The awareness of the Jordanian population about OTC medications: A cross-sectional study.

Due to the shortage of literature related to the safe use of over-the-counter (OTC) products by patients worldwide, the aim of this study was to evaluate people's knowledge and attitudes regarding the use of OTC products in Jordan. Using an internet-based questionnaire mainly spread through social media platforms, a descriptive cross-sectional study was conducted with Jordanian candidates who consume OTC products. A total of 274 OTC product users answered the survey questions. The results showed that analgesics were the most commonly used OTC products among the participants (50.4%). The majority used the OTC products only as needed rather than on a regular basis. Only 42.4% of the participants sought a pharmacist's help in determining the dose of the OTC medicine. Most of the participants were very interested in reading a patient information leaflet (80.3%) and the side effects and contraindications (89.5%). The majority of participants agreed that antibiotics have to be prescribed (68.5%), and anti-allergy medications should not be used as sleep aid medications (75.0%). About 53.4% thought that OTCs are sometimes enough to treat their health conditions without the need to follow-up with a physician. A chi-square analysis showed an association between gender, age, educational level and having a family member in the medical field and OTC products knowledge among Jordanians. Females, for example, were more interested in reading leaflet, checking production and expiry dates, knowing adverse effects, and appropriate storage conditions (P < .001, 0.022, 0.003, 0.007, respectively). We concluded that a good level of knowledge on the use of OTC products among the study population was identified in the present study.

Australian pharmacists: ready for increased non-prescription medicines reclassification.

OBJECTIVES: Reclassification of medicines from prescription to non-prescription increases timely access to treatment, promotes self-management of minor ailments and relieves healthcare system burden. Previous research identified that Australia lagged behind the United Kingdom and New Zealand in medicines reclassification. This study aimed to identify Australian pharmacists' opinions on the current state of medicines reclassification; the prescription medicines consumers requested without prescription; the medicines pharmacists believed should and should not be considered for reclassification; and perceived barriers to reclassification. METHODS: A 2016 national online survey that sought pharmacists' opinions on the state of reclassification, perceived barriers to reclassification and readiness of the profession for further reclassification. Pharmacists' comments were invited through open-ended questions. KEY FINDINGS: Two hundred and thirty-five valid surveys were completed. Respondents practised in community, hospital, consultant and academic contexts, and the majority were female (58.7%, n = 138). More than two thirds (70.66%, n = 166) of pharmacists reported receiving daily or weekly requests for non-prescription access to prescription medicines. The majority of pharmacists (71.7%) agreed that the Australian pharmacy profession is ready for further medicines reclassification, guided by patient safety, harm minimisation and medication continuance. The most prominent barrier to further reclassification was opposition from other healthcare professionals. CONCLUSIONS: Australian pharmacists believe that their profession has the capacity to safely and effectively manage a wider range of non-prescription medicines through increased reclassification in the contexts of patient safety and risk mitigation. This study has contributed to the global conversation on non-prescription medicines access, providing momentum for practice and policy change.

Analysing the landscape for prescription to non-prescription reclassification (switch) in Germany: an interview study of committee members and stakeholders.

BACKGROUND: Non-prescription medicines are increasingly used in Germany, aided by prescription-to-non-prescription reclassification (or switch). This study aimed to examine the barriers and enablers to reclassification of medicines in Germany and provide recommendations for change. METHODS: Face-to-face conversational interviews with purposively selected key informants in Germany were conducted in 2017 by a researcher informed in the area. Interviews were transcribed, coded in NVIVO and systematically analysed using a framework approach. RESULTS: Twenty-four interviews were conducted with 32 participants including members of the committee considering reclassifications, and representatives from government, industry, health insurance, academia, and pharmacy, medical, and patients' organisations. A range of enablers and barriers emerged that influence reclassification including effects on the committee and process, or the desire of pharmaceutical companies to pursue reclassifications. Enabling market factors included the large population and a culture of self-medication. Enabling health system factors include the pharmacy-only category. Some pharmacy factors appeared enabling (e.g. a positive experience after reclassifying emergency contraception) while others appeared to hinder reclassification (e.g. insufficient pharmacy practice research). Some medical factors were enabling (e.g. reported waiting times) and others limited reclassification (e.g. opposition to some reclassifications). Some committee and government openness to reclassification and self-medication reportedly enabled reclassification, while conservatism was considered a barrier, particularly for classifications with special conditions for supply such as initial doctor diagnosis or other complexities. Some improvements to the committee constitution and considerations were recommended. Some participants found the reclassification process after the committee recommendation opaque, with opportunity for delays and political interference. Industry factors included both enablers such as capability in reclassification, and barriers, such as a perceived low market potential of some reclassifications, and doubt that some candidates would be approved. A need for more data emerged strongly, both pre-reclassification in applications, and post-reclassification. Many participants saw merit with reclassification in non-traditional areas such as hypertension, diabetes and oral contraception. CONCLUSIONS: Many factors influence reclassification in Germany. Recommended improvements included aspects of the process and committee consideration, and more data collection. Sufficient market exclusivity linked to data collection could aid the generation of evidence to aid committee considerations and encourage more applications of high quality.

Cost-Effectiveness of Reclassifying Triptans in Australia: Application of an Economic Evaluation Approach to Regulatory Decisions.

BACKGROUND: Migraine is a common, chronic, disabling headache disorder. Triptans, used as an acute treatment for migraine, are available via prescription in Australia. An Australian Therapeutic Goods Administration (TGA) committee rejected reclassifying sumatriptan and zolmitriptan from prescription medicine to pharmacist-only between 2005 and 2009, largely on the basis of concerns about patient risk. Nevertheless, pharmacist-only triptans may reduce migraine duration and free up healthcare resources. OBJECTIVES: To estimate the cost-effectiveness of reclassifying triptans from prescription-only to pharmacist-only in Australia. METHODS: The study design included decision-analytic modeling combining data from various sources. Behavior before and after reclassification was estimated using medical practitioner and patient surveys and also administrative data. Health outcomes included migraine frequency and duration as well as adverse events (AEs) discussed by the TGA committee. Efficacy and AEs were estimated using randomized controlled trials and observational studies. RESULTS: Reclassifying triptans will reduce migraine duration but increase AEs. This will result in 337 quality-adjusted life-years gained at an increased cost of A$5.9 million over 10 years for all Australian adults older than 15 years (19.6 million). The incremental cost-effectiveness ratio was estimated to be A$17 412/quality-adjusted life-year gained. CONCLUSIONS: The incremental cost-effectiveness ratio is likely to be considered cost-effective by Australian decision makers. Serotonin syndrome, a key concern of the TGA committee, had little impact on the results. Further research is needed regarding pharmacist-only triptan use by migraineurs currently using over-the-counter medicines and by nonmigraineurs, the efficacy of triptans, and the risk of cardiovascular and cerebrovascular AEs and chronic headaches with triptans.

Medicines reclassification from a pharmaceutical industry perspective: An international qualitative study.

BACKGROUND: Widening access to medicines through reclassification ('switching') of medicines from prescription to non-prescription is an international trend generally welcomed by community pharmacists. Research has focused on scheduling and committee deliberations affecting reclassification, rather than industry aspects, despite industry's role in driving reclassifications. The research aimed to identify how pharmaceutical industry and product-related factors influence reclassification, and to explore stakeholder acceptability of government or third-party driven reclassifications. METHODS: Sixty-five in-depth, semi-structured interviews were conducted with 80 key informants (including representatives from regulatory bodies, industry, pharmacy and medicine) in developed countries including the United States, the United Kingdom, Japan, Australia, and New Zealand. The questions explored barriers and enablers to reclassification at the local (micro-), regional (meso-) and global (macro-) levels. Analysis of transcribed interviews entailed descriptive and thematic approaches. RESULTS: Pharmaceutical industry decisions to drive medicine reclassification reflect characteristics of the company, product, and external environment at all levels. For the company, financial factors, company focus (e.g. on prescription business versus non-prescription business), and capability in non-prescription medicines and reclassification were common influences. Products with significant non-prescription market potential and a well-known prescription medicine brand name most suited reclassification, usually near patent expiry. Barriers included immediate generic entry post-reclassification, and a short-term profitability and/or prescription business focus. Some countries allow government or a third-party (including pharmacy) to drive reclassifications, with examples of successful reclassifications ensuing. Some industry and other participants held concerns about this practice, particularly in the United States. Concerns included insufficient resourcing, and the pharmaceutical company's business, potentially encouraging product withdrawal or legal challenge. CONCLUSIONS: This study is the first to explore both pharmaceutical industry factors affecting reclassification and acceptability of alternate drivers of reclassification. Factors beyond clinical safety and efficacy and the local reclassification environment can influence reclassification. Pharmacy-driven reclassification might be one alternative.

Australian pharmacy perspectives on increasing access to medicines through reclassification.

OBJECTIVES: Availability of medicines without prescription can increase consumers' timely access to treatment and promote self-management of minor ailments and adherence to long-term medications. Globally, access to relevant medicines has improved through increased reclassification of medicines from prescription to non-prescription availability. However, Australian reclassification lags behind countries with comparable health systems, and the factors influencing this are poorly understood. METHODS: Semi-structured interviews were conducted during May 2015 to explore the perspectives of Australian pharmacists and support staff on future reclassification. Interview responses were transcribed verbatim, and the data were analysed thematically, primarily informed by the general inductive approach. RESULTS: Participants identified a broad range of medicines as candidates for future reclassification by applying risk versus benefit judgements, assessing any medicines with potential for misuse and hazardous medicines as unsuitable. Key drivers for change in classification were underpinned by participants' desire to support consumers' management of minor ailments and adherence for those on long-term therapy. Barriers to reclassification were identified by pharmacy staff as internal, negatively impacting pharmacists' readiness for reclassification and external, negatively impacting the overall progress of change. CONCLUSIONS: While the research provided valuable insights to inform the ongoing discussion on future reclassification, a larger, more representative sample is needed to confirm these findings.

Prescription and Other Medication Use in Pregnancy.

OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured. Additionally, reasons the medications were taken were recorded. Trends in medications taken across pregnancy and in the first trimester were determined. RESULTS: Of the 9,546 study participants, 9,272 (97.1%) women took at least one medication during pregnancy with 9,139 (95.7%) taking a medication in the first trimester. Polypharmacy, defined as taking at least five medications, occurred in 2,915 (30.5%) women. Excluding vitamins, supplements, and vaccines, 73.4% of women took a medication during pregnancy with 55.1% taking one in the first trimester. The categories of drugs taken in pregnancy and in the first trimester include the following: gastrointestinal or antiemetic agents (34.3%, 19.5%), antibiotics (25.5%, 12.6%), and analgesics (23.7%, 15.6%, which includes 3.6%; 1.4% taking an opioid pain medication). CONCLUSION: In this geographically and ethnically diverse cohort of nulliparous pregnant women, medication use was nearly universal and polypharmacy was common. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01322529.

Schedules of Controlled Substances: Table of Excluded Nonnarcotic Products: Vicks® VapoInhaler®.

This final rule adopts the interim final rule, with a correction to spelling of the manufacturer's name that was published in the Federal Register on October 27, 2015. The Drug Enforcement Administration is amending the table of Excluded Nonnarcotic Products to update the listing for Vicks® VapoInhaler®, containing 50 mg levmetamfetamine in a nasal decongestant inhaler, marketed by The Procter & Gamble Company. This over-the-counter, non-narcotic drug product is excluded from provisions of the Controlled Substances Act.

Schedules of Controlled Substances: Table of Excluded Nonnarcotic Products: Nasal Decongestant Inhaler/Vapor Inhaler. Final rule.

This final rule adopts, without change, the interim final rule that was published in the Federal Register on October 27, 2015. The Drug Enforcement Administration is amending the table of Excluded Nonnarcotic Products to update the company name for the drug product Nasal Decongestant Inhaler/Vapor Inhaler (containing 50 milligrams levmetamfetamine) to Aphena Pharma Solutions--New York, LLC. This over-the-counter, nonnarcotic drug product is excluded from the provisions of the Controlled Substances Act.

[Pharmacy Medicines Not Subject to Medical Prescription in Portugal: An Underused Access Opportunity?] / Medicamentos Não Sujeitos a Receita Médica de Dispensa Exclusiva em Farmácia em Portugal: Uma Oportunidade de Acesso Sub-Aproveitada?

INTRODUCTION: In 2013 medicinal products for human use not subject to medical prescription dispensed exclusively in pharmacy, a subcategory of products not subject to medical prescription was introduced in Portugal. This category of medicinal products promotes the accessibility to treatment, ensuring safety and efficacy, with benefits to public health. This article analyzed the medicines classified as medicinal products for human use not subject to medical prescription dispensed exclusively in pharmacy or equivalent in seven European countries, United Kingdom, Denmark, Sweden, Norway, Italy, Czech Republic and Portugal, and proposes a preliminary list of common international names/ medicines that possess the characteristics that justify their inclusion in Portugal, in this category. MATERIAL AND METHODS: For the selection, common international names /medicines approved in the considered countries were selected if, in at least one of the countries considered, they are classified as medicinal products for human use not subject to medical prescription dispensed exclusively in pharmacy or equivalent, and/ or have the classification of medicinal products subject to medical prescription in Portugal and medicinal products not subject to medical prescription in one of the considered countries. RESULTS: The preliminary list obtained contains 271 different common international names / presentations. About 19% of the selected common international names do not have a valid marketing authorization in Portugal and the majority (42%) is classified in Portugal as medicinal products not subject to medical prescription, a lower percentage (35%) as medicinal products subject to medical prescription, and only 4% as medicinal products for human use not subject to medical prescription dispensed exclusively in pharmacy. CONCLUSION: Safety is one of the main aspects to be considered in the context of the reclassification of medicines regarding their supply to the public. The results obtained promote a reflection on the relevance of extending the availability of medicines with the classification of medicinal products for human use not subject to medical prescription dispensed exclusively in pharmacy in Portugal, which, due to their characteristics and indications, would benefit from an access without a medical prescription, ensuring the safety in its use.

Introdução: Em 2013 foi introduzida em Portugal a classificação quanto à dispensa de medicamentos não sujeitos a receita médica de dispensa exclusiva em farmácia, uma subclassificação dos medicamentos não sujeitos a receita médica. A existência desta classificação de medicamentos promove a acessibilidade aos medicamentos, garantindo a eficácia e a segurança na sua utilização, com benefícios para a saúde pública. O presente artigo analisa os medicamentos classificados como medicamentos não sujeitos a receita médica de dispensa exclusiva em farmácia ou com classificação equivalente em sete países europeus, Reino Unido, Dinamarca, Suécia, Noruega, Itália, República Checa e Portugal, e propõe uma lista preliminar das denominações comuns internacionais/ medicamentos que reúnem características que justificariam a sua classificação, em Portugal, como medicamentos não sujeitos a receita médica de dispensa exclusiva em farmácia. Material e Métodos: Para a seleção efetuada, foram analisadas, no universo dos medicamentos autorizados nos países em estudo denominações comuns internacionais/ apresentações que, em pelo menos num dos países considerados, se encontram classificadascomo medicamentos não sujeitos a receita médica de dispensa exclusiva em farmácia ou categoria equivalente, e/ou têm a classificação de medicamentos sujeitos a receita médica em Portugal e medicamentos não sujeitos a receita médica em algum dos países considerados.Resultados: A lista preliminar obtida continha 271 denominações comuns internacionais /apresentações diferentes. Cerca de 19% das denominações comuns internacionais selecionadas não possuíam uma autorização de introdução no mercado válida em Portugal e a maioria (42%) encontra-se classificada em Portugal como medicamentos não sujeitos a receita médica, uma percentagem menor (35%) como medicamentos sujeitos a receita médica, e apenas 4% como medicamentos não sujeitos a receita médica de dispensa exclusiva em farmácia.Conclusão: A segurança constitui um dos fatores mais relevantes a ter em conta no contexto da reclassificação dos medicamentos quanto à sua dispensa ao público. Os dados obtidos permitem uma reflexão acerca da pertinência do alargamento a nível nacional da disponibilidade de medicamentos com a classificação de medicamentos não sujeitos a receita médica de dispensa exclusiva em farmácia, que pelas suas características e indicações terapêuticas a que se destinam, beneficiariam de um acesso sem necessidade de prescrição médica, garantindo a segurança na sua utilização.

Barriers to positive policy change that aims to increase access to medicines through reclassification: the case of oseltamivir in New Zealand.

OBJECTIVES: This study aims to identify and explore emergent barriers to consumers accessing oseltamivir without prescription following policy change introduced in New Zealand to increase access via community pharmacies. METHODS: Semi-structured interviews were conducted with 26 community pharmacists immediately following the first season of oseltamivir availability without prescription in October 2007. Interviews were transcribed verbatim and coded using a framework approach to identify themes. KEY FINDINGS: Non-prescription sales of oseltamivir were slow during this period. Participants acknowledged that they may have missed opportunities to recommend oseltamivir and attributed this to a range of reasons. Pharmacy-related barriers identified included limited pharmacist confidence, concerns about efficacy and safety of the product, location of the product in the pharmacy, affordability and the role of support staff. Many pharmacists adopted a 'risk-benefit analysis' that balanced symptom severity with perceived value for money. Consumer barriers included cost, limited awareness of availability and limited ability to correctly self-diagnose and manage influenza. CONCLUSIONS: Complexity in the factors that influenced pharmacist motivation to supply oseltamivir without prescription highlighted the potential for positive policy change to be hindered by multiple barriers. Greater understanding of such barriers is important for effective transition of medicines from prescription to non-prescription availability to achieve increased consumer access through reclassification. Concerns that pharmacists are influenced by commercial priorities when medicines are newly reclassified were not substantiated in this study.

Analysis of over-the-counter medicines use among nursing students.

BACKGROUND/AIM: The use of over-the-counter (OTC) medication is widespread among the adult and student populations in Slovenia. The aim of the study was to analyse the prevalence of OTC medicines use among nursing students with respect to sociodemographic characteristics. METHODS: A total of 241 nursing students in the Faculty of Health Sciences, Ljubljana, were included in the cross-sectional study. A questionnaire was created for the purposes of the study. Statistical analysis was performed with SPSS 20. Descriptive statistics, t-test and the contingency coefficient were calculated. Statistical significance was set at the p-value of < 0.05. RESULTS: The study showed that the use of prescription drugs was significantly higher in women (p = 0.029), students living in rural areas (p = 0.005) and students who described themselves as being of bad health (p = 0.008). At the same time, a third of the respondents had been taking one OTC medicine within the last month; those taking several prescription drugs commonly administered several over-the-counter medicines (p = 0.027). Women used OTC medicines to treat pain and fever (p = 0.001), respiratory issues (p = 0.015), and fungal infections (p < 0.000) more often than men. OTC medicines were also used to treat minor mental health issues by a higher proportion of respondents over 21 years of age (p = 0.005) and women (p < 0.000), while over-the-counter medicines for treating skin conditions were more frequently used in rural areas (p = 0.006). CONCLUSION: Nursing students tend to use OTC medicines on their own accord, receiving instructions for safe use with their purchase, which points to adequate promotion of safe use of medications in Slovenia. Men's assessment of their personal health tends to be better than that of women, who also use medication more frequently. A connection between poor health and a higher incidence of the use of OTC medicines was established. The use of OTC medicines to treat minor mental health issues increased with age and was more typical of women. The results obtained demonstrate the importance of personal control over the safe use of medicines, motivation for personal good health and a healthy lifestyle.

Review of Italian primary care paediatricians identifies 38 commonly prescribed drugs for children.

AIM: Most Italian children are cared for by a family paediatrician until they are 14 years old, and their duties include prescribing drugs recommended by specialists so that they are free. This study aimed to draw up a list of the drugs most commonly prescribed by family paediatricians. METHODS: We surveyed 64 experienced family paediatricians to find out what drugs they prescribed over an 8-week period, including those recommended by a specialist, using cartons of drugs as the unit of measurement. A list of commonly prescribed drugs was then drawn up. RESULTS: A total of 381 active substances were prescribed. The most commonly prescribed drugs were amoxicillin (25.8% of the cartons), amoxicillin clavulanate (9.2%) and cetirizine (9.0%). The most commonly prescribed drug classes were antibiotics (43.8%), anti-asthmatics (12.9%) and antihistamines (11.8%). A list of 38 commonly prescribed drugs belonging to 16 therapeutic subgroups and covering 83.1% of cartons was identified. Of these, 33 were prescribed by 50% or more of the paediatricians and five were mainly prescribed following the recommendation of a specialist. CONCLUSION: Our review of the prescribing habits of family paediatricians showed that 38 commonly prescribed drugs were sufficient to treat most common diseases in children under 15 years of age.

Use of medicines by homeless people in Porto, Portugal.

The objective of this study was to describe patterns of medication use among homeless adults from the city of Porto, Portugal. We recruited 146 homeless participants in four social services institutions. Data on the use of medicines in the previous week were collected using face-to-face interviews. We described the prevalence and main correlates of use of medicines from different Anatomical Therapeutic Chemical classification (ATC) groups. A total of 56.8% of the homeless reported to have used at least one medicine in the previous week. The most frequently reported were benzodiazepines (21.9%) and antipsychotics (15.1%); socio-demographic characteristics, lifestyle variables and use of health care were not found to be significantly associated with their use. The prevalence was 1.4% for anti-inflammatory and antirheumatic products, and 6.2% for antihypertensives, diuretics and beta-blocking agents. Medicines pertaining to the nervous system ATC group were by far the most frequently used, while those for the treatment of other common chronic and acute conditions seem to be underused.

Pharmacists' adoption into practice of newly reclassified medicines from diverse therapeutic areas in Scotland: a quantitative study of factors associated with decision-making.

BACKGROUND: In the UK, over 90 medicines that were previously available only through prescription have been reclassified to allow over-the-counter (OTC) availability via pharmacies. Pharmacists are personally responsible for undertaking or supervising the sales and supplies of these OTC 'pharmacy only' (P) medicines. Reclassification facilitates pharmacy management of a wide range of conditions. OBJECTIVE: This research aimed to evaluate Scottish community pharmacists' perspectives of newly reclassified 'P' medicines from diverse therapeutic areas and to identify factors associated with their adoption into practice of these medicines. METHODS: A cross-sectional postal survey of all community pharmacies in Scotland (N = 1138) was undertaken. The questionnaire was mailed to the pharmacist responsible for OTC medicines. Four newly reclassified 'P' medicines: omeprazole, naproxen, simvastatin and chloramphenicol eye drops were evaluated. Outcomes of interests included pharmacist support for the reclassified status, perceived adoption into practice of these medicines (i.e., how often they supplied each of these medicines) and factors associated with decision-making. Analyses included descriptive, bivariate correlation, principal component factor and binary regression. RESULTS: Five hundred sixty-three pharmacists responded (response rate: 49.5%). Newly reclassified medicines studied had been adopted into practice by the respondent pharmacists to varying degrees. A high majority of the respondents expressed support for the reclassified status (82.4%) and perceived that the level of adoption into practice of OTC chloramphenicol was high (92.1%). In contrast, over 80% of respondents had not yet made a supply of OTC simvastatin to patients, mainly owing to pharmacists' perceptions of lack of evidence of efficacy of the OTC dose and patient demand. Decision-making was influenced by factors such as perceived benefits to patients and pharmacy practice; e.g., respondents who agreed that reclassified naproxen was a good opportunity to develop their professional role were significantly more likely to rate their support for the reclassified status highly than those who were unsure or disagreed (odds ratio = 3.7 (95% confidence interval: 2.1-6.7); P value <0.001). CONCLUSIONS: Key factors informing decisions to adopt the reclassified medicines into pharmacists' practice relate to perceptions regarding the benefits of reclassification to patient care and their professional roles. The results have relevance to future reclassification decisions.

Predictors of the use of medications before and during pregnancy.

BACKGROUND: Drug use in pregnancy is often reason of concern for mothers and their physicians. However, only few studies investigated predictors of drug use in pregnancy. OBJECTIVES: To examine maternal characteristics as predictors of medication use in the 6 months before pregnancy and during the first 6 months of pregnancy. To examine whether prescription and over-the-counter (OTC) medication use in the 6 months before pregnancy had an impact on medication use in pregnancy. SETTING: Six maternity care units and five community pharmacies. METHOD: Data were collected using a specially designed self-reported questionnaire during the period March 2009-March 2010. Logistic regression was used to identify factors associated with medication use. MAIN OUTCOME MEASURE: Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were used as association measures. RESULTS: A total of 236 women were included in the analysis. After controlling for maternal characteristics, parity of more than one was associated with lower prescription medication use in pregnancy (aOR 0.46; 95% CI 0.22-0.93), higher household income with higher OTC medication use before pregnancy (aOR 3.13; 95% CI 1.22-8.00), and miscarriage with higher C and D Food and Drug Administration (FDA) risk category medication use in pregnancy (aOR 3.65; 95% CI 1.30-10.25). Prescription medication use before pregnancy was associated with higher prescription medication use in pregnancy (aOR 2.49; 95% CI 1.12-5.52), OTC medication use before pregnancy with higher OTC medication use in pregnancy (aOR 35.95; 95% CI 7.95-162.49), and C and D FDA risk category medication use before pregnancy with the same category medication use in pregnancy (aOR 3.54; 95% CI 1.23-10.17). CONCLUSION: Different maternal characteristics were shown as predictors of medication use before and during pregnancy. However, medication use before pregnancy was shown as the most important predicting factor for the medication use in pregnancy.