Improving drug safety for pregnant women by delivering current and authoritative information via mobile devices

Project SummaryAbstract! An!estimated!!infants!delivered!annually!in!the!United!States!are!born!with!birth!defects!caused!by!the!use!of! medication!during!pregnancy !!Since!the!peak!prevalence!of!some!diseases !such!as!hypertension !autoimmune!disease ! and!depression !occurs!during!the!childbearing!years !it!is!not!surprising!that!medication!use!during!pregnancy!is! common !with!nine!out!of!ten!pregnant!women!in!the!United!States!taking!at!least!one!medication!to!treat!a!medical! condition !!Although!recent!advances!in!technology!have!increased!access!to!health!care!information !evidence based! information!related!to!the!use!of!medications!during!pregnancy!can!be!difficult!to!find !!Even!so !much!of!the! information!that!is!available!is!inadequate!when!it!comes!to!prescribing!for!the!individual!patient !or!it!is!not!easily! understood!or!evaluated!by!healthcare!providers! HCPs !who!lack!specialized!training!in!teratology !!As!the!Center!for! Disease!Control!and!Prevention!notes !a!few!databases!exist!that!provide!expert!review!and!interpretation!of!the!available! scientific!data!regarding!the!adverse!effects!of!medications!on!the!fetus !but!these!resources!are!generally!available!by! subscription!only!and!thus!not!widely!available!to!HCPs!or!their!patients !!As!a!result !these!databases!are!underutilized!!This!dilemma!ultimately!impacts!two!vulnerable!patient!populations! !pregnant!women!and!their! unborn!children ! ! To!address!this!dilemma !RightAnswer! httpwww rightanswer com !and!the!TERIS!team!at!the!University!of! Washington!have!collaborated!to!develop!a!specialized!mobile!application!that!presents!the!relevant!medication! information!in!a!format!that!is!both!easily!readable!and!searchable!in!novel!ways!relevant!to!the!end!users!knowledge! level !!In!Phase!I!of!this!project !!HCPs!that!care!for!pregnant!women!were!surveyed!to!better!understand!their! current!practices!and!information!needs !!Based!on!these!findings !a!prototype!mobile!app!was!designed!that! consolidated!drug!information!across!multiple!sources!to!create!a!single!repository!that!included!patient!handouts!and! information!about!breastfeeding !dosage !and!alternative!medications !!An!interface!was!created!to!allow!users!to! navigate!between!concise!and!detailed!summaries!of!the!research!findings !!The!prototype!was!evaluated!by!!HCPs! who!found!the!information!presented!to!be!valuable!and!the!app!easy!to!use !! ! Using!what!was!learned!in!Phase!I !the!Phase!II!plan!will!focus!on!two!goals !!!continuing!to!improve!the!organization! and!presentation!of!data!to!support!diverse!querying!of!medical!options!and!!testing!mobile!app!models!on!a!large! scale!and!expanding!the!user!base!through!commercial!development !!The!data!collected!in!Phase!I!will!provide! additional!insights!for!Phase!II!development!regarding!critical!data!for!different!clinical!settings!so!that!alternative!forms! of!delivery!can!be!explored !including!import!into!existing!pharmacy!or!electronic!medical!record!systems!or!pre loading! data!on!mobile!devices!for!environments!where!network!access!may!be!unavailable !