Does a patient information sheet lead to better understanding of pre-eclampsia? A randomised controlled trial

Abstract

ObjectiveTo investigate whether a structured patient information sheet would improve women’s satisfaction and understanding of pre-eclampsia, its management and risks. Study designA randomised, controlled trial conducted in a referral centre in South Africa. Seventy-four women with early pre-eclampsia, who qualified for expectant management, were enroled. They all completed an anonymous, structured, and self-administered questionnaire before randomisation.Cases (n=37) received a patient information sheet addressing key features of pre-eclampsia; controls (n=37) received a welcome note. Within 5–7days, but still before delivery, they completed the same questionnaire again. Main outcome measuresPrimarily assessing their general understanding and knowledge of pre-eclampsia, secondarily to assess their satisfaction and the impact of the information received. ResultsThe patient information sheet improved their understanding of the immediate and long-term risks (p<0.01) and the chance of recurrence (p<0.01). Controls had good levels of understanding and appreciation. Most women in both groups felt well informed but levels of concern remained high. ConclusionsThe structured information sheet improved patients’ understanding and knowledge in a limited way but did not alleviate their anxiety. Although women appear to be generally well counselled in the study unit, measures to alleviate associated anxiety should be investigated.