Objective: To evaluate the association between antipsychotic use in pregnancy and the risk of congenital malformations in children.Data sources: Searches of PubMed, EMBASE, PsycINFO and Cochrane Library were conducted from inception to 06 January 2020 using keywords: antipsychotics, pregnancy, pregnancy complication and congenital abnormalities.Study selection: Of 38 reports initially identified as being of potential interest, 13 studies met our inclusion criteria: English observational studies that examined the association between gestational antipsychotic use and congenital malformations in children.Data extraction: Data were extracted independently by 2 investigators including the publication year, study site, study period, data source, study design, sample size, medication exposure, exposure period and pregnancy definition, exposure as well as outcome ascertainment, selection of study and comparison group, confounding adjustment, statistical analysis, and method of linkage between mother and children. Risk estimates were pooled using a random‐effect model and the I2 statistic was used to evaluate the degree of heterogeneity.Results: Thirteen studies met our systematic review inclusion criteria. Six studies with a total of 2 515 272 pregnancy episodes were included in our meta‐analysis, which provided a pooled adjusted risk ratio of 1.23, 95% confidence interval: 0.96–1.58. The I2 result showed moderate heterogeneity between studies (I2 = 35.2%, P = .173).Conclusion: We did not find strong evidence of an association between prenatal exposure to antipsychotic medications and the risk of congenital malformations in children. We recommend further studies investigate this association, focusing on specific medication classes and dose responses, which would help clinicians decide whether to prescribe certain antipsychotics during pregnancy.
13 November 2019 in Journal of Autism and Developmental Disorders
Autism spectrum disorder (ASD) is a lifelong disorder. In the UK, risperidone is the only psychotropic medication approved for the management of the behavioural symptoms that may accompany autism. This is a population-based study aimed to provide an evaluation of the changing trend in the incidence and prevalence of ASD and to analyse the pattern of psychotropic medication prescribing in the UK. 20,194 patients with ASD were identified. The prevalence increased 3.3-fold from 0.109 per 100 persons in 2009 to 0.355 per 100 persons in 2016. Approximately one-third of the identified cohort was prescribed at least one psychotropic medication. Although the medications approved to manage the symptoms of ASD are limited, the prescribing of such medications is increasing.
Background: Privacy in healthcare is a fundamental right essential to maintain patient confidentiality and trust. Community pharmacies in Saudi Arabia (SA) play a critical role in the healthcare system by providing accessible services and serving as initial points of contact for medical advice. However, the open nature of these settings poses significant challenges in maintaining patient privacy. Methods: This cross-sectional study used electronic surveys distributed across various online platforms. The target sample included Saudi adults, with a sample size of 385 participants to achieve 80% statistical power at a 95% confidence interval. The survey comprised demographic questions and sections evaluating perceptions of privacy, the importance of privacy, and personal experiences regarding privacy in community pharmacies. Descriptive statistics and logistic regression models were used for the analysis. Results: A total of 511 responses were obtained. The mean age was 33.5 years, with an almost equal distribution of males (49.71%) and females (50.29%). Most participants held a bachelor’s degree or higher (78.67%). Privacy perceptions varied, with only 9.0% strongly agreeing that there was a private space for consultations, while 64.0% felt that the design of community pharmacies did not adequately consider patient privacy, and 86.9% reported that conversations could be overheard. Privacy concerns were notable, with almost one-half of the participants (47.6%) having concerns about privacy and 56.6% doubting the confidentiality of their health information. Moreover, 17.6% reported being asked for unnecessary personal information when buying medication, and 56.2% admitted to avoiding discussing a health problem with the pharmacist due to privacy concerns. Experiences of privacy breaches were reported by 15.7% of respondents. Logistic regression analysis revealed that the availability of private space in the pharmacy and patients feeling that the pharmacy respects their privacy were associated with a lower likelihood of avoiding discussions with pharmacists due to privacy concerns (OR = 0.758, CI = 0.599–0.0957 and OR = 0.715, CI = 0.542–0.945 respectively) Conversely, greater privacy concerns and previous privacy breaches significantly increased the likelihood of avoiding discussions with pharmacists in the community pharmacy (OR = 1.657, CI = 1.317–2.102 and OR = 4.127, CI = 1.886–9.821 respectively). Conclusions: This study highlights the significant concerns regarding privacy practices in community pharmacies in SA. Thus, there is a need for standards to improve privacy in community pharmacies, such as mandating the need for private consultation areas and enhanced staff training on handling privacy-related issues. Addressing the issue of privacy is crucial for maintaining patient trust, improving healthcare service quality, and ensuring effective patient–pharmacist interactions.
9 November 2021 in Journal of Autism and Developmental Disorders
There are many case reports of seizures apparently associated with the prescription of antipsychotics. This study aimed to examine whether there is an association between the prescription of antipsychotics and incident seizures in individuals with autism spectrum disorder using retrospective data based on patients’ chart review. A cohort study was conducted to compare the rate of incident seizure between 3923 users of antipsychotics with 10,086 users of other psychotropics. This was followed by a self-controlled case series (SCCS) analysis of 149 patients to eliminate the effect of time-invariant confounders. The results showed no evidence of increased risk of seizure after exposure to antipsychotic agents (Hazard Ratio 1.28, 95% CI 0.74–2.19) compared to other psychotropics.
Cultural competence is a crucial outcome of pharmacy programs because it may affect the medical care that patients receive. This study evaluates the level