Program in Peds Rheumatology Clinic Ups Education on Teratogenic Rx

Findings seen among girls, women of childbearing age prescribed teratogenic meds

TUESDAY, March 5, 2019 (HealthDay News) -- A series of interventions introduced through a quality improvement project can increase the frequency of both teratogen education and urine pregnancy screening in patients taking teratogenic medications for rheumatic disease, according to a study published online March 5 in Pediatrics.

Ashley M. Cooper, M.D., from Children's Mercy Kansas City in Missouri, and colleagues performed a quality improvement project to increase education and pregnancy screening in girls and women of childbearing age prescribed teratogenic medications in a single pediatric rheumatology clinic. The seven plan-do-study-act cycles tested the effectiveness of visible project reminders, physician and nurse education, progress updates, previsit planning, and development of an electronic health record education template. A chart review was conducted to compare improvement between control cases and those cases seen during the intervention.

At baseline, the researchers found that during 57 of 231 (24.7 percent) clinic encounters, education was documented for female patients age ≥10 years within the last 12 months; a pregnancy screening was performed at the visit for 47 of 231 patients (20.3 percent). Implementation of the interventions increased documentation of annual teratogen education to 79.6 percent (904 of 1,135) and routine pregnancy screening to 82.8 percent (940 of 1,135). Chart review showed sustained improvement for more than one year.

"Development of a standardized education template in the electronic health record played a key role in sustaining these improvements over time," the authors write.

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