Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic
<p><strong>Objective</strong></p> This study aimed to understand the views and practice of obstetricians regarding self-monitoring for hypertensive disorders of pregnancy (blood pressure (BP) and proteinuria), the potential for self-management (including actions taken on self...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2021
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| _version_ | 1797053909538177024 |
|---|---|
| author | Fletcher, B Chappell, LC Lavallee, L Wilson, HM Stevens, R Mackillop, L McManus, RJ Tucker, KL |
| author_facet | Fletcher, B Chappell, LC Lavallee, L Wilson, HM Stevens, R Mackillop, L McManus, RJ Tucker, KL |
| author_sort | Fletcher, B |
| collection | OXFORD |
| description | <p><strong>Objective</strong></p>
This study aimed to understand the views and practice of obstetricians regarding self-monitoring for hypertensive disorders of pregnancy (blood pressure (BP) and proteinuria), the potential for self-management (including actions taken on self-monitored parameters) and to understand the impact of the COVID-19 pandemic on such views.
<p><strong>Design</strong></p>
Cross-sectional online survey pre- and post- the first wave of the COVID-19 pandemic.
<p><strong>Setting and Sample</strong></p>
UK obstetricians recruited via an online portal.
<p><strong>Methods</strong></p>
A survey undertaken in two rounds: December 2019-January 2020 (pre-pandemic), and September-November 2020 (during pandemic)
<p><strong>Results</strong></p>
251 responses were received across rounds one (1 5 0) and two (1 0 1). Most obstetricians considered that self-monitoring of BP and home urinalysis had a role in guiding clinical decisions and this increased significantly following the first wave of the COVID-19 pandemic (88%, (132/150) 95%CI: 83–93% first round vs 96% (95%CI: 92–94%), (97/101), second round; p = 0.039). Following the pandemic, nearly half were agreeable to women self-managing their hypertension by using their own readings to make a pre-agreed medication change themselves (47%, 47/101 (95%CI: 37–57%)).
<p><strong>Conclusions</strong></p>
A substantial majority of UK obstetricians considered that self-monitoring had a role in the management of pregnancy hypertension and this increased following the pandemic. Around half are now supportive of women having a wider role in self-management of hypertensive treatment. Maximising the potential of such changes in pregnancy hypertension management requires further work to understand how to fully integrate women’s own measurements into clinical care. |
| first_indexed | 2024-03-06T18:50:10Z |
| format | Journal article |
| id | oxford-uuid:0ff54280-9df5-489e-8c92-acf28d0a2f88 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:50:10Z |
| publishDate | 2021 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:0ff54280-9df5-489e-8c92-acf28d0a2f882022-03-26T09:53:52ZChanges to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemicJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0ff54280-9df5-489e-8c92-acf28d0a2f88EnglishSymplectic ElementsElsevier2021Fletcher, BChappell, LCLavallee, LWilson, HMStevens, RMackillop, LMcManus, RJTucker, KL<p><strong>Objective</strong></p> This study aimed to understand the views and practice of obstetricians regarding self-monitoring for hypertensive disorders of pregnancy (blood pressure (BP) and proteinuria), the potential for self-management (including actions taken on self-monitored parameters) and to understand the impact of the COVID-19 pandemic on such views. <p><strong>Design</strong></p> Cross-sectional online survey pre- and post- the first wave of the COVID-19 pandemic. <p><strong>Setting and Sample</strong></p> UK obstetricians recruited via an online portal. <p><strong>Methods</strong></p> A survey undertaken in two rounds: December 2019-January 2020 (pre-pandemic), and September-November 2020 (during pandemic) <p><strong>Results</strong></p> 251 responses were received across rounds one (1 5 0) and two (1 0 1). Most obstetricians considered that self-monitoring of BP and home urinalysis had a role in guiding clinical decisions and this increased significantly following the first wave of the COVID-19 pandemic (88%, (132/150) 95%CI: 83–93% first round vs 96% (95%CI: 92–94%), (97/101), second round; p = 0.039). Following the pandemic, nearly half were agreeable to women self-managing their hypertension by using their own readings to make a pre-agreed medication change themselves (47%, 47/101 (95%CI: 37–57%)). <p><strong>Conclusions</strong></p> A substantial majority of UK obstetricians considered that self-monitoring had a role in the management of pregnancy hypertension and this increased following the pandemic. Around half are now supportive of women having a wider role in self-management of hypertensive treatment. Maximising the potential of such changes in pregnancy hypertension management requires further work to understand how to fully integrate women’s own measurements into clinical care. |
| spellingShingle | Fletcher, B Chappell, LC Lavallee, L Wilson, HM Stevens, R Mackillop, L McManus, RJ Tucker, KL Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic |
| title | Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic |
| title_full | Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic |
| title_fullStr | Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic |
| title_full_unstemmed | Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic |
| title_short | Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic |
| title_sort | changes to management of hypertension in pregnancy and attitudes to self management an online survey of obstetricians before and following the first wave of the covid 19 pandemic |
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