Experiences with an integrated screening programme targeted at women who had a hypertensive disorder or diabetes in pregnancy in the Netherlands: a qualitative study.

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  • Additional Information
    • Source:
      Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
    • Subject Terms:
      Diabetes Mellitus, Type 2*/diagnosis ; Diabetes, Gestational*/diagnosis ; Pre-Eclampsia*/diagnosis ; Pre-Eclampsia*/prevention & control ; Hypertension*/diagnosis ; Cardiovascular Diseases*/diagnosis ; Cardiovascular Diseases*/prevention & control; Pregnancy ; Humans ; Female ; Netherlands ; Memory Disorders
    • Abstract:
      Objectives: Pregnancy is a predictor of women's health later in life. The risk of eventually developing cardiovascular disease (CVD) and/or type 2 diabetes (T2D) increases three to seven times, after pre-eclampsia, hypertension gravidarum or gestational diabetes. The Heart for Women in The Hague project was designed to offer targeted screening to this high-risk population. This research aimed to gather insight regarding the initial experiences of healthcare providers and women with pre-eclampsia, hypertension gravidarum or gestational diabetes.
      Design and Setting: This study applied a qualitative semistructured interview design using an interview guide based on 'The Consolidated Framework for Implementation Research (CFIR).' Interviews were recorded, transcribed and coded in accordance with the five main CFIR themes. The setting of the study was primary and secondary care in The Hague, the Netherlands. Interviews were carried out from December 2021 until February 2022. The language was Dutch or English.
      Participants: Participants (n=13) were women of the target population (n=7) and relevant healthcare professionals (n=6).
      Results: Healthcare providers and women were generally positive concerning screening. Healthcare providers agreed that this forgotten group deserves attention and felt that the regional transmural agreement (RTA) provided a clear policy. Women stated that they would like screening to continue and were open-minded regarding lifestyle guidance. Reported barriers included current lack of an easy way of contacting the population after a year, lack of knowledge among the women concerning increased risk, unfamiliarity of new colleagues with the RTA and lack of evidence that screening actually prevents disease.
      Conclusion: Implementation of screening programmes to prevent or delay the development of CVD and/or T2D after complicated pregnancies will likely improve awareness in both patients and healthcare providers. Healthcare providers considered the RTA important because it concerns a forgotten high-risk population. Future research should focus on the improved effectiveness of tailored interventions to delay or prevent CVD.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
    • References:
      Diabet Med. 2013 Aug;30(8):986-93. (PMID: 23534548)
      BJOG. 2018 Dec;125(13):1642-1654. (PMID: 29978553)
      Eur Heart J. 2016 Aug 1;37(29):2315-2381. (PMID: 27222591)
      Circ Res. 2017 Sep 1;121(6):677-694. (PMID: 28860318)
      Med J Aust. 2014 Aug 4;201(3 Suppl):S78-81. (PMID: 25047889)
      Front Endocrinol (Lausanne). 2020 Aug 28;11:602. (PMID: 32982985)
      BMJ. 2003 Apr 19;326(7394):845. (PMID: 12702615)
      BMC Pregnancy Childbirth. 2020 Aug 24;20(1):486. (PMID: 32831032)
      Eur J Prev Cardiol. 2012 Oct;19(5):1138-44. (PMID: 21859777)
      Mayo Clin Proc. 2016 Sep;91(9):1158-65. (PMID: 27594183)
      Circulation. 2020 Feb 18;141(7):592-599. (PMID: 32065772)
      BMJ. 2007 Nov 10;335(7627):974. (PMID: 17975258)
      Circ Cardiovasc Qual Outcomes. 2017 Feb;10(2):. (PMID: 28228456)
      Aust N Z J Obstet Gynaecol. 2021 Jun;61(3):474-477. (PMID: 33734427)
      Lancet. 2009 May 23;373(9677):1773-9. (PMID: 19465232)
      Implement Sci. 2009 Aug 07;4:50. (PMID: 19664226)
      BJOG. 2013 Jul;120(8):924-31. (PMID: 23530583)
      Prog Cardiovasc Dis. 2022 Jan-Feb;70:8-15. (PMID: 34922952)
      Hypertension. 2018 Mar;71(3):491-498. (PMID: 29437895)
      Curr Opin Obstet Gynecol. 2003 Dec;15(6):465-71. (PMID: 14624211)
      J Womens Health (Larchmt). 2016 Jan;25(1):38-49. (PMID: 26700931)
      Prev Chronic Dis. 2014 Jun 19;11:E104. (PMID: 24945238)
      Heart. 2019 Aug;105(16):1273-1278. (PMID: 31175138)
      Diabetologia. 2019 Jun;62(6):905-914. (PMID: 30843102)
      J Obstet Gynaecol Can. 2019 Aug;41(8):1157-1167.e1. (PMID: 30655227)
      Diabetes Res Clin Pract. 2015 Nov;110(2):109-22. (PMID: 26421361)
      Heart. 2019 Nov;105(21):1656-1660. (PMID: 31315936)
      Eur J Prev Cardiol. 2022 Dec 21;:. (PMID: 36545905)
    • Contributed Indexing:
      Keywords: Diabetes in pregnancy; Hypertension; PRIMARY CARE; QUALITATIVE RESEARCH
    • Publication Date:
      Date Created: 20230817 Date Completed: 20230821 Latest Revision: 20240821
    • Publication Date:
      20240821
    • Accession Number:
      PMC10441084
    • Accession Number:
      10.1136/bmjopen-2022-066198
    • Accession Number:
      37591646