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Preventing Pregnancies in Teens Taking Teratogenic Drugs

A multidisciplinary team addressed the problem of pregnancies among teens taking teratogenic drugs for rheumatic diseases by weaving behavioral economic (BE) strategies into a quality improvement (QI) project. “We leveraged BE-inspired interventions including improved accessibility of consents, utilizing distinctly colored consent forms, real-time reminders, peer comparison, and audit and feedback,” the authors report. During phase 1 of the project, the team “focused on annual consenting of female adolescents prescribed teratogenic drugs. Phase 2 emphasized sexual history screening and pregnancy prevention planning at every clinic visit for females ≥12 years on teratogenic medications.”

The authors report these results: “We increased the days between pregnancies for female adolescents prescribed teratogenic medications from 52 days to >900 days by using QI methodology with BE strategies. In phase 1, annual consents for postmenarcheal patients on teratogenic medications improved from 0% in 2017 to 95% in 2021. In phase 2, sexual history screening and pregnancy prevention planning at every clinic visit improved from 2% in 2019 to over 78% in 2021.”

A second article in the January 2023 issue of Pediatrics discusses the challenges adolescents and young adults face when their parents monitoring of menstrual supplies affects their choice of contraceptives.

Source: Pediatrics