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Hyperlink
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URL
https://doi.org/10.1016/j.ajogmf.2022.100663
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Title
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Assessment of adherence to aspirin for preeclampsia prophylaxis and reasons for nonadherence
Creator
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Danielle N Olson
Theresa Russell
Angela C Ranzini
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Description
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Background: Preeclampsia is a hypertensive disease unique to pregnancy and has a significant impact on maternal and neonatal morbidity and mortality. Daily aspirin has been demonstrated to reduce the risk of preeclampsia. The American College of Obstetricians and Gynecologists recommends daily low-dose aspirin, ideally before 16 weeks' gestation, in at-risk patients for preeclampsia risk reduction. This study examined whether patients at-risk for preeclampsia by the American College of Obstetricians and Gynecologists criteria recalled aspirin recommendation and factors associated with treatment adherence.
Objective: This study examined whether patients at-risk for preeclampsia by the American College of Obstetricians and Gynecologists criteria recalled aspirin recommendation and factors associated with treatment adherence.
Study design: This study used an anonymous written survey. Pregnant patients were asked to record self-reported risk factors and to recall recommendation to take aspirin for preeclampsia prophylaxis. Participants were then determined to be high-, moderate-, or low-risk on the basis of the American College of Obstetricians and Gynecologists guidelines. Self-reported adherence to recommendations and factors contributing to the patients' decisions to take or decline aspirin were assessed. Secondary outcomes included demographic characteristics of adherent patients and patients who did not recall aspirin recommendation.
Results: A total of 544 surveys were distributed and 500 were returned (91.9% response rate). Of the 104 high-risk pregnancies identified, aspirin was recommended in 60 (57.7%; 95% confidence interval, 0.48-0.67). Of the 269 patients with 2 or more moderate-risk factors, aspirin was recommended for 13 (4.8%; 95% confidence interval, 0.03-0.08). Among the participants who recalled aspirin recommendation, adherence was similar between high-risk (81.7%) and moderate-risk (76.9%) groups (P=.69). Patients with chronic hypertension, a history of preeclampsia or gestational hypertension in a previous pregnancy, and pregestational diabetes mellitus were most likely to report receiving aspirin recommendation (78.8%, 76.5%, 63.8%, and 53.3%, respectively). No high-risk factor was associated with a decreased likelihood of adherence. Nonadherent patients rarely discussed their decision with their medical provider (5.9%). In the 42.3% of high-risk participants who did not recall aspirin recommendation, autoimmune disease, multiple gestation, and kidney disease were the most prevalent risk factors (42.9%, 35.7%, and 25.0%, respectively).
Conclusion: In the population studied, many at-risk patients, as defined by the American College of Obstetricians and Gynecologists criteria, did not recall recommendations to take aspirin for preeclampsia prophylaxis. This raises concerns for absent or ineffective counseling. Of the patients who recalled aspirin recommendation, most reported adherence, and a history of hypertensive disorders or preeclampsia, autoimmune disease, and pregestational diabetes mellitus were most often associated with adherence. There was no single factor most strongly associated with intentional nonadherence.
Source
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Am J Obstet Gynecol MFM
. 2022 Sep;4(5):100663. doi: 10.1016/j.ajogmf.2022.100663. Epub 2022 May 14.
Language
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English
2022
aspirin prophylaxis
chronic hypertension
high-risk pregnancy
medication adherence
patient–physician relationship
Preeclampsia
pregnancy-induced hypertension
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Text
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URL Address
<a href="http://doi.org/10.1186/s12884-016-0952-6" target="_blank" rel="noreferrer noopener">http://doi.org/10.1186/s12884-016-0952-6</a>
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Pages
11-11
Volume
16
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Identifying Families' Shared Disease Experiences Through A Qualitative Analysis Of Online Twin-to-twin Transfusion Syndrome Stories
Publisher
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Bmc Pregnancy and Childbirth
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
2016-07
Subject
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children; Emotions; Health; high-risk pregnancy; information; laser-surgery; Lived experience; Obstetrics & Gynecology; parents; perspective; prenatal-diagnosis; psychological-aspects; Psychosocial; Qualitative; stress; Twin-to-twin transfusion syndrome (TTTS)
Creator
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Fischbein R; Meeker J; Saling J R; Chyatte M; Nicholas L
Identifier
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<a href="http://doi.org/10.1186/s12884-016-0952-6" target="_blank" rel="noreferrer noopener">10.1186/s12884-016-0952-6</a>
Format
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Journal Article or Conference Abstract Publication
2016
BMC pregnancy and childbirth
Children
Chyatte M
Emotions
Fischbein R
Health
high-risk pregnancy
information
laser-surgery
Lived experience
Meeker J
Nicholas L
Obstetrics & Gynecology
Parents
perspective
prenatal-diagnosis
psychological-aspects
Psychosocial
Qualitative
Saling J R
Stress
Twin-to-twin transfusion syndrome (TTTS)