Evaluation of folic acid supplementation guidelines in Mexico 2012-2013: Prevalence of missed-opportunities of folic acid intake

Author (s): 

Dra. Lenny Navarrete-Martínez, Dr. Cutberto Espinosa-López, and Dr. Fernando Meneses-González

Background: Every time a reproductive aged woman attends to a medical consult, it represents an opportunity to recommend folic acid intake. In Mexico, physicians must know and apply the norm “NOM-043-SSA2-2002, for congenital defects prevention and control.”

Objective:To measure missed-opportunities of folic acid intake in women attending obstetric consult in Mexico City’s and State of Mexico’s primary health care centers during 2012-2013.

Method:

·         Design: Cross sectional study.

·         Study Population: Reproductive aged women, physicians and pharmacies.

·         Data Collection: Questionnaire for women,  NOM-034 questionnaire for physicians, and sufficiency checklist for pharmacies.

Results: Only .3% of the patients received folic acid in the correct periconceptional period.  99.7% of missed opportunities.

Conclusions:

·         Most of the patients know that they must take folic acid during gestation.

·         Intake indication, dose and treatment time are not registered in medical records.

·         Most of the physicians know folic acid importance for neural tube defects prevention.

·         Physicians do not explain folic acid intake benefits for neural tube defects prevention.

·         Folic acid is indicated in most of the medical consults, without considering periconceptional period.

·         Poor neural tube defect risk classification by physicians.

·         Dose and administration time are not always correct.

·         Folic acid is sufficient in 61.9% of the pharmacies.

·         The 5 mg presentation is rarely distributed. 

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