A Survey of Drug Information References Emergency Medicine Clinicians Utilize for Prescribing in Pregnant Patients

Abstract

Background: Clinicians practicing in Emergency Departments (EDs) using outdated pocket guides and other non–pregnancy-specific references when prescribing in pregnancy may place the pregnancy or fetus at risk. Objective: To identify the references that emergency medicine (EM) clinicians use for prescribing in pregnant patients, the prescribing trends when clinicians are given the pregnancy category information, and clinician awareness of access to drug information references. Methods: This cross-sectional survey was administered to EM clinicians. In part I, clinicians listed the top 3 drug information references that they routinely use in clinical practice. In part II, clinicians ranked their willingness to prescribe a Category A, B, C, D, or X drug using a 5-point Likert scale. In part III, clinicians selected from a list of electronic and print resources those that they consider available to them in the ED to find pregnancy-related drug prescribing information. Statistical analyses included frequency distribution and bivariate analysis. Results: Fifty-five clinicians with an average of 5.71 ± 7.95 years (± SD) in the profession completed the survey. The most commonly used references included Micromedex, Tarascon Pocket Pharmacopoeia, and Epocrates (29%, 18%, and 14%, respectively). Ten (18%) respondents stated that they would be willing to prescribe Category C drugs. Among the 5 pregnancy-specific drug information references that are available in our ED, only 20% of EM clinicians stated that these references were available to them. Conclusions: EM clinicians rely on general references to make prescribing decisions for pregnant patients and are willing to prescribe medications that have data to support safe use in pregnancy. A minority of EM clinicians acknowledged the availability of pregnancy-specific references in the ED. Increased awareness of references that incorporate human data into their pharmacotherapy recommendations is warranted to assist EM clinicians in achieving their goal of prescribing safely in the pregnant patient.