Awareness Regarding Drug Teratogenicity, Contraception and Mode of Contraception Used by Patients with Rheumatologic Diseases

Abstract

Objective of the current study is to find the awareness regarding drug teratogenicity, contraception and mode of contraception in rheumatology patients. A cross sectional descriptive study has been done at Fauji Foundation Hospital, Rawalpindi, Pakistan. Patients in rheumatology outdoor with rheumatoid arthritis (RA), systemic lupus erythromatosis (SLE), Scleroderma (SSc) or polymyositis were included in the study and asked questions about demographic details, duration of disease, medications taken by the patient. After that specific questions regarding counseling on medications, teratogenic potential of the drugs and any prior counseling regarding contraception and mode of contraception used by the patients were asked. 52 patients all females were enrolled. Mean age ±SD (in years) is 39.25±5.43; disease duration ±SD (in years) is 5.69±4.67. 22(42.3%) patients were on methotrexate, 11(21.2%) on leflunomide, 7(13.5%) on Mycophenolate mofetil, 1(1.9%) on cyclophosphamide, 11 (21.2%) were taking methotrexate and leflunomide combination. Only 27(51.9%) patients were counseled regarding teratogenicity of drugs and 21(40.4%) patients knew correctly, the possible teratogenic drug they are taking. Only 12(23.1%) patients knew the correct time to stop the drug before conception. 18(34.6%) patients were counseled regarding using contraception with these drugs. 29(55.8%) patients were using contraception and amongst these 18(34.6%) were using barrier methods, 4(7.7%) employed coitus interuptus, 3(5.8%) used oral contraceptive pills, 3(5.8%) had placed intrauterine device, 4(7.7%) had undergone tubal ligation and 1(1.9%) had hysterectomy. 4 (7.7%) patients used emergency contraceptive pill (ECP) once in their lifetime while taking medicines. It has become to make a conclusion about disease awareness, drug teratogenicity and contraception is under addressed aspect of the management in rheumatologic diseases.