Knowledge, Information Sources, and Institutional Trust of Patients Regarding Medication Use in Pregnancy:  A Systematic Review

Abirami Kirubarajan; Andrew Lam; Amy Yu; Cameron Taheri; Shawn Khan; Claire Sethuram; Vikita Mehta; Nancy Olivieri

doi:10.18502/jfrh.v15i3.7133

Abirami Kirubarajan Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Andrew Lam Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Amy Yu Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
Cameron Taheri Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Shawn Khan Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Claire Sethuram Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Vikita Mehta Arts and Sciences, McMaster University, Hamilton, Ontario, Canada
Nancy Olivieri Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada

DOI: https://doi.org/10.18502/jfrh.v15i3.7133

Keywords: Health Literacy; Pregnancy; Drug Safety

Abstract

Objective: The objective of our study is to characterize the knowledge, information sources, and institutional trust of patients regarding medication use in pregnancy.

Materials and methods: We conducted a review of three databases: MEDLINE, EMBASE, and CINAHL. We included observational studies and knowledge assessments that examined the knowledge, attitudes, beliefs or information sources of pregnant patients related to medication use during pregnancy. Extraction was completed by two independent reviewers, outcomes were summarized descriptively, and appraisal was conducted.

Results: Of the 1359 search results, 34 studies met inclusion criteria. Thus, our systematic review encompasses the beliefs of 11,757 pregnant participants. In most studies, participants described apprehension regarding potential risks to the fetus and the inadequacy of safety information. Across the 23 knowledge assessments, the majority of studies reported patient misconceptions about prescription medication in pregnancy. The most preferred information source was a healthcare provider. However, many participants expressed frustration, mistrust, and skepticism regarding physician knowledge. A common source of mistrust was due to perceived physician self-interest as well as a lack of education tailored to pregnancy. Consequently, informal sources of information were also popular.

Conclusion: There is a need to improve the health literacy and trust among pregnant patients regarding drug prescribing. There are modifiable risk factors for mistrust that require further attention.