Unintended pregnancies and serious birth defects might be prevented if women who take a powerful acne drug receive contraception literature while at the dermatologist.
Isotretinoin, formerly marketed as Accutane, is an effective drug for the treatment of acne, but is considered a teratogen—a drug that can cause birth defects.
Because of this, the Food and Drug Administration (FDA) strictly regulates the distribution of the drug to women of childbearing age.
Through the FDA’s iPLEDGE program, woman who are prescribed the drug must pledge to use two forms of contraception, in addition to taking regular pregnancy tests while on the drug and online tests to make sure they understand the dangers of getting pregnant while taking the drug.
How handouts help
Despite the regulations, 122 pregnancies affected by isotretinoin were reported in the United States during the first year of the iPLEDGE program. Gaps in patients’ knowledge about the most effective forms of contraception may be a reason.
“While contraceptive counseling isn’t something a dermatologist has to do on a daily basis—like an obstetrician or gynecologist would—it does matter for young women using these drugs,” says lead author Carly A. Werner, a resident in the obstetrics, gynecology and seproductive sciences department at University of Pittsburgh Medical Center.
“Our goal was to show that a simple intervention like our handout could be added to dermatology office visits to enhance contraceptive counseling and decrease the number of exposed fetuses through more effective means of contraception.”
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For the study, published in the journal JAMA Dermatology, researchers surveyed 100 women from a single dermatology clinic between April and May 2014. Prior to viewing the contraceptive fact sheet, 75 percent overestimated the effectiveness of condoms, while 51 percent did the same for oral contraceptives.
Thirty-four percent of women said they had never heard of contraceptive implants, and 16 percent had never heard of IUDs, or intrauterine contraceptive devices, despite their effectiveness being much higher than that of condoms and oral options.
Researchers surveyed those women again after they had reviewed the fact sheet and found significant improvement in knowing about contraceptives.
“This shows us that dermatologists can make a difference by providing women who take this drug more education regarding effective forms of contraception,” says Laura Ferris, director of clinical trials for the dermatology department, who was a coauthor of the study.
Future study is needed to determine how much the information provided on the fact sheet was retained and if it does reduce the risk of medication-induced birth defects.
The study was funded in part by a grant from the FDA.
Source: University of Pittsburgh
