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

Marianne Vidler; Laura A. Magee; Peter von Dadelszen; Evelyne Rey; Susan Ross; Elizabeth Asztalos; Kellie E. Murphy; Jennifer Menzies; Johanna Sanchez; Joel Singer; Amiram Gafni; Andrée Gruslin; Michael Helewa; Eileen Hutton; Shoo K. Lee; Terry Lee; Alexander G. Logan; Wessel Ganzevoort; Ross Welch; Jim G. Thornton; Jean-Marie Moutquin

doi:10.1016/j.ejogrb.2016.07.509

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

Marianne Vidler, Laura A. Magee, Peter von Dadelszen, Evelyne Rey, Susan Ross, Elizabeth Asztalos, Kellie E. Murphy, Jennifer Menzies, Johanna Sanchez, Joel Singer, Amiram Gafni, Andrée Gruslin, Michael Helewa, Eileen Hutton, Shoo K. Lee, Terry Lee, Alexander G. Logan, Wessel Ganzevoort, Ross Welch, Jim G. ThorntonJean-Marie Moutquin

Women & Children's Health

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). Quantitative and qualitative analysis of questionnaire responses. International randomised trial (94 sites, 15 countries). 911 (92.9%) women randomised to ‘tight’ (target diastolic blood pressure, 85mmHg) or ‘less tight’ (target diastolic blood pressure, 100mmHg) who completed questionnaires. 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. Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. 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). 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 language	English
Pages (from-to)	105-113
Number of pages	9
Journal	European Journal of Obstetrics Gynecology and Reproductive Biology
Volume	206
DOIs	https://doi.org/10.1016/j.ejogrb.2016.07.509
Publication status	Published - 2016

Keywords

Hypertension
Blood pressure control
Pregnancy
Postpartum
Satisfaction

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10.1016/j.ejogrb.2016.07.509

http://www.sciencedirect.com/science/article/pii/S0301211516308417

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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

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

abstract = "To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). Quantitative and qualitative analysis of questionnaire responses. International randomised trial (94 sites, 15 countries). 911 (92.9%) women randomised to {\textquoteleft}tight{\textquoteright} (target diastolic blood pressure, 85mmHg) or {\textquoteleft}less tight{\textquoteright} (target diastolic blood pressure, 100mmHg) who completed questionnaires. 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. Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. Among the 533 women in {\textquoteleft}tight{\textquoteright} (N=265) vs. {\textquoteleft}less tight{\textquoteright} (N=268) control who provided comments for qualitative analysis, women in {\textquoteleft}tight{\textquoteright} (vs. {\textquoteleft}less tight{\textquoteright}) 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 {\textquoteleft}tight{\textquoteright} 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 {\textquoteleft}less tight{\textquoteright} 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). Women in {\textquoteleft}tight{\textquoteright} (vs. {\textquoteleft}less tight{\textquoteright}) control were equally satisfied with their care, and more so in the face of adverse perinatal or maternal outcomes.",

keywords = "Hypertension, Blood pressure control, Pregnancy, Postpartum, Satisfaction",

author = "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{\'e}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 Jean-Marie Moutquin",

year = "2016",

doi = "10.1016/j.ejogrb.2016.07.509",

language = "English",

volume = "206",

pages = "105--113",

journal = "European Journal of Obstetrics Gynecology and Reproductive Biology",

issn = "0301-2115",

publisher = "Elsevier Ireland Ltd",

}

Vidler, M, Magee, LA , von Dadelszen, P, Rey, E, Ross, S, Asztalos, E, Murphy, KE, Menzies, J, Sanchez, J, Singer, J, Gafni, A, Gruslin, A, Helewa, M, Hutton, E, Lee, SK, Lee, T, Logan, AG, Ganzevoort, W, Welch, R, Thornton, JG & 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, vol. 206, pp. 105-113. https://doi.org/10.1016/j.ejogrb.2016.07.509

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

PY - 2016

Y1 - 2016

N2 - To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). Quantitative and qualitative analysis of questionnaire responses. International randomised trial (94 sites, 15 countries). 911 (92.9%) women randomised to ‘tight’ (target diastolic blood pressure, 85mmHg) or ‘less tight’ (target diastolic blood pressure, 100mmHg) who completed questionnaires. 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. Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. 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). 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 - To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). Quantitative and qualitative analysis of questionnaire responses. International randomised trial (94 sites, 15 countries). 911 (92.9%) women randomised to ‘tight’ (target diastolic blood pressure, 85mmHg) or ‘less tight’ (target diastolic blood pressure, 100mmHg) who completed questionnaires. 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. Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. 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). 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 - Hypertension

KW - Blood pressure control

KW - Pregnancy

KW - Postpartum

KW - Satisfaction

U2 - 10.1016/j.ejogrb.2016.07.509

DO - 10.1016/j.ejogrb.2016.07.509

M3 - Article

SN - 0301-2115

VL - 206

SP - 105

EP - 113

JO - European Journal of Obstetrics Gynecology and Reproductive Biology

JF - European Journal of Obstetrics Gynecology and Reproductive Biology

ER -

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

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Keywords

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