Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital
Abstract Background Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries. Met...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05363-5 |
| _version_ | 1797945699931783168 |
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| author | Namratha Atluri Titus K. Beyuo Samuel A. Oppong Sarah D. Compton Cheryl A. Moyer Emma R. Lawrence |
| author_facet | Namratha Atluri Titus K. Beyuo Samuel A. Oppong Sarah D. Compton Cheryl A. Moyer Emma R. Lawrence |
| author_sort | Namratha Atluri |
| collection | DOAJ |
| description | Abstract Background Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries. Methods This cross-sectional mixed methods study evaluated obstetric doctors’ perspectives on the benefits of and barriers to the implementation of home blood pressure monitoring among pregnant women in Ghana. Participants were doctors providing obstetric care at Korle Bu Teaching Hospital. Electronic surveys were completed by 75 participants (response rate 49.3%), consisting of demographics and questions on attitudes and perceived benefits and challenges of home BP monitoring. Semi-structured interviews were completed by 22 participants to expand on their perspectives. Results Quantitative and qualitative results converged to highlight that the current state of blood pressure monitoring among pregnant women in Ghana is inadequate. The majority agreed that delayed diagnosis of preeclampsia leads to poor health outcomes in their patients (90.6%, n = 68) and earlier detection would improve outcomes (98.7%, n = 74). Key qualitative benefits to the adoption of home blood pressure monitoring were patient empowerment and trust of diagnosis, more quantity and quality of blood pressure data, and improvement in systems-level efficiency. The most significant barriers were the cost of monitors, lack of a communication system to convey abnormal values, and low health literacy. Overall, doctors felt that most barriers could be overcome with patient education and counseling, and that benefits far outweighed barriers. The majority of doctors (81.3%, n = 61), would use home BP data to inform their clinical decisions and 89% (n = 67) would take immediate action based on elevated home BP values. 91% (n = 68) would recommend home BP monitoring to their pregnant patients. Conclusion Obstetric doctors in Ghana strongly support the implementation of home blood pressure monitoring, would use values to inform their clinical management, and believe it would improve patient outcomes. Addressing the most significant barriers, including cost of blood pressure monitors, lack of a communication system to convey abnormal values, and need for patient education, is essential for successful implementation. |
| first_indexed | 2024-04-10T20:59:15Z |
| format | Article |
| id | doaj.art-ce1b32580abe40f7ad84067c8a6f3271 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-10T20:59:15Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-ce1b32580abe40f7ad84067c8a6f32712023-01-22T12:28:13ZengBMCBMC Pregnancy and Childbirth1471-23932023-01-0123111110.1186/s12884-023-05363-5Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospitalNamratha Atluri0Titus K. Beyuo1Samuel A. Oppong2Sarah D. Compton3Cheryl A. Moyer4Emma R. Lawrence5University of Michigan Medical SchoolDepartment of Obstetrics and Gynaecology, University of Ghana Medical SchoolDepartment of Obstetrics and Gynaecology, University of Ghana Medical SchoolDepartment of Obstetrics and Gynecology, University of MichiganDepartment of Obstetrics and Gynecology, University of MichiganDepartment of Obstetrics and Gynecology, University of MichiganAbstract Background Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries. Methods This cross-sectional mixed methods study evaluated obstetric doctors’ perspectives on the benefits of and barriers to the implementation of home blood pressure monitoring among pregnant women in Ghana. Participants were doctors providing obstetric care at Korle Bu Teaching Hospital. Electronic surveys were completed by 75 participants (response rate 49.3%), consisting of demographics and questions on attitudes and perceived benefits and challenges of home BP monitoring. Semi-structured interviews were completed by 22 participants to expand on their perspectives. Results Quantitative and qualitative results converged to highlight that the current state of blood pressure monitoring among pregnant women in Ghana is inadequate. The majority agreed that delayed diagnosis of preeclampsia leads to poor health outcomes in their patients (90.6%, n = 68) and earlier detection would improve outcomes (98.7%, n = 74). Key qualitative benefits to the adoption of home blood pressure monitoring were patient empowerment and trust of diagnosis, more quantity and quality of blood pressure data, and improvement in systems-level efficiency. The most significant barriers were the cost of monitors, lack of a communication system to convey abnormal values, and low health literacy. Overall, doctors felt that most barriers could be overcome with patient education and counseling, and that benefits far outweighed barriers. The majority of doctors (81.3%, n = 61), would use home BP data to inform their clinical decisions and 89% (n = 67) would take immediate action based on elevated home BP values. 91% (n = 68) would recommend home BP monitoring to their pregnant patients. Conclusion Obstetric doctors in Ghana strongly support the implementation of home blood pressure monitoring, would use values to inform their clinical management, and believe it would improve patient outcomes. Addressing the most significant barriers, including cost of blood pressure monitors, lack of a communication system to convey abnormal values, and need for patient education, is essential for successful implementation.https://doi.org/10.1186/s12884-023-05363-5PreeclampsiaEclampsiaLMICSub-Saharan AfricaHome monitoringPatient monitoring |
| spellingShingle | Namratha Atluri Titus K. Beyuo Samuel A. Oppong Sarah D. Compton Cheryl A. Moyer Emma R. Lawrence Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital BMC Pregnancy and Childbirth Preeclampsia Eclampsia LMIC Sub-Saharan Africa Home monitoring Patient monitoring |
| title | Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital |
| title_full | Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital |
| title_fullStr | Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital |
| title_full_unstemmed | Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital |
| title_short | Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital |
| title_sort | benefits and barriers of home blood pressure monitoring in pregnancy perspectives of obstetric doctors from a ghanaian tertiary hospital |
| topic | Preeclampsia Eclampsia LMIC Sub-Saharan Africa Home monitoring Patient monitoring |
| url | https://doi.org/10.1186/s12884-023-05363-5 |
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