Prescribing teratogenic medicines in women of reproductive age
- Principal Investigator: Elizabeth Lovegrove
- 1 March 2023 to 29 February 2024
- Project No: 631
- Funding round: FR5
Background
The number of people living with long-term conditions, such as high blood pressure, high cholesterol, and diabetes, is on the rise. This includes women of reproductive or childbearing age. Increasing numbers of women in this group are prescribed medicines by their GPs to treat these conditions. Some of these medicines, if taken during pregnancy, have the potential to harm an unborn baby. Although this is rare, because of the serious impact, women should be told about this risk so that they can decide whether to continue the medication, use contraception or switch to a different medication. Unfortunately, previous research shows that doctors and nurses don’t always tell women about these risks, even if the medication has a high chance of causing harm to an unborn baby.
Our earlier published work focussed on medications for high blood pressure, called angiontensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs). We estimated that over half of women are not told about the risks of these medications and not told to use effective contraception.
To our knowledge, this research has not been expanded to look at a wider range of other potentially harmful medicines, to understand how big this problem is.
Aims
We plan to find out:
How often are medications for high blood pressure, high cholesterol and diabetes are prescribed to women of childbearing age?
How many of these women have a pregnancy?
How often are this group prescribed effective contraception?
Methods
We will answer these questions by using the Clinical Practice Research Datalink (CPRD) which collects anonymised patient data from UK GP practices. This includes 60 million patient records. We will look the medical records of a sample of women aged 15-49 from this database to answer our questions.
Patient and public involvement
We have worked with public contributors to develop this application, have consulted with pregnancy charities, and sought the views of women of childbearing age. We will continue to involve and engage PPI representatives to refine research design, delivery and dissemination.
Impact
We will use our results to understand how large this problem is in UK primary care and try to find out whether current practice is putting women and their babies at potential risk. We will inform patient groups, GPs and appropriate regulatory bodies about our results, to ensure any improvements needed can be made long term. The knowledge gained will form essential preliminary work towards future research, to help women to make better decisions about their treatments and pregnancy plans and improve care and prescribing in this area.
Amount Awarded: £28,500