title: Perceptions and Attitudes Towards Medication Adherence during Pregnancy in Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Women with inflammatory bowel disease [IBD] report concerns about medication safety during pregnancy. Adherence to IBD medications may be lower in pregnant patients as a result. The aim of this study was to assess medication adherence during pregnancy in women with inflammatory bowel disease.
  
  
  METHODS
  Female patients of childbearing age completed a self-administered, structured survey. We collected demographic data, medication history, and self-reported adherence to IBD medications during pregnancy. We also assessed knowledge and perceptions of IBD medication safety in pregnancy. A time trade-off [TTO] analysis was done to assess health utilities for continuing or discontinuing IBD medications during pregnancy.
  
  
  RESULTS
  A total of 204 women completed the survey [mean age was 32.8 years]. Current or previous pregnancy was reported by 101 patients [median parity 2, median gravity 1]. While pregnant or attempting to conceive, 47 [46.5%] participants reported stopping a prescribed IBD medication. Of those, 20 participants reported stopping medications without the advice of a physician. TTO analysis was completed by 31 patients. When presented with the option of continuing a potentially teratogenic medication, switching to less effective medication that is non-teratogenic, or stopping medication all together, participants consistently preferred to not remain on the most effective IBD therapy.
  
  
  CONCLUSIONS
  Women with IBD report preference to not remain on IBD medications during pregnancy. This is driven by concerns about safety and uncertainty about teratogenic effects. Women with IBD may benefit from increased education about medication safety in pregnancy.
authors.affiliation: Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, ON, Canada.
authors.forename: Zane R
authors.initials: ZR
authors.lastname: Gallinger
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Amir
authors.initials: A
authors.lastname: Rumman
authors.affiliation: Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, ON, Canada geoff.nguyen@utoronto.ca.
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nguyen
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010465:Perception; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000523:psychology; D057566:Self Report; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000893:Anti-Inflammatory Agents
keywords: Adherence; inflammatory bowel disease; medication; pregnancy