The PRAISE survey

Perception of doctors and health care professionals Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives

Dear colleague,

You are invited by the EULAR Study Group on Reproductive Health and Family Planning (ReHFaP) to take part in a survey on medication use in pregnancy.

Our aim is to explore how you feel about giving advice and prescribe anti-rheumatics including pain medications and disease modifying drugs in pregnancy and breastfeeding, and secondly, your beliefs on patients' perception on information about pain medications and disease modifying drugs in pregnancy and breastfeeding.

The survey is anonymous, and will take 7 minutes to complete.

Any questions or concerns may addressed at:

Karen Schreiber (kschreiber@danskgigthospital.dk)

Laura Andreoli (laura.andreoli@unibs.it)

Christine Graversgaard (cgraversgaard@danskgigthospital.dk)

Thank you for your help!

Question Title

1. What is your gender? (Required.)

Male

Female

Prefer not to disclose

Question Title

2. What is your age? (Required.)

<30

30-39

40-49

50-59

60-70

>70

Question Title

3. State your profession (Required.)

Doctor

Midwife

Nurse

Student

Other (please specify)

Question Title

4. In which country do you currently practice? (Required.)

Question Title

5. What is your specialty? (Required.)

Question Title

6. How many years have you been practicing? (Required.)

1-5 years

5-10 years

> 10 years

Question Title

7. Do you give advice on anti-rheumatic medications in patients who are planning pregnancy, are pregnant or lactating? (Required.)

Yes

Question Title

8. How many patients who are planning pregnancy, are pregnant or lactate do you advise on average per month? (Required.)

Question Title

9. Do you prescribe anti-rheumatic medications in patients who are planning pregnancy, are pregnant or lactating? (Required.)

Yes

I am not a prescriber

Question Title

10. In how many women who are planning pregnancy, are pregnant or lactate do you prescribe on average per month? (Required.)

Question Title

11. Do you feel overall comfortable on advising and/or prescribing antirheumatics in patients who are planning pregnancy, are pregnant or lactating? (Required.)

Yes

Not applicable

Question Title

12. How comfortable are you in advising patients with rheumatic diseases on the use of anti-rheumatic medications during pregnancy and fertility planning? (Required.)

Extremely comfortable

Very comfortable

Moderately comfortable

Somewhat comfortable

Not comfortable at all

Question Title

13. How comfortable do you feel in discussing with your patient that maternal disease control (and subsequent medication use in pregnancy) is detrimental for fetal wellbeing and pregnancy outcome? (Required.)

0=not comfortable, 10=very comfortable

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

14. How frequently do you discuss your patients or collaborate with other medical specialties (e.g. obstetrics, gynecology) when managing patients with rheumatic diseases during pregnancy and fertility planning? (Required.)

Very frequently

Frequently

Occasionally

Rarely

Never

Question Title

15. Do you use clinical guideline documents on medication use in pregnancy (such as EULAR, ACR, BSR etc.)? (Required.)

Yes

Question Title

16. Which guidance document do you use most frequently? (Required.)

EULAR

ACR

BSR

Other (please specify)

Question Title

17. How useful do you find the clinical guidance for the safe prescribing of anti-rheumatic drugs in patients with rheumatic diseases during pregnancy and fertility planning? (Required.)

Extremely useful

Very useful

Moderately useful

Somewhat useful

Not useful at all

Do not use at all

I am not a prescriber

Question Title

18. How comfortable do you feel in discussing with your patient that a recommendation not to use a given medication during pregnancy is often due to the lack of data (as opposed to evidence of harm to the fetus (particularly malformations))? (Required.)

0=not comfortable, 10=very comfortable

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

19. How likely are you to stop any ongoing treatment in patients with rheumatic diseases if the patient information leaflet states that the drug is NOT safe during pregnancy, but the clinical guidance states the drug IS compatible with pregnancy? (Required.)

Very likely

Likely

Neutral

Unlikely

Very unlikely

Not applicable/does not apply to my practice

Question Title

20. In your experience, how likely is it that a patient stops taking a medication if the Summary of Product Characteristics (SmPC) or patient information leaflet states that the drug may be associated with "a small increased risk of major malformations and should not be used during pregnancy unless your doctor considers the benefits outweigh the risk"? (Required.)

0=not like to stop, 10=very likely to stop

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

21. In your experience, how often do patients express concerns or worries when you inform them about a discrepancy between a medication patient leaflet and your advice (i.e. the leaflet states that the drug is not safe but you wish to prescribe the drug for maternal disease control)? (Required.)

Very frequently

Frequently

Occasionally

Rarely

Never

Question Title

22. How do you typically address patient concerns or worries when dealing with conflicting information between the clinical guidelines and the Summary of Product Characteristics (SmPC) or patient information leaflet? (Required.)

Provide clear explanations and reassurance based on the clinical guidelines

Engage in shared decision-making, involving the patient in the decision-making process

Refer the patient to a specialist or a multidisciplinary team for further consultation

Offer additional resources or educational materials to help the patient make informed decisions

Other (please specify)

Question Title

23. In your experience, how does the existence of conflicting information between the clinical guidelines and the Summary of Product Characteristics (SmPC) or patient information leaflet impact the patient-doctor relationship? (Required.)

It enhances trust and strengthens the patient-doctor relationship

It causes confusion and tension in the patient-doctor relationship

It has no significant impact on the patient-doctor relationship

Other (please specify)

Question Title

24. In your experience, how does conflicting information between different health care specialties or health care providers impact the patient-doctor relationship? (Required.)

It enhances trust and strengthens the patient-doctor relationship

It causes confusion and tension in the patient-doctor relationship

It has no significant impact on the patient-doctor relationship

Other (please specify)

The PRAISE surveyPerception of doctors and health care professionals Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives

Question Title

* 1. What is your gender? (Required.)

Question Title

* 2. What is your age? (Required.)

Question Title

* 3. State your profession (Required.)

Question Title

* 4. In which country do you currently practice? (Required.)

Question Title

* 5. What is your specialty? (Required.)

Question Title

* 6. How many years have you been practicing? (Required.)

Question Title

* 7. Do you give advice on anti-rheumatic medications in patients who are planning pregnancy, are pregnant or lactating? (Required.)

Question Title

* 8. How many patients who are planning pregnancy, are pregnant or lactate do you advise on average per month? (Required.)

Question Title

* 9. Do you prescribe anti-rheumatic medications in patients who are planning pregnancy, are pregnant or lactating? (Required.)

Question Title

* 10. In how many women who are planning pregnancy, are pregnant or lactate do you prescribe on average per month? (Required.)

Question Title

* 11. Do you feel overall comfortable on advising and/or prescribing antirheumatics in patients who are planning pregnancy, are pregnant or lactating? (Required.)

Question Title

* 12. How comfortable are you in advising patients with rheumatic diseases on the use of anti-rheumatic medications during pregnancy and fertility planning? (Required.)

Question Title

* 13. How comfortable do you feel in discussing with your patient that maternal disease control (and subsequent medication use in pregnancy) is detrimental for fetal wellbeing and pregnancy outcome? (Required.)

Question Title

* 14. How frequently do you discuss your patients or collaborate with other medical specialties (e.g. obstetrics, gynecology) when managing patients with rheumatic diseases during pregnancy and fertility planning? (Required.)

Question Title

* 15. Do you use clinical guideline documents on medication use in pregnancy (such as EULAR, ACR, BSR etc.)? (Required.)

Question Title

* 16. Which guidance document do you use most frequently? (Required.)

Question Title

* 17. How useful do you find the clinical guidance for the safe prescribing of anti-rheumatic drugs in patients with rheumatic diseases during pregnancy and fertility planning? (Required.)

Question Title

* 18. How comfortable do you feel in discussing with your patient that a recommendation not to use a given medication during pregnancy is often due to the lack of data (as opposed to evidence of harm to the fetus (particularly malformations))? (Required.)

Question Title

* 19. How likely are you to stop any ongoing treatment in patients with rheumatic diseases if the patient information leaflet states that the drug is NOT safe during pregnancy, but the clinical guidance states the drug IS compatible with pregnancy? (Required.)

Question Title

Question Title

* 21. In your experience, how often do patients express concerns or worries when you inform them about a discrepancy between a medication patient leaflet and your advice (i.e. the leaflet states that the drug is not safe but you wish to prescribe the drug for maternal disease control)? (Required.)

Question Title

* 22. How do you typically address patient concerns or worries when dealing with conflicting information between the clinical guidelines and the Summary of Product Characteristics (SmPC) or patient information leaflet? (Required.)

Question Title

* 23. In your experience, how does the existence of conflicting information between the clinical guidelines and the Summary of Product Characteristics (SmPC) or patient information leaflet impact the patient-doctor relationship? (Required.)

Question Title

* 24. In your experience, how does conflicting information between different health care specialties or health care providers impact the patient-doctor relationship? (Required.)

The PRAISE survey

Perception of doctors and health care professionals Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives

1. What is your gender? (Required.)

2. What is your age? (Required.)

3. State your profession (Required.)

4. In which country do you currently practice? (Required.)

5. What is your specialty? (Required.)

6. How many years have you been practicing? (Required.)

7. Do you give advice on anti-rheumatic medications in patients who are planning pregnancy, are pregnant or lactating? (Required.)

8. How many patients who are planning pregnancy, are pregnant or lactate do you advise on average per month? (Required.)

9. Do you prescribe anti-rheumatic medications in patients who are planning pregnancy, are pregnant or lactating? (Required.)

10. In how many women who are planning pregnancy, are pregnant or lactate do you prescribe on average per month? (Required.)

11. Do you feel overall comfortable on advising and/or prescribing antirheumatics in patients who are planning pregnancy, are pregnant or lactating? (Required.)

12. How comfortable are you in advising patients with rheumatic diseases on the use of anti-rheumatic medications during pregnancy and fertility planning? (Required.)

13. How comfortable do you feel in discussing with your patient that maternal disease control (and subsequent medication use in pregnancy) is detrimental for fetal wellbeing and pregnancy outcome? (Required.)

14. How frequently do you discuss your patients or collaborate with other medical specialties (e.g. obstetrics, gynecology) when managing patients with rheumatic diseases during pregnancy and fertility planning? (Required.)

15. Do you use clinical guideline documents on medication use in pregnancy (such as EULAR, ACR, BSR etc.)? (Required.)

16. Which guidance document do you use most frequently? (Required.)

17. How useful do you find the clinical guidance for the safe prescribing of anti-rheumatic drugs in patients with rheumatic diseases during pregnancy and fertility planning? (Required.)

18. How comfortable do you feel in discussing with your patient that a recommendation not to use a given medication during pregnancy is often due to the lack of data (as opposed to evidence of harm to the fetus (particularly malformations))? (Required.)

19. How likely are you to stop any ongoing treatment in patients with rheumatic diseases if the patient information leaflet states that the drug is NOT safe during pregnancy, but the clinical guidance states the drug IS compatible with pregnancy? (Required.)

21. In your experience, how often do patients express concerns or worries when you inform them about a discrepancy between a medication patient leaflet and your advice (i.e. the leaflet states that the drug is not safe but you wish to prescribe the drug for maternal disease control)? (Required.)

22. How do you typically address patient concerns or worries when dealing with conflicting information between the clinical guidelines and the Summary of Product Characteristics (SmPC) or patient information leaflet? (Required.)

23. In your experience, how does the existence of conflicting information between the clinical guidelines and the Summary of Product Characteristics (SmPC) or patient information leaflet impact the patient-doctor relationship? (Required.)

24. In your experience, how does conflicting information between different health care specialties or health care providers impact the patient-doctor relationship? (Required.)