gms | German Medical Science

Background and state of research: Embryotox.de provides evidence-based information on drug safety during pregnancy and breastfeeding since 2008. It is maintained by the publicly funded Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie, and contains freely accessible information for about 400 drugs in German language. Embryotox.de is independent of the pharmaceutical industry and not influenced by commercial interests. Initially intended for use by health care professionals, embryotox.de is today also widely used by patients, with user accesses of around 3.8 million per year. By providing well-founded information on drug safety, embryotox.de supports a rational drug therapy considering potential risks and benefits. Thus, it helps to avoid serious adverse effects like congenital malformations in children and to reduce unfounded fears, improving the compliance of pregnant patients.

Research question and objectives, hypothesis: We aimed to examine, describe and compare barriers in the use of embryotox.de for medical doctors and patients, the two main user groups of the website.

Method: Semi-structured qualitative phone interviews with fourteen physicians and nine patients were conducted between February and November 2022 (purposeful and snowball sampling). Kuckartz’s content analysis was employed to point out information.

Results: Next to many benefits and an overall positive feedback on embryotox.de, semi-structured interviews revealed three very similar barriers for patients and physicians:

1.

presentation of only a limited number of drugs (occasionally unsuccessful search),

2.

navigation on the website (information difficult to find) and

3.

a feeling of uncertainty by given content (lack of understanding and uncertainty how to deal with given information in risk-benefit assessment).

In addition, main barriers for patients were the use of medical terminology and the complexity of displayed information. For physicians, a lack of time and particularly the apprehension that patients cannot deal with given information by embryotox.de (medical terms and content) were barriers too. Interview statements suggest that physician’s barriers may result in physicians using embryotox.de less frequently than they would actually consider it useful and appropriate in the context of medical counseling. For the same reasons the use of embryotox.de is less frequently recommended to patients.

Discussion: The results show parallels between barriers of patients and physicians for using embryotox.de. The limited number of presented drugs, difficulties to find information on the website and feeling of uncertainty were reported in both groups. Interestingly, doctors tried to anticipate barriers for their patients and reported their concern that patients might be overstrained or unsettled by medical terminology, content, or complexity of information. While complexity of medical content cannot always be simply reduced, it might be worth the effort to look for ways in which patient’s understanding of information on drug safety can be made easier.

Implication for care: Addressing the identified barriers might be a way to better support physicians and to promote the process of shared decision-making.

Funding: Innovationsfonds/Versorgungsforschung; 01VSF20010