High-Risk Medication Prescriptions in Primary Care for Women Without Documented Contraception

Area of Science:

• Reproductive Health
• Pharmacology
• Primary Care Medicine

Background:

• Teratogenic medications pose risks during pregnancy, potentially leading to adverse maternal-fetal outcomes.
• Effective contraception management is crucial for women of childbearing age using such medications.

Purpose of the Study:

• To assess the prevalence of teratogenic medication prescriptions in women of childbearing age.
• To evaluate the concurrent prescription of contraception for these women in primary care.

Main Methods:

• Retrospective chart review of 3,956 nonpregnant women aged 13-45 years at two family medicine practices.
• Analysis of medication use and documented contraception (medication, sterilization, postmenopause).
• Multivariable logistic regression and subgroup analysis excluding ondansetron.

Main Results:

• 25% of women received at least one high-risk medication; 55% lacked contraception.
• Ondansetron and lisinopril were the most common high-risk drugs.
• Women under 25 had significantly lower odds of receiving contraception (aOR 0.47).

Conclusions:

• A significant proportion of women of childbearing age receive teratogenic medications without adequate contraception in primary care.
• Younger women are less likely to receive contraceptive management when prescribed teratogenic drugs.
• Healthcare providers must counsel patients on teratogenic medication risks and assess reproductive plans.