title: Physicians' Perception of Teratogenic Risk and Confidence in Prescribing Drugs in Pregnancy-Influence of Norwegian Drug Information Centers.
abstract: OBJECTIVE
  Clinical decision support provided by drug information centers is an intervention that can ensure rational drug therapy for pregnant women. We have examined whether physicians' teratogenic risk perceptions and confidence in prescribing drugs to pregnant women is altered after advice from the Norwegian drug information centers, Regional Medicines and Pharmacovigilance Centres i Norway (RELIS).
  
  
  METHODS
  Physicians who consulted RELIS for advice on patient-specific drug use in pregnancy from November 2013 to April 2014 completed questionnaires before and after receiving the advice. A scale from 1 to 7 was used to rate confidence in prescribing and perception of teratogenic risk. The lower part of the scale represented a low perception of teratogenic risk and a high confidence in prescribing a drug in pregnancy. The data were analyzed using a mixed linear model.
  
  
  RESULTS
  A total of 45 physicians participated in the study and they assessed 64 drugs or categories of drugs. Advice from RELIS increased confidence in prescribing, with a statistically significant mean change on the scale from 4.1 to 2.9. The assessment of teratogenic risk was reduced after advice from RELIS, with a mean change from 3.2 to 2.5, though this was not significant. A subgroup of 26 physicians completed questionnaires both before and after advice from RELIS and assessed a total of 32 drugs or categories of drugs. In 94% of these assessments, advice from RELIS altered the physician's confidence in prescribing. Perception of teratogenic risk was altered in 78% of the assessments.
  
  
  CONCLUSIONS
  Our results show that physicians' perception of teratogenic risk and confidence in prescribing drugs to pregnant women is influenced by advice from Norwegian drug information centers.
authors.affiliation: Regional Medicines and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway. Electronic address: tina.bakkebo@helse-bergen.no.
authors.forename: Tina
authors.initials: T
authors.lastname: Bakkebø
authors.affiliation: Regional Medicines and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Sofia Frost
authors.initials: SF
authors.lastname: Widnes
authors.affiliation: Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Synnøve Stubmo
authors.initials: SS
authors.lastname: Aamlid
authors.affiliation: Regional Medicines and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Schjøtt
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D010465:Perception; D060735:Pharmacovigilance; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D012306:Risk; D011795:Surveys and Questionnaires; D013723:Teratogens
chemical_list: D013723:Teratogens
keywords: attitude of health personnel; drug information services; pregnancy; prescription drugs; risk perception; teratogenic drugs