41. Views and preferences of medical professionals and pregnant women about a novel primary prevention intervention for hypertensive disorders of pregnancy: A qualitative research

Abstract

Objective To explore the acceptability, views and preferences of pregnant women and primary healthcare providers for a fixed-dose combined preparation of aspirin and calcium (the polypill) as primary prevention of hypertensive disorders in pregnancy in an unselected pregnant population. Method A qualitative study was conducted, consisting of seven focus group discussions with 25 women with low-risk pregnancies and eight in-depth semi-structured interviews with primary care midwives and general practitioners of varying primary care practices in the Netherlands. Topics discussed were: perceptions of preeclampsia; information provision about preeclampsia and the polypill within antenatal care; views on the polypill concept; and preferences and needs regarding implementation of the polypill. MAXQDA computer software was used to carry out thematic analysis of the data transcripts to identify emerging themes. Results Two major themes shaped medical professionals’ and women’s views on the polypill: ‘Informed Choice’ and ‘Medicalization’. Both could be divided into subthemes related to information provision, personal choice and discussions with regard to the balance between ‘unnecessary medicalization’ and ‘scientific progress’. Discussion In general, women and healthcare practitioners expressed a positive attitude towards the polypill intervention as primary prevention strategy with aspirin and calcium, providing some conditions are met. The most important conditions for implementation of such a strategy were safety, effectiveness and the possibility to make a well-informed autonomous decision.