于25周的妇女）。结果：16.16%（655/4054）的被调查者表示需要信息，其中16.16%（655/4054）的被调查者表示需要一个信息源，83.69%（3393/4054）的被调查者表示需要多个信息源。在使用多个信息来源的受访者中，22.62%（759/3355）的受访者表示信息存在冲突。根据多变量逻辑回归分析，与经历医学信息冲突显着相关的因素包括母亲身份（OR 1.32，95%CI 1.11-1.58），大学学历（OR 1.33，95% CI 1.09-1.63）或其他教育（OR 1.49，95% CI 1.09-2.03），居住在东欧（OR 1.52，95% CI 1.22-1.89）或澳大利亚（OR 2.28，95% CI 1.42-3.67），使用3（OR 1.29，95% CI 1.04-1.60）或>4个信息来源（OR 1.82，95% CI 1.49-2.23），且患有>= 2种慢性疾病（OR 1.49，95% CI 1.18-1.89）。43.61%（331/759）的孕妇因信息不一致而决定不使用药物，30.30%（230/759）的孕妇寻求新的信息来源，32.67%（248/759）的孕妇选择依赖一个信息来源而忽略另一个信息来源，25.03%（190/759）的孕妇感到焦虑，2.64%（20/759）的患者未采取任何措施。与由于信息冲突而不使用药物显著相关的因素是怀孕（OR 1.75，95% CI 1.28-2.41）或经历3-4种健康疾病（OR 1.99，95% CI 1.10-3.58）。无慢性病的女性比有≥ 2种慢性病的女性更可能不服药（OR 2.22，95%CI 1.47-3.45）。与焦虑显著相关的因素是>4个信息来源（OR 2.67，95% CI 1.70-4.18）且居住在东欧（OR 0.57，95% CI 0.36-0.90）。几乎所有的孕妇在寻求怀孕期间服用药物的信息时都使用了多种信息来源，五分之一的孕妇获得了相互矛盾的信息，导致焦虑和决定不使用药物。区域，教育和慢性疾病特征与经历冲突的信息相关，并影响不使用药物或增加焦虑的决定。应更多地向公众提供准确和统一的畸形学信息。
Background: A wide variety of information sources on medicines is available for pregnant women. When using multiple information sources, there is the risk that information will vary or even conflict.Objective: The objective of this multinational study was to analyze the extent to which pregnant women use multiple information sources and the consequences of conflicting information, and to investigate which maternal sociodemographic, lifestyle, and medical factors were associated with these objectives.Methods: An anonymous Internet-based questionnaire was made accessible during a period of 2 months, on 1 to 4 Internet websites used by pregnant women in 5 regions (Eastern Europe, Western Europe, Northern Europe, Americas, Australia). A total of 7092 responses were obtained (n=5090 pregnant women; n=2002 women with a child younger than 25 weeks). Descriptive statistics and logistic regression analysis were used.Results: Of the respondents who stated that they needed information, 16.16% (655/4054) used one information source and 83.69% (3393/4054) used multiple information sources. Of respondents who used more than one information source, 22.62% (759/3355) stated that the information was conflicted. According to multivariate logistic regression analysis, factors significantly associated with experiencing conflict in medicine information included being a mother (OR 1.32, 95% CI 1.11-1.58), having university (OR 1.33, 95% CI 1.09-1.63) or other education (OR 1.49, 95% CI 1.09-2.03), residing in Eastern Europe (OR 1.52, 95% CI 1.22-1.89) or Australia (OR 2.28, 95% CI 1.42-3.67), use of 3 (OR 1.29, 95% CI 1.04-1.60) or >4 information sources (OR 1.82, 95% CI 1.49-2.23), and having >= 2 chronic diseases (OR 1.49, 95% CI 1.18-1.89). Because of conflicting information, 43.61% (331/759) decided not to use medication during pregnancy, 30.30% (230/759) sought a new information source, 32.67% (248/759) chose to rely on one source and ignore the conflicting one, 25.03% (190/759) became anxious, and 2.64% (20/759) did nothing. Factors significantly associated with not using medication as a consequence of conflicting information were being pregnant (OR 1.75, 95% CI 1.28-2.41) or experiencing 3-4 health disorders (OR 1.99, 95% CI 1.10-3.58). Women with no chronic diseases were more likely not to take medicines than women with >= 2 chronic diseases (OR 2.22, 95% CI 1.47-3.45). Factors significantly associated with becoming anxious were >4 information sources (OR 2.67, 95% CI 1.70-4.18) and residing in Eastern Europe (OR 0.57, 95% CI 0.36-0.90).Conclusions: Almost all the pregnant women used multiple information sources when seeking information on taking medicines during pregnancy and one-fifth obtained conflicting information, leading to anxiety and the decision not to use the medication. Regional, educational, and chronic disease characteristics were associated with experiencing conflicting information and influenced the decision not to use medication or increased anxiety. Accurate and uniform teratology information should be made more available to the public.