European Journal of Clinical Pharmacology

, Volume 74, Issue 4, pp 513–520 | Cite as

The limitations of some European healthcare databases for monitoring the effectiveness of pregnancy prevention programmes as risk minimisation measures

  • R. A. CharltonEmail author
  • V. Bettoli
  • H. J. Bos
  • A. Engeland
  • E. Garne
  • R. Gini
  • A. V. Hansen
  • L. T. W. de Jong-van den berg
  • S. Jordan
  • K. Klungsøyr
  • A. J. Neville
  • A. Pierini
  • A. Puccini
  • M. Sinclair
  • D. Thayer
  • H. Dolk
Pharmacoepidemiology and Prescription



Pregnancy prevention programmes (PPPs) exist for some medicines known to be highly teratogenic. It is increasingly recognised that the impact of these risk minimisation measures requires periodic evaluation. This study aimed to assess the extent to which some of the data needed to monitor the effectiveness of PPPs may be present in European healthcare databases.


An inventory was completed for databases contributing to EUROmediCAT capturing pregnancy and prescription data in Denmark, Norway, the Netherlands, Italy (Tuscany/Emilia Romagna), Wales and the rest of the UK, to determine the extent of data collected that could be used to evaluate the impact of PPPs.


Data availability varied between databases. All databases could be used to identify the frequency and duration of prescriptions to women of childbearing age from primary care, but there were specific issues with availability of data from secondary care and private care. To estimate the frequency of exposed pregnancies, all databases could be linked to pregnancy data, but the accuracy of timing of the start of pregnancy was variable, and data on pregnancies ending in induced abortions were often not available. Data availability on contraception to estimate compliance with contraception requirements was variable and no data were available on pregnancy tests.


Current electronic healthcare databases do not contain all the data necessary to fully monitor the effectiveness of PPP implementation, and thus, special data collection measures need to be instituted.


Pregnancy Teratogen Pregnancy prevention programme Electronic health records Isotretinoin 



The authors wish to thank Professor Corinne de Vries for her valuable contribution to the initial stages of this work. The authors would also like to acknowledge the input from the EUROmediCAT Steering Group members who reviewed this paper.


This study was part of the EUROmediCAT research project ( which has been supported by the European Commission under the 7th Framework Programme Grant agreement n° 260598.

Compliance with ethical standards

Conflicts of interest

RA Charlton, HJ Bos, E Garne, AV Hansen, LTW de Jong-van den berg, S Jordan, K Klungsøyr, A Pierini, M Sinclair, D Thayer and H Dolk had financial support from the European Union for the submitted work under the 7th Framework Programme (Grant agreement HEALTH-F5-2011-260598). AJ Neville was paid as a consultant to the Retinoids Consensus Conference and works for the IMER Registry which is financed by the Emilia Romagna Health Authority. V Bettoli, A Engeland, R Gini and A Puccini have no conflicts of interest to report relevant to the content of this manuscript.

Supplementary material

228_2017_2398_MOESM1_ESM.docx (17 kb)
Table S1 (DOCX 17 kb).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • R. A. Charlton
    • 1
    Email author
  • V. Bettoli
    • 2
  • H. J. Bos
    • 3
  • A. Engeland
    • 4
    • 5
  • E. Garne
    • 6
  • R. Gini
    • 7
  • A. V. Hansen
    • 8
  • L. T. W. de Jong-van den berg
    • 3
  • S. Jordan
    • 9
  • K. Klungsøyr
    • 5
    • 10
  • A. J. Neville
    • 11
  • A. Pierini
    • 12
  • A. Puccini
    • 13
  • M. Sinclair
    • 14
  • D. Thayer
    • 15
  • H. Dolk
    • 14
  1. 1.Department of Pharmacy and PharmacologyUniversity of BathBathUK
  2. 2.Department of Clinical and Experimental Medicine, Section of DermatologyUniversity of FerraraFerraraItaly
  3. 3.Pharmacoepidemiology and Pharmacoeconomics Unit, Department of PharmacyUniversity of GroningenGroningenThe Netherlands
  4. 4.Department of PharmacoepidemiologyThe Norwegian Institute of Public HealthOsloNorway
  5. 5.Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
  6. 6.Paediatric DepartmentHospital LillebaeltKoldingDenmark
  7. 7.Agenzia Regionale di Sanità della ToscanaFlorenceItaly
  8. 8.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
  9. 9.Department of Nursing, College of Human and Health SciencesSwansea UniversitySwanseaUK
  10. 10.Domain for Health Data and DigitalisationThe Norwegian Institute of Public HealthOsloNorway
  11. 11.IMER (Emilia Romagna Registry of Birth Defects), Centre for Clinical and Epidemiological ResearchUniversity of Ferrara and Azienda Ospedaliero-Universitaria di FerraraFerraraItaly
  12. 12.Institute of Clinical Physiology-National Research Council (IFC-CNR)/Fondazione Toscana “Gabriele Monasterio”PisaItaly
  13. 13.Drug Policy ServiceEmilia Romagna Region Health AuthorityBolognaItaly
  14. 14.University of Ulster, Institute of Nursing and Health ResearchNewtownabbeyNorthern Ireland
  15. 15.School of MedicineSwansea UniversitySwanseaUK

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