Lack of time, resources to blame for primary care doctors rarely counseling women on birth-defect-causing drugs
Primary care physicians (PCPs) claim they have neither the time nor the resources to provide women with information on whether the drugs they prescribe can cause miscarriages or birth defects, a new study finds. Eleanor Bimla Schwarz, M.D., M.S., and her colleagues at the University of Pittsburgh conducted 8 focus groups of 48 PCPs. They found that, although these doctors feel responsible for counseling women on the effect so-called teratogenic drugs may have on an unborn child, they encounter several barriers in routinely providing this information. These include short appointment times, lack of reimbursement for counseling, limited resources for finding up-to-date information on teratogenic drugs, difficulty in determining women's reproductive plans, and concerns that discussing a drug's side effects may result in a woman refusing to take it.
The PCPs proposed technological solutions, including online resources that provide plain-language information on the risks of taking teratogenic drugs and reminders to ask a woman about her pregnancy plans in electronic medical records or when computerized order entry is used to issue prescriptions. The doctors also suggested development of patient education materials to assist them in informing their patients of drug risks but said they would still have difficulty finding time to go over the information with their patients.
The authors hope that pinpointing these barriers and gathering suggestions from PCPs will assist in ensuring women receive timely information on the risks of birth defects caused by medicines. They also note a toll-free information service from the Organization of Teratology Information Specialists that may assist PCPs in finding the information they seek on these drugs. This study was funded in part by the Agency for Healthcare Research and Quality (HS17093).
See "Perspectives of primary care clinicians on teratogenic risk counseling," by Dr. Schwarz, Aimee Santucci, Ph.D., Sonya Borrero, M.D., and others in the October 2009 Birth Defects Research (Part A) Clinical and Molecular Teratology 85(10), pp. 858-863.
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