Patterns and factors associated with low adherence to psychotropic medications during pregnancy; a cross-sectional, multinational web-based study
Lupattelli, A; Spigset, O; Björnsdottir, I; Hämeen-Anttila, K; Mårdby, A-C; Panchaud, A; Gjergja Juraski, R; Rudolf, G; Odalovic, M; Drozd, M; Twigg, MJ; Juch, H; Moretti, ME; Kennedy, D; Rieutord, A; Zagorodnikova, K; Passier, A; Nordeng, H (2015)
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Lupattelli, A
Spigset, O
Björnsdottir, I
Hämeen-Anttila, K
Mårdby, A-C
Panchaud, A
Gjergja Juraski, R
Rudolf, G
Odalovic, M
Drozd, M
Twigg, MJ
Juch, H
Moretti, ME
Kennedy, D
Rieutord, A
Zagorodnikova, K
Passier, A
Nordeng, H
2015
Depression and Anxiety
Tiivistelmä
Background: No previous studies have explored how closely women follow their
psychotropic drug regimens during pregnancy. This study aimed to explore patterns
of and factors associated with low adherence to psychotropic medication
during pregnancy. Methods: Multinational web-based study was performed in
18 countries in Europe, North America, and Australia. Uniform data collection
was ensured via an electronic questionnaire. Pregnant women were eligible to
participate. Adherence was measured via the 8-item Morisky Medication Adherence
Scale (MMAS-8). The Beliefs about Prescribed Medicines Questionnaire
(BMQ-specific), the Edinburgh Postnatal Depression Scale (EPDS), and a numeric
rating scale were utilized to measure women’s beliefs, depressive symptoms,
and antidepressant risk perception, respectively. Participants reporting use of psychotropic
medication during pregnancy (n = 160) were included in the analysis.
Results: On the basis of the MMAS-8, 78 of 160 women (48.8%, 95% CI:
41.1–56.4%) demonstrated low adherence during pregnancy. The rates of low
adherence were 51.3% for medication for anxiety, 47.2% for depression, and
42.9% for other psychiatric disorders. Smoking during pregnancy, elevated antidepressant
risk perception (risk 6), and depressive symptoms were associated
with a significant 3.9-, 2.3-, and 2.5-fold increased likelihood of low medication
adherence, respectively. Women on psychotropic polytherapy were less likely
to demonstrate low adherence. The belief that the benefit of pharmacotherapy
outweighed the risks positively correlated (r = .282) with higher medication
adherence. Conclusions: Approximately one of two pregnant women using psychotropic
medication demonstrated low adherence in pregnancy. Life-style factors,
risk perception, depressive symptoms, and individual beliefs are important
factors related to adherence to psychotropic medication in pregnancy.
psychotropic drug regimens during pregnancy. This study aimed to explore patterns
of and factors associated with low adherence to psychotropic medication
during pregnancy. Methods: Multinational web-based study was performed in
18 countries in Europe, North America, and Australia. Uniform data collection
was ensured via an electronic questionnaire. Pregnant women were eligible to
participate. Adherence was measured via the 8-item Morisky Medication Adherence
Scale (MMAS-8). The Beliefs about Prescribed Medicines Questionnaire
(BMQ-specific), the Edinburgh Postnatal Depression Scale (EPDS), and a numeric
rating scale were utilized to measure women’s beliefs, depressive symptoms,
and antidepressant risk perception, respectively. Participants reporting use of psychotropic
medication during pregnancy (n = 160) were included in the analysis.
Results: On the basis of the MMAS-8, 78 of 160 women (48.8%, 95% CI:
41.1–56.4%) demonstrated low adherence during pregnancy. The rates of low
adherence were 51.3% for medication for anxiety, 47.2% for depression, and
42.9% for other psychiatric disorders. Smoking during pregnancy, elevated antidepressant
risk perception (risk 6), and depressive symptoms were associated
with a significant 3.9-, 2.3-, and 2.5-fold increased likelihood of low medication
adherence, respectively. Women on psychotropic polytherapy were less likely
to demonstrate low adherence. The belief that the benefit of pharmacotherapy
outweighed the risks positively correlated (r = .282) with higher medication
adherence. Conclusions: Approximately one of two pregnant women using psychotropic
medication demonstrated low adherence in pregnancy. Life-style factors,
risk perception, depressive symptoms, and individual beliefs are important
factors related to adherence to psychotropic medication in pregnancy.
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