Use of prescription medicines in Australian women of child-bearing age

Abstract

Background: This study aimed to examine current utilisation of prescribed medicines amongst Australian women of child-bearing age, with a particular focus on the extent of use of medicines in Category D and X risk groups, which are moderate and high risk teratogens, respectively. The use of those medicines may pose risk of birth defects in pregnant women. Methods: A retrospective cross-sectional study was undertaken involving all women of child-bearing age (15 to 44years) who were dispensed medicines in 2013 using the 10% random sample of dispensing data from the Australian Government Department of Human Services. Dispensing patterns were reported by medicine, therapeutic class, pregnancy risk category and women's age. Results: Over one-third of women aged 15 to 44years received at least one prescribed medicine in 2013. Psychoanaleptics, antibiotics and analgesics were the top three classes. Around 9% of all dispensings were for medicines from risk category D, with statins, agents acting on renin-angiotensin system, and some anti-epileptic agents being the most commonly used. Both statins and agents acting on renin-angiotensin system showed increasing use with age, estimated to be 35,600 women nationally for each group. Collectively between 2% and 4% of women used anti-epileptics from risk category D in each year of age, with overall use estimated to be 51,000 women nationally. Below 1% of all dispensings were for category X medicines, mainly isotretinoin. Conclusions: It is important for medical practitioners to offer counselling around pregnancy planning and the risk of birth defects when prescribing moderate or high risk teratogens to women in child-bearing age. For the antihypertensives and some anti-epileptics, alternative medicines with lower risk categorization are available.