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Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study).
Eur J Obstet Gynecol Reprod Biol. 2016 Nov; 206:105-113.EJ

Abstract

OBJECTIVE

To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412).

DESIGN

Quantitative and qualitative analysis of questionnaire responses.

SETTING

International randomised trial (94 sites, 15 countries).

POPULATION/SAMPLE

911 (92.9%) women randomised to 'tight' (target diastolic blood pressure, 85mmHg) or 'less tight' (target diastolic blood pressure, 100mmHg) who completed questionnaires.

METHODS

A questionnaire was administered at ∼6-12 weeks postpartum regarding post-discharge morbidity and views about trial participation. Questionnaires were administered by the site co-ordinator, and contact was made by phone, home or clinic visit; rarely, data was collected from medical records. Quantitative analyses were Chi-square or Fisher's exact test for categorical variables, mixed effects multinomial logistic regression to adjust for confounders, and p<0.001 for statistical significance. NVivo software was used for thematic analysis of women's views.

MAIN OUTCOME MEASURES

Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend.

RESULTS

Among the 533 women in 'tight' (N=265) vs. 'less tight' (N=268) control who provided comments for qualitative analysis, women in 'tight' (vs. 'less tight') control made fewer positive comments about the amount of medication taken (5 vs. 28 women, respectively) and intensity of BP monitoring (7 vs. 17, respectively). However, this did not translate into less willingness to either have the same treatment in another pregnancy (434, 95.8% vs. 423, 92.4%, respectively; p=0.14) or recommend that treatment to a friend (435, 96.0% and 428, 93.4%, respectively; p=0.17). Importantly, although satisfaction remained high among women with an adverse outcome, those in 'tight' control who suffered an adverse outcome (vs. those who did not) were not consistently less satisfied, whereas this was not the case among women in 'less tight' control among whom satisfaction was consistently lower for the CHIPS primary outcome (p<0.001), severe hypertension (p≤0.01), and pre-eclampsia (p<0.001).

CONCLUSIONS

Women in 'tight' (vs. 'less tight') control were equally satisfied with their care, and more so in the face of adverse perinatal or maternal outcomes.

Authors+Show Affiliations

Obstetrics and Gynaecology, University of British Columbia, Canada.Medicine, University of British Columbia, Canada. Electronic address: LMagee@sgul.ac.uk.Medicine, University of British Columbia, Canada.Medicine and Obstetrics and Gynaecology, University of Montreal, Canada.Obstetrics and Gynaecology, University of Alberta, Canada.Pediatrics, University of Toronto, Canada; Obstetrics and Gynaecology, University of Toronto, Canada; The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Canada.Obstetrics and Gynaecology, University of Toronto, Canada; The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Canada.Medicine, University of British Columbia, Canada.The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Canada.School of Population and Public Health, University of British Columbia, Canada; Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Care Research Institute, UBC, Vancouver, Canada.Clinical Epidemiology and Biostatistics, McMaster University, Canada.Obstetrics and Gynaecology, University of Ottawa, Canada.Obstetrics and Gynaecology, University of Manitoba, Canada.Obstetrics and Gynaecology, McMaster University, Canada.Pediatrics, University of Toronto, Canada.Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Care Research Institute, UBC, Vancouver, Canada.Medicine, University of Toronto, Canada.Obstetrics and Gynaecology, University of Amsterdam, Netherlands.Obstetrics and Gynaecology, Derriford Hospital, United Kingdom.Obstetrics and Gynaecology, University of Nottingham, United Kingdom.Obstetrics and Gynaecology, Université de Sherbrooke, Canada.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

27665372

Citation

Vidler, Marianne, et al. "Women's Views and Postpartum Follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study)." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 206, 2016, pp. 105-113.
Vidler M, Magee LA, von Dadelszen P, et al. Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study). Eur J Obstet Gynecol Reprod Biol. 2016;206:105-113.
Vidler, M., Magee, L. A., von Dadelszen, P., Rey, E., Ross, S., Asztalos, E., Murphy, K. E., Menzies, J., Sanchez, J., Singer, J., Gafni, A., Gruslin, A., Helewa, M., Hutton, E., Lee, S. K., Lee, T., Logan, A. G., Ganzevoort, W., Welch, R., ... Moutquin, J. M. (2016). Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study). European Journal of Obstetrics, Gynecology, and Reproductive Biology, 206, 105-113. https://doi.org/10.1016/j.ejogrb.2016.07.509
Vidler M, et al. Women's Views and Postpartum Follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study). Eur J Obstet Gynecol Reprod Biol. 2016;206:105-113. PubMed PMID: 27665372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study). AU - Vidler,Marianne, AU - Magee,Laura A, AU - von Dadelszen,Peter, AU - Rey,Evelyne, AU - Ross,Susan, AU - Asztalos,Elizabeth, AU - Murphy,Kellie E, AU - Menzies,Jennifer, AU - Sanchez,Johanna, AU - Singer,Joel, AU - Gafni,Amiram, AU - Gruslin,Andrée, AU - Helewa,Michael, AU - Hutton,Eileen, AU - Lee,Shoo K, AU - Lee,Terry, AU - Logan,Alexander G, AU - Ganzevoort,Wessel, AU - Welch,Ross, AU - Thornton,Jim G, AU - Moutquin,Jean-Marie, AU - ,, Y1 - 2016/09/10/ PY - 2016/03/04/received PY - 2016/07/11/revised PY - 2016/07/26/accepted PY - 2016/9/26/pubmed PY - 2017/4/21/medline PY - 2016/9/26/entrez KW - Blood pressure control KW - Hypertension KW - Postpartum KW - Pregnancy KW - Satisfaction SP - 105 EP - 113 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 206 N2 - OBJECTIVE: To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). DESIGN: Quantitative and qualitative analysis of questionnaire responses. SETTING: International randomised trial (94 sites, 15 countries). POPULATION/SAMPLE: 911 (92.9%) women randomised to 'tight' (target diastolic blood pressure, 85mmHg) or 'less tight' (target diastolic blood pressure, 100mmHg) who completed questionnaires. METHODS: A questionnaire was administered at ∼6-12 weeks postpartum regarding post-discharge morbidity and views about trial participation. Questionnaires were administered by the site co-ordinator, and contact was made by phone, home or clinic visit; rarely, data was collected from medical records. Quantitative analyses were Chi-square or Fisher's exact test for categorical variables, mixed effects multinomial logistic regression to adjust for confounders, and p<0.001 for statistical significance. NVivo software was used for thematic analysis of women's views. MAIN OUTCOME MEASURES: Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. RESULTS: Among the 533 women in 'tight' (N=265) vs. 'less tight' (N=268) control who provided comments for qualitative analysis, women in 'tight' (vs. 'less tight') control made fewer positive comments about the amount of medication taken (5 vs. 28 women, respectively) and intensity of BP monitoring (7 vs. 17, respectively). However, this did not translate into less willingness to either have the same treatment in another pregnancy (434, 95.8% vs. 423, 92.4%, respectively; p=0.14) or recommend that treatment to a friend (435, 96.0% and 428, 93.4%, respectively; p=0.17). Importantly, although satisfaction remained high among women with an adverse outcome, those in 'tight' control who suffered an adverse outcome (vs. those who did not) were not consistently less satisfied, whereas this was not the case among women in 'less tight' control among whom satisfaction was consistently lower for the CHIPS primary outcome (p<0.001), severe hypertension (p≤0.01), and pre-eclampsia (p<0.001). CONCLUSIONS: Women in 'tight' (vs. 'less tight') control were equally satisfied with their care, and more so in the face of adverse perinatal or maternal outcomes. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/27665372/Women's_views_and_postpartum_follow_up_in_the_CHIPS_Trial__Control_of_Hypertension_in_Pregnancy_Study__ DB - PRIME DP - Unbound Medicine ER -