Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey

Background: Treating rheumatic musculoskeletal diseases (RMDs) during pregnancy and breastfeeding presents significant complexities, mainly due to inconsistencies between the clinical guidance documents and the reference safety information, including the summary of product characteristics (SmPC) and...

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Main Authors: Karen Schreiber, Christine Graversgaard, Ioannis Parodis, Nancy Agmon-Levin, Silvia Aguilera, Aleksandra Antovic, George K. Bertsias, Ilaria Bini, Anca Bobirca, Susana Capela, Ricard Cervera, Nathalie Costedoat-Chalumeau, Radboud Dolhain, Oseme Etomi, Julia Flint, Joao Eurico Fonseca, Ruth Fritsch-Stork, Frauke Förger, Ian Giles, Bethan Goulden, Carina Götestam Skorpen, Iva Gunnarsson, Latika Gupta, Hege Svean Koksvik, Louise Linde, Jacob Lykke, Yvette Meissner, Anna Molto, Louise Moore, Marta Mosca, Catherine Nelson-Piercy, Luis Fernando Perez-Garcia, Luigi Raio, Ane Lilleoere Rom, Amihai Rottenstreich, Muna Saleh, Savino Sciascia, Anja Strangfeld, Elisabet Svenungsson, Maria G. Tektonidou, Angela Tincani, Anne Troldborg, Jelena Vojinovic, Anne Voss, Marianne Wallenius, Nuria Zuniga-Serrano, Laura Andreoli
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Therapeutic Advances in Musculoskeletal Disease
Online Access:https://doi.org/10.1177/1759720X251350087
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author Karen Schreiber
Christine Graversgaard
Ioannis Parodis
Nancy Agmon-Levin
Silvia Aguilera
Aleksandra Antovic
George K. Bertsias
Ilaria Bini
Anca Bobirca
Susana Capela
Ricard Cervera
Nathalie Costedoat-Chalumeau
Radboud Dolhain
Oseme Etomi
Julia Flint
Joao Eurico Fonseca
Ruth Fritsch-Stork
Frauke Förger
Ian Giles
Bethan Goulden
Carina Götestam Skorpen
Iva Gunnarsson
Latika Gupta
Hege Svean Koksvik
Louise Linde
Jacob Lykke
Yvette Meissner
Anna Molto
Louise Moore
Marta Mosca
Catherine Nelson-Piercy
Luis Fernando Perez-Garcia
Luigi Raio
Ane Lilleoere Rom
Amihai Rottenstreich
Muna Saleh
Savino Sciascia
Anja Strangfeld
Elisabet Svenungsson
Maria G. Tektonidou
Angela Tincani
Anne Troldborg
Jelena Vojinovic
Anne Voss
Marianne Wallenius
Nuria Zuniga-Serrano
Laura Andreoli
author_facet Karen Schreiber
Christine Graversgaard
Ioannis Parodis
Nancy Agmon-Levin
Silvia Aguilera
Aleksandra Antovic
George K. Bertsias
Ilaria Bini
Anca Bobirca
Susana Capela
Ricard Cervera
Nathalie Costedoat-Chalumeau
Radboud Dolhain
Oseme Etomi
Julia Flint
Joao Eurico Fonseca
Ruth Fritsch-Stork
Frauke Förger
Ian Giles
Bethan Goulden
Carina Götestam Skorpen
Iva Gunnarsson
Latika Gupta
Hege Svean Koksvik
Louise Linde
Jacob Lykke
Yvette Meissner
Anna Molto
Louise Moore
Marta Mosca
Catherine Nelson-Piercy
Luis Fernando Perez-Garcia
Luigi Raio
Ane Lilleoere Rom
Amihai Rottenstreich
Muna Saleh
Savino Sciascia
Anja Strangfeld
Elisabet Svenungsson
Maria G. Tektonidou
Angela Tincani
Anne Troldborg
Jelena Vojinovic
Anne Voss
Marianne Wallenius
Nuria Zuniga-Serrano
Laura Andreoli
author_sort Karen Schreiber
collection DOAJ
description Background: Treating rheumatic musculoskeletal diseases (RMDs) during pregnancy and breastfeeding presents significant complexities, mainly due to inconsistencies between the clinical guidance documents and the reference safety information, including the summary of product characteristics (SmPC) and the patient information leaflets (PIL). Objectives: To assess healthcare professionals’ (HCPs) prescribing behaviors, comfort levels, and challenges when advising patients, focusing on discrepancies between clinical guidance documents and SmPC/PIL. Design: Online survey entitled PRAISE (Perception of healthcare providers Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives) and disseminated through HCPs groups and social media. Methods: A cross-sectional survey was conducted among 414 HCPs globally. Respondents were divided into prescribers ( n  = 336) and non-prescribers ( n  = 78) based on their self-reported role in prescribing antirheumatic medications to pregnant or breastfeeding patients with RMDs. The survey covered demographics, clinical experience, confidence in prescribing, use of clinical guidelines, and experiences managing conflicting information between guidelines and SmPC/PIL. Results: Prescribers were more likely than non-prescribers to feel comfortable discussing medication safety during pregnancy. Most prescribers found clinical guidance documents useful, with 48% rating them as “very useful” and 38% as “extremely useful.” In case of conflicting information between clinical guidance documents and SmPC/PIL, 58% of HCPs reported that it caused confusion and tension in patient–doctor relationships, and almost 20% of them are “likely” or “very likely” to discontinue ongoing treatment. Clear communication and shared decision-making were the most common strategies used to address patient concerns. Conclusion: HCPs often face significant challenges when advising patients with RMDs on the use of medications during pregnancy and breastfeeding. Conflicting information between clinical guidance documents and SmPC/PIL can disrupt patient–doctor relationship and lead to treatment discontinuation, with potential consequences on maternal disease control. Improved alignment between clinical guidance documents and the SmPC/PIL could enhance patient care and prevent confusion among HCPs and patients.
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spelling doaj-art-6e4d765c4b29498c9f685862d98b40fc2025-08-20T03:50:39ZengSAGE PublishingTherapeutic Advances in Musculoskeletal Disease1759-72182025-07-011710.1177/1759720X251350087Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE surveyKaren SchreiberChristine GraversgaardIoannis ParodisNancy Agmon-LevinSilvia AguileraAleksandra AntovicGeorge K. BertsiasIlaria BiniAnca BobircaSusana CapelaRicard CerveraNathalie Costedoat-ChalumeauRadboud DolhainOseme EtomiJulia FlintJoao Eurico FonsecaRuth Fritsch-StorkFrauke FörgerIan GilesBethan GouldenCarina Götestam SkorpenIva GunnarssonLatika GuptaHege Svean KoksvikLouise LindeJacob LykkeYvette MeissnerAnna MoltoLouise MooreMarta MoscaCatherine Nelson-PiercyLuis Fernando Perez-GarciaLuigi RaioAne Lilleoere RomAmihai RottenstreichMuna SalehSavino SciasciaAnja StrangfeldElisabet SvenungssonMaria G. TektonidouAngela TincaniAnne TroldborgJelena VojinovicAnne VossMarianne WalleniusNuria Zuniga-SerranoLaura AndreoliBackground: Treating rheumatic musculoskeletal diseases (RMDs) during pregnancy and breastfeeding presents significant complexities, mainly due to inconsistencies between the clinical guidance documents and the reference safety information, including the summary of product characteristics (SmPC) and the patient information leaflets (PIL). Objectives: To assess healthcare professionals’ (HCPs) prescribing behaviors, comfort levels, and challenges when advising patients, focusing on discrepancies between clinical guidance documents and SmPC/PIL. Design: Online survey entitled PRAISE (Perception of healthcare providers Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives) and disseminated through HCPs groups and social media. Methods: A cross-sectional survey was conducted among 414 HCPs globally. Respondents were divided into prescribers ( n  = 336) and non-prescribers ( n  = 78) based on their self-reported role in prescribing antirheumatic medications to pregnant or breastfeeding patients with RMDs. The survey covered demographics, clinical experience, confidence in prescribing, use of clinical guidelines, and experiences managing conflicting information between guidelines and SmPC/PIL. Results: Prescribers were more likely than non-prescribers to feel comfortable discussing medication safety during pregnancy. Most prescribers found clinical guidance documents useful, with 48% rating them as “very useful” and 38% as “extremely useful.” In case of conflicting information between clinical guidance documents and SmPC/PIL, 58% of HCPs reported that it caused confusion and tension in patient–doctor relationships, and almost 20% of them are “likely” or “very likely” to discontinue ongoing treatment. Clear communication and shared decision-making were the most common strategies used to address patient concerns. Conclusion: HCPs often face significant challenges when advising patients with RMDs on the use of medications during pregnancy and breastfeeding. Conflicting information between clinical guidance documents and SmPC/PIL can disrupt patient–doctor relationship and lead to treatment discontinuation, with potential consequences on maternal disease control. Improved alignment between clinical guidance documents and the SmPC/PIL could enhance patient care and prevent confusion among HCPs and patients.https://doi.org/10.1177/1759720X251350087
spellingShingle Karen Schreiber
Christine Graversgaard
Ioannis Parodis
Nancy Agmon-Levin
Silvia Aguilera
Aleksandra Antovic
George K. Bertsias
Ilaria Bini
Anca Bobirca
Susana Capela
Ricard Cervera
Nathalie Costedoat-Chalumeau
Radboud Dolhain
Oseme Etomi
Julia Flint
Joao Eurico Fonseca
Ruth Fritsch-Stork
Frauke Förger
Ian Giles
Bethan Goulden
Carina Götestam Skorpen
Iva Gunnarsson
Latika Gupta
Hege Svean Koksvik
Louise Linde
Jacob Lykke
Yvette Meissner
Anna Molto
Louise Moore
Marta Mosca
Catherine Nelson-Piercy
Luis Fernando Perez-Garcia
Luigi Raio
Ane Lilleoere Rom
Amihai Rottenstreich
Muna Saleh
Savino Sciascia
Anja Strangfeld
Elisabet Svenungsson
Maria G. Tektonidou
Angela Tincani
Anne Troldborg
Jelena Vojinovic
Anne Voss
Marianne Wallenius
Nuria Zuniga-Serrano
Laura Andreoli
Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey
Therapeutic Advances in Musculoskeletal Disease
title Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey
title_full Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey
title_fullStr Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey
title_full_unstemmed Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey
title_short Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey
title_sort impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding perspectives of healthcare providers from the global praise survey
url https://doi.org/10.1177/1759720X251350087
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