PMID- 33262186
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20240330
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 10
IP  - 12
DP  - 2020 Dec 1
TI  - Exploring the potential for introducing home monitoring of blood pressure during 
      pregnancy into maternity care: current views and experiences of staff-a 
      qualitative study.
PG  - e037874
LID - 10.1136/bmjopen-2020-037874 [doi]
LID - e037874
AB  - OBJECTIVE: One in 20 women are affected by pre-eclampsia, a major cause of 
      maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis 
      is made from monitoring blood pressure (BP) and urine and symptoms at antenatal 
      visits after 20 weeks of pregnancy. There are no randomised data from 
      contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in 
      pregnancy. We explored the perspectives of maternity staff to understand the 
      context and health system challenges to introducing and implementing SMBP in 
      maternity care, ahead of undertaking a trial. DESIGN: Exploratory study using a 
      qualitative approach. SETTING: Eight hospitals, English National Health Service. 
      PARTICIPANTS: Obstetricians, community and hospital midwives, pharmacists, 
      trainee doctors (n=147). METHODS: Semi-structured interviews with site research 
      team members and clinicians, interviews and focus group discussions. Rapid 
      content and thematic analysis undertaken. RESULTS: The main themes to emerge 
      around SMBP include (1) different BP changes in pregnancy, (2) reliability and 
      accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) 
      anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty 
      and evidence, (6) concerns over action/inaction and patient safety. CONCLUSIONS: 
      The potential impact of SMBP on maternity services is profound although nuanced. 
      While introducing SMBP does not reduce the responsibility clinicians have for 
      women's health, it may enhance the responsibilities and agency of pregnant women, 
      and introduces a new set of relationships into maternity care. This is a new 
      space for reconfiguration of roles, mutual expectations and the relationships 
      between and responsibilities of healthcare providers and women. TRIAL 
      REGISTRATION NUMBER: NCT03334149.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published 
      by BMJ.
FAU - Hinton, Lisa
AU  - Hinton L
AUID- ORCID: 0000-0002-6082-3151
AD  - THIS Institute, Department of Public Health and Primary Care, University of 
      Cambridge, Cambridge, UK lisa.hinton@thisinstitute.cam.ac.uk.
FAU - Hodgkinson, James
AU  - Hodgkinson J
AUID- ORCID: 0000-0002-7583-5278
AD  - Primary Care Clinical Sciences, Institute of Applied Health Research, University 
      of Birmingham, Birmingham, UK.
FAU - Tucker, Katherine L
AU  - Tucker KL
AUID- ORCID: 0000-0001-6544-8066
AD  - Nuffield Department of Primary Care Health Sciences, University of Oxford, 
      Oxford, UK.
FAU - Rozmovits, Linda
AU  - Rozmovits L
AD  - Freelance Researcher, Montreal, Quebec, Canada.
FAU - Chappell, Lucy
AU  - Chappell L
AD  - Women's Health Academic Centre, King's College, London, UK.
FAU - Greenfield, Sheila
AU  - Greenfield S
AD  - Primary Care Clinical Sciences, Institute of Applied Health Research, University 
      of Birmingham, Birmingham, UK.
FAU - McCourt, Christine
AU  - McCourt C
AD  - Department of Midwifery and Child Health, City University of London, London, UK.
FAU - Sandall, Jane
AU  - Sandall J
AD  - Department of Women and Children's Health, Kings College, London, UK.
FAU - McManus, Richard J
AU  - McManus RJ
AUID- ORCID: 0000-0003-3638-028X
AD  - Nuffield Department of Primary Care Health Sciences, University of Oxford, 
      Oxford, UK.
LA  - eng
SI  - ClinicalTrials.gov/NCT03334149
GR  - NIHR-RP-02-12-015/DH_/Department of Health/United Kingdom
GR  - RP-2014-05-019/DH_/Department of Health/United Kingdom
PT  - Clinical Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201201
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Blood Pressure
MH  - Female
MH  - Humans
MH  - *Maternal Health Services
MH  - *Obstetrics
MH  - Pregnancy
MH  - Qualitative Research
MH  - Reproducibility of Results
MH  - State Medicine
PMC - PMC7709507
OTO - NOTNLM
OT  - hypertension
OT  - maternal medicine
OT  - organisation of health services
OT  - qualitative research
COIS- Competing interests: RJM has received BP monitors for research from Omron.
EDAT- 2020/12/03 06:00
MHDA- 2021/05/15 06:00
PMCR- 2020/12/01
CRDT- 2020/12/02 05:25
PHST- 2020/12/02 05:25 [entrez]
PHST- 2020/12/03 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/12/01 00:00 [pmc-release]
AID - bmjopen-2020-037874 [pii]
AID - 10.1136/bmjopen-2020-037874 [doi]
PST - epublish
SO  - BMJ Open. 2020 Dec 1;10(12):e037874. doi: 10.1136/bmjopen-2020-037874.