Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study)

The CHIPS Study Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

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, 85 mmHg) or ‘less tight’ (target diastolic blood pressure, 100 mmHg) 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.

Original languageEnglish (US)
Pages (from-to)105-113
Number of pages9
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume206
DOIs
StatePublished - Nov 1 2016

Fingerprint

Postpartum Period
Hypertension
Pregnancy
Blood Pressure
Outcome Assessment (Health Care)
House Calls
Therapeutics
Ambulatory Care
Pre-Eclampsia
Medical Records
Software
Logistic Models
Mothers
Morbidity
Surveys and Questionnaires
Population

Keywords

  • Blood pressure control
  • Hypertension
  • Postpartum
  • Pregnancy
  • Satisfaction

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study). / The CHIPS Study Group.

In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 206, 01.11.2016, p. 105-113.

Research output: Contribution to journalArticle

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title = "Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study)",
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, 85 mmHg) or ‘less tight’ (target diastolic blood pressure, 100 mmHg) 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.",
keywords = "Blood pressure control, Hypertension, Postpartum, Pregnancy, Satisfaction",
author = "{The CHIPS Study Group} and Marianne Vidler and Magee, {Laura A.} and {von Dadelszen}, Peter and Evelyne Rey and Susan Ross and Elizabeth Asztalos and Murphy, {Kellie E.} and Jennifer Menzies and Johanna Sanchez and Joel Singer and Amiram Gafni and Andr{\~A}{\circledC}e Gruslin and Michael Helewa and Eileen Hutton and Lee, {Shoo K.} and Terry Lee and Logan, {Alexander G.} and Wessel Ganzevoort and Ross Welch and Thornton, {Jim G.} and Moutquin, {Jean Marie} and Alexander Logan and Sue Ross and Trinh Hoac and Joanne Kirton and Katherine Trigiani and Ainy Zahid and Bracken, {Michael B.} and Patricia Crowley and Lelia Duley and Richard Ehrenkranz and Kevin Thorpe and Sunny Chan and Michael Shi and Shelley Yu and Martin, {Raquel de Lourdes} and Bassi, {Maria Florencia} and Caruso, {Mirta Clara} and Valeria Lagunas and Fernando Vera and {de Duhalde}, {Maria Mohedano} and Roque, {Alicia Beatriz} and Patricia Roldan and Duhalde, {Esteban Marcos} and Viviana Dip and Aguirre, {Jesus Daniel} and Morales, {Elba Mirta Alicia} and Abreo, {Griselda Itati} and Jorge Tolosa and Leonardo Pereira",
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TY - JOUR

T1 - Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study)

AU - The CHIPS Study Group

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 - Logan, Alexander

AU - Ross, Sue

AU - Hoac, Trinh

AU - Kirton, Joanne

AU - Trigiani, Katherine

AU - Zahid, Ainy

AU - Bracken, Michael B.

AU - Crowley, Patricia

AU - Duley, Lelia

AU - Ehrenkranz, Richard

AU - Thorpe, Kevin

AU - Chan, Sunny

AU - Shi, Michael

AU - Yu, Shelley

AU - Martin, Raquel de Lourdes

AU - Bassi, Maria Florencia

AU - Caruso, Mirta Clara

AU - Lagunas, Valeria

AU - Vera, Fernando

AU - de Duhalde, Maria Mohedano

AU - Roque, Alicia Beatriz

AU - Roldan, Patricia

AU - Duhalde, Esteban Marcos

AU - Dip, Viviana

AU - Aguirre, Jesus Daniel

AU - Morales, Elba Mirta Alicia

AU - Abreo, Griselda Itati

AU - Tolosa, Jorge

AU - Pereira, Leonardo

PY - 2016/11/1

Y1 - 2016/11/1

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, 85 mmHg) or ‘less tight’ (target diastolic blood pressure, 100 mmHg) 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.

AB - 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, 85 mmHg) or ‘less tight’ (target diastolic blood pressure, 100 mmHg) 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.

KW - Blood pressure control

KW - Hypertension

KW - Postpartum

KW - Pregnancy

KW - Satisfaction

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