AUTHOR=Shakeel Sadia , Iffat Wajiha , Qamar Ambreen , Nesar Shagufta , Butt Fareeha , Siddiqui Sobia Naseem , Rehman Hina , Rehman Anees ur 

TITLE=Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues

JOURNAL=Frontiers in Public Health

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.829339

DOI=10.3389/fpubh.2022.829339

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>Off-label medication usage (OLMU) is prevalent in the treatment of various diseases, including female reproductive health issues (FRHIs). However, there is a paucity of literature on the perspective of health professionals on this subject. The purpose of the current study was to assess gynecologists/obstetricians' knowledge, attitude and practice toward OLMU in the treatment of FRHIs.</p></sec><sec><title>Methods</title><p>The current cross-sectional study was conducted in September and October 2021, at five tertiary care hospitals (two public and three private sector), different clinics and maternity homes in a metropolitan city of Karachi, Pakistan. The target population was gynecologists, obstetricians and physicians/residents working in the ob/gyn department in various hospitals and clinical settings of Karachi.</p></sec><sec><title>Results</title><p>The overall response rate was 77.1%. The mean age of the study respondents was 36.1 ± 7.7 years; <italic>n</italic> = 85 (55.9%) respondents were working in primary patient care. The majorly reported OLMU by the respondents were clomiphene citrate in unexplained infertility (<italic>n</italic> = 66; 43.4%), metformin to improve cycle regularity in females with polycystic ovary syndrome (PCOS) (<italic>n</italic> = 59; 38.8%) and letrozole to induce ovulation (<italic>n</italic> = 31; 20.4%). The majorly stated categories of OLMU were at a different dose (<italic>n</italic> = 95; 62.5%) and at different indications than approved to treat (<italic>n</italic> = 89; 58.5%). It was reported by the majority of the respondents (<italic>n</italic> = 95; 62.5%) that they do not follow any guidelines or regulations for OLMU in their work setting; however, the response was statistically varied with the working organization (CI 2.14–2.93; <italic>p</italic> = 0.037) and practice area (CI 2.85–4.32; <italic>p</italic> = 0.0001) of respondents.</p></sec><sec><title>Conclusions</title><p>The present study revealed that the respondents were well-familiar with the practice of OLMU in the treatment of FRHIs. They expressed their concerns about decreasing such practices by being involved in collective decision-making procedures, and they were inclined to accept initiatives aimed at ensuring drug safety in patients.</p></sec>