Online medication purchasing behaviour in pregnancy: a structured review of the literature

Background: When deciding to purchase medication online a pregnant woman has to negotiate a complex health system that involves concerns regarding risk, safety and responsibility for the baby along with her own needs. Research is required to determine what modifiable factors influence a pregnant women’s behaviour with regard to the purchasing of medications online. Research question: What modifiable factors influence a pregnant woman’s intention to purchase medication online? Methods: A structured review of the literature was completed using the 12-step approach described by Kable et al (2012). PRISMA guidelines were followed to ensure credibility and transparency in the review. A systematic search of the literature was carried out on eight databases including: MEDLINE (OVID), CINAHL Plus, PsycINFO, Web of Science, Scopus, Google Scholar, EtHOS and PROSPERO. Inclusion criteria were primary quantitative, qualitative, mixed method studies or literature reviews, having been published in peer review journals between January 2007 to January 2018 in English. The population was pregnant women, and the outcomes of interest were the modifiable factors that influence intention to purchase medication online. Quality appraisal of the retrieved papers was assessed using the Joanna Briggs Checklists for Analytical Cross Sectional Studies, Qualitative Studies and Diagnostic Test Accuracy. Findings: The search of the databases retrieved 4150 papers. Only four papers were eligible for inclusion in the review. Themes of medication safety, online purchasing of medication and the mother’s relationship with healthcare professionals were identified. Sub themes included attitudes towards taking medication, safety of the unborn baby, risks of online medication purchasing, advertising factors, customer reviews, changing dynamic of the doctor/patient relationship, and ability to bypass medical consultation. Conclusion: There is a definitive lack of empirical studies in this field and further qualitative and quantitative research is needed. Implications for practice: Midwives and healthcare professionals need to be aware that pregnant women are purchasing medications online.