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THU0639 Rheumatological medication use in pregnancy, planning pregnancy, and breastfeeding at mothersafe during the years 2010 to 2015
  1. S-N Luong1,
  2. D Kennedy2,
  3. JV Bertouch1
  1. 1Rheumatology, Prince of Wales Hospital
  2. 2Clinical Genetics, Royal Hospital for Women, Randwick, Australia

Abstract

Background MotherSafe is a free, statewide, phone based counselling service for the general public and healthcare professionals concerned about exposures during pregnancy, pregnancy planning and breastfeeding (1). Obstetric drug information services such as MotherSafe are important in guiding decision-making in pregnancy, breastfeeding and planning of future pregnancies, and are increasingly used worldwide by both patients and healthcare providers (1, 2). At MotherSafe, phone advice is provided by trained telephone counsellors who are generally pharmacists. Data from each phone call is entered onto an electronic document. Some patients are then referred onto the MotherSafe clinic for specialised counselling by a clinical geneticist.

Objectives To analyse data including patient and medication characteristics and trends from phone calls made to MotherSafe regarding disease modifying antirheumatic drugs (DMARDs) and biologic DMARDs (bDMARDs) from January 2010 to December 2015 inclusive.

Methods Retrospective study of phone calls made to MotherSafe from January 2010 to December 2015 regarding conventional DMARDs and biologic DMARDs. SPSS software facilitated statistical analysis.

Results A total of 135,115 phone calls were made to MotherSafe from 2010–2015 with 2611 (1.93%) phone calls pertaining to DMARDs and bDMARDs.

Of these 2611 phone calls, 65.4% were made by patients and 13.5% by general practitioners. Most phone calls were made in metropolitan New South Wales (69.3%). 43% of phone calls were concerning exposures during breastfeeding, followed by exposures during pregnancy (32.9%), exposures whilst planning pregnancy (17.7%) and paternal exposures (2.9%). Where a specific diagnosis was given, inflammatory bowel disease was the most common indication (18.4%), followed by rheumatoid arthritis (8.2%). Corticosteroids were the most common medication exposure (37.3%), followed by azathioprine (18.8%), sulfasalazine (11.2%) and methotrexate (8.5%).

Most callers just received phone advice, especially if the call was just regarding breastfeeding exposures (73.4%). 383 callers (14.7%) were referred onto the MotherSafe clinic, which is run by a clinical geneticist.

bDMARDs made up 9.5% of calls with calls tending to increase over the years, but there was a slight decrease in 2012 and 2013 albeit with small numbers. TNF inhibitors still made up the majority of calls regarding bDMARDs.

Conclusions This study evaluated the only obstetric medicine exposure information service in New South Wales, Australia. It is the first time that DMARDs and bDMARDs have been analysed for MotherSafe. There was a trend to increasing number of calls regarding bDMARDs over 2010 to 2015, which presumably reflects change in prescribing patterns. This study highlights the need for services like MotherSafe so patients and health care professionals can receive evidence based information and make choices about treatment in pregnancy.

References

  1. Kennedy D, Eamus M, Hill M, Oei JL. Review of calls to an australian teratogen information service regarding psychotropic medications over a 12 year period. Aust N Z J Obstet Gynaecol. 2013;53(6):544–52. doi: 10.1111/ajo.12129.

  2. De Santis M et al. Prenatal drug exposure and teratological risk one year experience of an italian teratology information service. Med Sci Monit 20–8;14:PH1–8.

References

Acknowledgements MotherSafe staff.

Disclosure of Interest None declared

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