臺灣博碩士論文加值系統

Background : Medication use among pregnant women is common. Globally, approximately half of pregnancies each year exposed to medication in their early weeks of gestation. Without proper monitoring, medication use during pregnancy, especially over the counter (OTC), may harm both the mother and the fetus. Lack of information regarding the risks and benefits of medication use during pregnancy, is a concern not only for the pregnant women but also for the healthcare professionals. This study was aimed to investigate the prevalence of medication use (OTC and prescribed medication) during pregnancy and its associated factors among pregnant women attending healthcare services in Malang, Indonesia.
Materials and methods: A cross-sectional study was conducted from July to September 2018 in five different healthcare services among pregnant women attending their routine antenatal care visit in Malang, Indonesia. Convenience sampling method was used to select the study participants. Data collection process was did using a self-administered questionnaire in the waiting room at each of the healthcare service and collected on site immediately after the questionnaires were completed. The association between medication use (OTC and prescribed medication) and selected factors among pregnant women were analyzed using logistic regression models.
Results: A total of 333 women, 39 women (11.7%) used OTC medication and 293 women (88%) took prescribed medication during pregnancy. Women with higher knowledge about OTC medication (overall knowledge) were more likely to practice OTC medication compared with those who had lower knowledge [aOR = 2.15, 95% CI = 1.03-4.46]. Meanwhile, pregnant women who had correct knowledge about possible risk from taking OTC during pregnancy were less likely to use OTC medication [aOR = 0.29, 95% CI = 0.14-0.60] compared with those without correct knowledge. The effect of higher knowledge regarding OTC medication on use of OTC medication was significant among women who had middle and lower education group [aOR = 8.18, 95% CI = 1.70 - 39.35]. The effect of knowledge on the possible risks of taking OTC medication during pregnancy was significant only among women who had attended high school and higher education (aOR = 0.17, 95% CI = 0.07-0.42). Age and number of ANC visit were two factors associated with the use of prescribed medication during pregnancy.
Conclusion: There is a need to improve the education of mother by healthcare professionals on the potential harmful effect of medicine for the unborn baby and give the right direction to the mother regarding the use of medicine during pregnancy. Providing evidence-based information about the medication used to the pregnant women since their early gestation during antenatal care visit (ANC) is an important strategy to protect them from any potential dangerous effect.

Background : Medication use among pregnant women is common. Globally, approximately half of pregnancies each year exposed to medication in their early weeks of gestation. Without proper monitoring, medication use during pregnancy, especially over the counter (OTC), may harm both the mother and the fetus. Lack of information regarding the risks and benefits of medication use during pregnancy, is a concern not only for the pregnant women but also for the healthcare professionals. This study was aimed to investigate the prevalence of medication use (OTC and prescribed medication) during pregnancy and its associated factors among pregnant women attending healthcare services in Malang, Indonesia.
Materials and methods: A cross-sectional study was conducted from July to September 2018 in five different healthcare services among pregnant women attending their routine antenatal care visit in Malang, Indonesia. Convenience sampling method was used to select the study participants. Data collection process was did using a self-administered questionnaire in the waiting room at each of the healthcare service and collected on site immediately after the questionnaires were completed. The association between medication use (OTC and prescribed medication) and selected factors among pregnant women were analyzed using logistic regression models.
Results: A total of 333 women, 39 women (11.7%) used OTC medication and 293 women (88%) took prescribed medication during pregnancy. Women with higher knowledge about OTC medication (overall knowledge) were more likely to practice OTC medication compared with those who had lower knowledge [aOR = 2.15, 95% CI = 1.03-4.46]. Meanwhile, pregnant women who had correct knowledge about possible risk from taking OTC during pregnancy were less likely to use OTC medication [aOR = 0.29, 95% CI = 0.14-0.60] compared with those without correct knowledge. The effect of higher knowledge regarding OTC medication on use of OTC medication was significant among women who had middle and lower education group [aOR = 8.18, 95% CI = 1.70 - 39.35]. The effect of knowledge on the possible risks of taking OTC medication during pregnancy was significant only among women who had attended high school and higher education (aOR = 0.17, 95% CI = 0.07-0.42). Age and number of ANC visit were two factors associated with the use of prescribed medication during pregnancy.
Conclusion: There is a need to improve the education of mother by healthcare professionals on the potential harmful effect of medicine for the unborn baby and give the right direction to the mother regarding the use of medicine during pregnancy. Providing evidence-based information about the medication used to the pregnant women since their early gestation during antenatal care visit (ANC) is an important strategy to protect them from any potential dangerous effect.

Table of Contents
Acknowledgments i
Table of Contents ii
Abstract iv
List of Tables vi
List of Figures vii
List of Abbreviations viii
CHAPTER 1. GENERAL INTRODUCTION 1
1.1. Background 1
1.1.1. Medication use during pregnancy 1
1.1.2. Food and Drug Administration (FDA) Regulation 2
1.1.3. Important factors that associate with use of medication 3
1.1.4. Aims 3
1.1.5. Study Hypothesis 4
1.2. Conceptual Framework 5
1.3. Organization of the Thesis report 6
CHAPTER 2. LITERATURE REVIEW 7
2.1. Description of medication use 7
2.1.1. Prevalence of medication use during pregnancy 7
2.2. Report of Medication Use in Indonesia 9
2.3. Factors associated with OTC medication use during pregnancy 11
2.3.1. Knowledge about OTC medication 11
2.3.2. Belief regarding medication 13
2.3.3. Socio-demographic characteristics 14
2.3.4. Health condition 16
2.4. Factors associated with prescription medication use during pregnancy 17
2.4.1. Belief about medication 17
2.4.2. Socio-demographic characteristics 18
2.4.3. Health behaviour and health condition 20
2.5.Knowledge Gap 21
2.5.1. Gap in OTC medication 21
2.5.2. Gap in prescribed medication 22
2.6. Significance of the study 23
CHAPTER 3. MATERIALS AND METHODS 25
3.1. Methods 25
3.1.1. Study area 25
3.1.2. Samples and data collection 25
3.1.3. Questionnaire development 26
3.1.4. Outcome variable 26
3.1.5. Independent variables 27
3.1.6. Statistical analysis 31
3.1.7. Ethical considerations 32
CHAPTER 4. RESULTS 33
4.1 Socio-demographic characteristics 33
4.2. Medication use during pregnancy 33
4.2.1. OTC medication use during pregnancy 33
4.2.2. Prescribed medication use during pregnancy 34
4.3. Knowledge of OTC and Attitude of medication use 34
4.3.1. Knowledge of OTC medication 35
4.4.1. Attitude about medication use 35
4.5. Factors associated with medication use during pregnancy 36
4.5.1. OTC medication used during pregnancy 36
4.5.2. Prescribed-medication use during pregnancy 37
4.6. Sub-group analysis for effects of knowledge regarding OTC-medication on OTC-medication practice by socio-demographics 38
CHAPTER 5. DISCUSSION 54
5.1. Chapter summary of medication used during pregnancy 54
5.1.2. OTC medication usage during pregnancy 54
5.1.3. Prescribed-medication used during pregnancy 59
5.2. Conclusion 62
CHAPTER 6 63
6.1. Strength of this study 63
6.2. Limitation of this study 63
6.3. Study Implication and future direction 63
REFERENCES 65
APPENDIX 73


List of Tables
Table 1. Distribution of participants according to OTC medication practice in general and supervised and unsupervised OTC usage during pregnancy 40
Table 2. Distribution of participants according to prescribed medication practice (with and without food supplement) during pregnancy 42
Table 3. Knowledge regarding OTC medication 46
Table 4. Belief of medicine in general 47
Table 5. Belief of medication during pregnancy 48
Table 6. Multiple logistic regression analysis of knowledge and other factors associated with the use of OTC medication during pregnancy 49
Table 7. Multiple logistic regression analysis of knowledge, belief, and other factors associated with the use of OTC medication during pregnancy 50
Table 8. Multivariate logistic regression analysis of belief and other factors associated with the use of prescribed medication during pregnancy 51
Table 9. Multivariate logistic regression analysis of belief and other factors associated with the use of prescribed medication during pregnancy 52

List of Figures
Figure 1. The Conceptual Framework of the association between potential factors with medication use among pregnant women in Malang, Indonesia 5
Figure 2. Women’s reasons to use OTC medication during pregnancy 44
Figure 3. Type of OTC medication used during pregnancy 44
Figure 4. Sources of information to use OTC medication during pregnancy 44
Figure 5. Percentage of correct answer in knowledge regarding OTC 45
Figure 6. Sub-group analysis effects of socio-demographics characteristic and knowledge regarding OTC medication (total score categorized into binary outcome) on practiced at least one OTC-medication 53
Figure 7. Sub-group analysis effects of socio-demographics and knowledge statement regarding OTC medication (There is possible risk if taking OTC medication during pregnancy) on practiced at least one OTC medication 53

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