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Identification of At-risk Pregnant Population for Over-the-Counter Drug Usage in Low-Resource Settings

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Abstract

Objective

Nearly 1.5 billion people of an Asian country are living their lives without a country-specific over-the-counter (OTC) drug list. A study was planned to assess the understanding and practice of OTC medication consumption in the pregnant population.

Methods

A questionnaire-based cross-sectional study evaluating different perspectives on OTC drug consumption was planned in around 500 pregnant women attending tertiary care outpatient antenatal clinics. The association of knowledge, attitude and practice versus indications, knowledge regarding harmful effects possible, reasons for choosing OTC medication, the practice of consulting nonmedical persons and drug interactions with the disease or prescription medications was determined. Regression analysis was performed in statistical software R.

Results

Seven percent (36/516) of pregnant women were found to consume oral antimicrobials without prescription. Local chemist consultation was the most common channel (72.48%) to procure the OTC medicines. Participants with good knowledge score showed an odds ratio (OR) of 1.87 (95% C.I.; 1.28–2.73), 1.6 (95% C.I.; 0.99–2.63), 1.66 (95% C.I.; 1.14–2.42) and 2.66 (95% C.I.; 1.49–4.89) for self-medication encouragement tendency possible, restricting sale of OTC medications, the habit of reading drug leaflets and understanding the potentially harmful effects, with OTC drugs, respectively. Right-attitude participants showed an OR of 1.89 (95% C.I.; 1.29–2.80) and 1.8 (95% C.I.; 1.19–2.76) for identifying knowledge of acetaminophen overdose and liver damage link as well as the disease symptom masking possibility with OTC, respectively. Participants with insufficient knowledge and attitude scores showed an association with more OTC antacid-antiemetics and analgesic use, respectively.

Conclusion

Antenatal pregnant women need to be guided on avoiding OTC antimicrobial usage. Both obstetricians and regulators have to play an active role in educating pregnant women and contributing to developing country-specific OTC drug lists with the guidelines.

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Acknowledgements

Authors would like to thank all study participant antenatal clinic visitors for the participation in the study and thank all study participant pregnant women, Mr. Himanshu Chaudhary and Mr Sunil Sharma for data collection and compilation.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Author notes

  1. Aashima Arora and M Praveen Kumar have contributed equally

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Aashima Arora & Pradip Kumar Saha

  2. Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    M. Praveen Kumar, Aishwarya Anand, Lekha Saha, Ankit Kumar & Amol N. Patil

  3. Municipal Corporation of Greater Mumbai, Sant Muktabai Principal General Hospital, Ghatkopar, Mumbai, 400084, India

    Haresh Shendge

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  1. Aashima Arora
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Correspondence to Amol N. Patil.

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Conflict of interest

The authors declare no conflict of interest.

Human or Animal Rights

Yes. The study received approval from the Institutional Ethics Committee with permission No. INT/IEC/2019/001760 dated August 28, 2019.

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Written informed consent was obtained from the study participants.

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Aashima Arora is an Associate Professor in Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. A. N. Patil. and A. Arora.: Contributed to conception, data check, execution of the entire study; A.Arora and Praveen Kumar-M: data analysis along with data extraction; A. Anand, L. Saha, P. K. Saha A. Kumar and H Shendge: Important intellectual content, literature review, and final approval; Praveen Kumar M and A. N. Patil: Manuscript writing and finalized important intellectual content. All authors critically revised the content.

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Arora, A., Praveen Kumar, M., Anand, A. et al. Identification of At-risk Pregnant Population for Over-the-Counter Drug Usage in Low-Resource Settings. J Obstet Gynecol India 71, 600–608 (2021). https://doi.org/10.1007/s13224-021-01481-2

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  • DOI: https://doi.org/10.1007/s13224-021-01481-2

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