Teratogenic Medication Safety in Primary Care

Abstract

Childbearing age women are often prescribed teratogenic medication without pregnancy risk or contraceptive counseling. With a 45% unintended pregnancy rate, women are at risk of unintentional teratogenic fetal exposure. The TARCC framework created by Shroff, McNeil, and Borrero (2017), is an acronym that providers can use while prescribing medication to reduce the risk of teratogenic exposure. Ultimately, the increase in TARCC usage could lead to decreased teratogen prescription, increased birth control use while on a teratogen, and reductions in birth defects and elective abortion. The purpose of the Doctor of Nursing Practice project was to increase primary care provider knowledge and use of the TARCC framework at two urban clinics in NC. The project interventions consisted of provider education, TARCC reminder cards, weekly teratogen information emails, and TARCC checklists to use during patient visits. The outcomes of the project included an increase in provider self-reported competence in TARCC usage and an increased provider awareness of safe prescribing. Site A had an average of 16% (SD=6.9%) use of the TARCC checklist over ten weeks. Overall, it was recommended to place a practice advisory in the electronic health record to help providers prescribe safely.