Tough Choices: Exploring Medication Decision-Making During Pregnancy and Lactation Among Women With Inflammatory Arthritis.
Tough Choices: Exploring Medication Decision-Making During Pregnancy and Lactation Among Women With Inflammatory Arthritis.
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DOI：
10.1002/acr2.11240
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发表时间：
2021-07
影响因子：
3.4
通讯作者：
Clowse MEB
中科院分区：
文献类型：
--
作者：
Birru Talabi M;Eudy AM;Jayasundara M;Haroun T;Nowell WB;Curtis JR;Crow-Hercher R;White W;Ginsberg S;Clowse MEB
这项研究探讨了女性对药物安全性的信念以及与医疗保健提供者的互动如何影响她们在怀孕和哺乳期间继续使用关节炎药物的决定。我们与患者驱动的研究网络ArthritisPower及其合作伙伴在线社区CreakyJoints合作，在诊断后至少有一次怀孕的炎症性关节炎患者中开展和传播调查。参与者的自由文本响应通过使用主题分析进行评估。样本中的女性平均年龄为40岁（N = 66）。其中19例妊娠以流产告终。15%的孕妇暴露于甲氨蝶呤。在使用安全关节炎药物的女性中，高达80%的人在准备怀孕或怀孕或哺乳期间停止治疗。妇女的决定，继续在怀孕期间的药物治疗的影响，他们的安全和保健提供者的承诺的看法，虽然他们经常描述，关于药物安全的建议是不一致的供应商之间。妇女经常选择忍受活动性炎症性关节炎，而不是使用疾病缓解抗风湿药物，因为担心怀孕和哺乳期间的药物安全性。拒绝医疗保健提供者的医疗建议破坏了患者对提供者和药物安全性的信任。围产期接触甲氨蝶呤（一种胎儿毒性药物）的比例很高，这突出表明有生育能力的妇女需要更好的计划生育护理。
This study explored how women’s beliefs about drug safety and interactions with their health care providers influenced their decisions to continue arthritis medications during pregnancy and lactation. We collaborated with ArthritisPower, a patient‐powered research network, and CreakyJoints, its partner online community, to develop and disseminate a survey among members with inflammatory arthritis who had at least one pregnancy after diagnosis. Participants’ free‐text responses were evaluated by using thematic analysis. Women in the sample were 40 years old on average (N = 66). Nineteen of their pregnancies had ended in fetal loss. Fifteen percent of all pregnancies were exposed to methotrexate. Among women who used safe arthritis medications, up to 80% discontinued treatment either in preparation for pregnancy or during pregnancy or lactation. Women’s decisions to continue medications during pregnancy were influenced by their perceptions of safety and advisement from health care providers, although they often described that advice about medication safety was inconsistent between providers. Women often chose to endure active inflammatory arthritis rather than to use disease‐modifying antirheumatic drugs because of concerns about medication safety during pregnancy and lactation. Conflicting medical advice from health care providers undermined patients’ trust in their providers and in the safety of their medications. The high rate of peripartum exposure to methotrexate, a fetotoxic drug, underscores the need for better family planning care for women with childbearing potential.
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影响因子：
7.4
作者：
Hameen-Anttila, Katri;Nordeng, Hedvig;Enlund, Hannes
通讯作者：
Enlund, Hannes
DOI：
10.1002/art.39521
发表时间：
2016-05
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
Desai RJ;Huybrechts KF;Bateman BT;Hernandez-Diaz S;Mogun H;Gopalakrishnan C;Patorno E;Kim SC
通讯作者：
Kim SC
影响因子：
4.7
作者：
Kavanaugh, Arthur;Cush, John J.;Weisman, Michael H.
通讯作者：
Weisman, Michael H.
影响因子：
5.5
作者：
Chen, Jian Sheng;Ford, Jane B.;March, Lyn M.
通讯作者：
March, Lyn M.
影响因子：
3.9
作者：
Genest, Genevieve;Spitzer, Karen A.;Laskin, Carl A.
通讯作者：
Laskin, Carl A.