For patients suffering from severe acne, isotretinoin, sometimes called by the brand-name Accutane, continues to be one of the most effective medications prescribed.
Because isotretinoin is known to induce birth defects if taken while pregnant, theU.S. Food and Drug Administration strictly regulates its distribution to women of childbearing age through a federal program called iPledge, which requires women to review an educational booklet, complete monthly comprehension tests, use two forms of contraception and take a series of pregnancy tests.
"Isotretinoin is one of the most problematic medications to take during pregnancy; however, efforts to help women avoid pregnancy while receiving this treatment have been relatively unsuccessful," explained Eleanor Bimla Schwarz, M.D., M.S., director of the women's health services research unit at the Center for Research on Health Care, Pitt School of Medicine, and senior author of the study. "Our research study was designed to better understand the messages that women receive through the iPledge program about contraception."
Led by Dr. Schwarz, the researchers interviewed 16 women about their experiences with the iPledge program, including counseling about isotretinoin and pregnancy prevention, past history of contraceptive use, and the role of friends, family and the media in influencing contraceptive choices. The participants also were asked to provide feedback on how to improve pregnancy prevention counseling for other women in the iPledge Program.
Researchers found that women who had participated in the iPledge program clearly understood isotretinoin's adverse effect on pregnancy. However, the women reported receiving less information about how to effectively protect themselves from unintended pregnancies while using the medication. In fact, no women were fully informed about their contraceptive options, and many had misconceptions about highly effective, reversible contraceptives, such as subdermal implants and intrauterine devices.
"Unfortunately, our medical community has a long tradition of telling women not to get pregnant without equipping them with the tools they need to avoid pregnancy," Dr. Schwarz notes. "The findings from our qualitative study indicate that dermatologists and other health care professionals need to ensure they are providing comprehensive education and access to contraceptives that will fully protect women from unintended pregnancies while taking this medication."
The study was supported by Food and Drug Administration grant No. U01FD004253.
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About the University of Pittsburgh School of Medicine
As one of the nation's leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.
Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region's economy. For more information about the School of Medicine, see www.medschool.pitt.edu.
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