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ORGANIZATION OF ORGANIZATION OF TERATOLOGY INFORMATION TERATOLOGY INFORMATION
SPECIALISTSSPECIALISTS
Sharon Voyer Lavigne, MSSharon Voyer Lavigne, MSCoordinator, CT Pregnancy Exposure Coordinator, CT Pregnancy Exposure
Information ServiceInformation ServicePresident, OTISPresident, OTIS
North American Network of North American Network of Telephone ServicesTelephone Services
– Based in universities, hospitals and health Based in universities, hospitals and health departmentsdepartments
– 18 sites throughout U.S. and Canada18 sites throughout U.S. and Canada– Provide services to approximately 100,000 Provide services to approximately 100,000
women or health care providers each year women or health care providers each year – Pregnancy and breastfeeding exposuresPregnancy and breastfeeding exposures
Teratology Information Services Teratology Information Services (TIS(TIS))
Comprehensive multidisciplinary resources
Access to numerous specialists in:- teratology, dysmorphology, - toxicology, pharmacology, - epidemiology, infectious diseases,- clinical genetics, obstetric / maternal fetal medicine,- radiation biology, occupational and environmental
health
No cost services available to health-care providers and patients
Organization of Teratology Organization of Teratology Information SpecialistsInformation Specialists
Health care providers including:Health care providers including:– Genetic counselorsGenetic counselors– PhysiciansPhysicians– NursesNurses– Public health educatorsPublic health educators– PharmacistsPharmacists– Social workersSocial workers– Other specialtiesOther specialties
TIS’s ProvideTIS’s Provide
ServiceService – Toll-free phone consultation to – Toll-free phone consultation to patients or health care providers about patients or health care providers about exposures during pregnancyexposures during pregnancy
EducationEducation – to public and academic groups, – to public and academic groups, including medical, nursing, genetic counseling, including medical, nursing, genetic counseling, pharmacy and otherspharmacy and others
ResearchResearch – collaborative projects looking at – collaborative projects looking at outcomes of exposures to specific agentsoutcomes of exposures to specific agents
SERVICESERVICE
Telephone or in-person consultations that Telephone or in-person consultations that are free-of-charge and confidentialare free-of-charge and confidential
Current data and risk assessmentCurrent data and risk assessment
Information to help women make informed Information to help women make informed reproductive choicesreproductive choices
Who calls a TIS:Who calls a TIS:
CALLER PROFILE:CALLER PROFILE:
Patients Patients 47% 47%
Health Care Providers 46%Health Care Providers 46%
Relatives Relatives 4%4%
General Public General Public 2% 2%
Breastfeeding Mothers 1% Breastfeeding Mothers 1%
1%2% 4%
47% 46%
Common Exposures:Common Exposures:
MedicationsMedications 58%58%
Occupational AgentsOccupational Agents 17%17%
Environmental AgentsEnvironmental Agents 8% 8%
Drugs of AbuseDrugs of Abuse 6% 6%
Maternal IllnessMaternal Illness 4% 4%
Herbal ProductsHerbal Products 4% 4%
RadiationRadiation 3% 3%
58%
17%
8%
6%
4%4%3%
Reproductive Status:Reproductive Status:
PregnancyPregnancy 74%74%
PreconceptionPreconception9%9%
BreastfeedingBreastfeeding8%8%
Not specifiedNot specified 6%6%
Paternal questionPaternal question 3%3%
3% 6%
8%
9%
74%
Developing a Risk AssessmentDeveloping a Risk Assessment
Essential information:Essential information:– TimingTiming– DoseDose– Family, medical and pregnancy historyFamily, medical and pregnancy history– Other exposuresOther exposures
Literature ReviewLiterature Review
Databases – REPROTOX, TERIS, Databases – REPROTOX, TERIS, Reprotext, Shepard’s CatalogReprotext, Shepard’s Catalog
Books – Briggs, Gleicher, Shardein, HaleBooks – Briggs, Gleicher, Shardein, Hale
Drug Compendiums, PDR, PDR for HerbalsDrug Compendiums, PDR, PDR for Herbals
Journal articlesJournal articles
Providing a Risk AssessmentProviding a Risk Assessment
Collection of data on specific agentCollection of data on specific agent
Interpretation of data based on intake Interpretation of data based on intake informationinformation
Elicit callers’ knowledge and sourceElicit callers’ knowledge and source
Discuss 3-5% background riskDiscuss 3-5% background risk
Review risk vs. benefitReview risk vs. benefit
EDUCATIONEDUCATION
Public and health care provider workshops, Public and health care provider workshops, seminars or lecturesseminars or lectures
Student lectures (high school, college, etc)Student lectures (high school, college, etc)
Fact Sheets (Fact Sheets (http://www.otispregnancy.org/))
Professional educationProfessional education– Annual Education ConferenceAnnual Education Conference– OTIS/Teratology Society/NBTS Joint OTIS/Teratology Society/NBTS Joint
WorkshopsWorkshops
RESEARCHRESEARCH
Autoimmune Diseases in Pregnancy Autoimmune Diseases in Pregnancy
Discontinuation of Antidepressant Medication Discontinuation of Antidepressant Medication During PregnancyDuring Pregnancy
West Nile Virus and PregnancyWest Nile Virus and Pregnancy
Vaccinations in PregnancyVaccinations in Pregnancy
CDC Pilot ProjectCDC Pilot Project
Isotretinoin Pregnancy Prevention SurveyIsotretinoin Pregnancy Prevention Survey
OTIS and CDCOTIS and CDC
– Grant funding for annual OTIS Grant funding for annual OTIS educational conferenceeducational conference
– Hurricane Katrina ProjectHurricane Katrina Project– Pilot Project for a Pregnancy and Pilot Project for a Pregnancy and
Lactation Monitoring SystemLactation Monitoring System
www.otispregnancy.org
National Phone Number:(866) 626-OTIS(866) 626-6847