Exploring perspectives, preferences and needs of a telemonitoring program for women at high risk for preeclampsia in a tertiary health facility of Karachi: a qualitative study protocol

Abstract

Background In Pakistan, deaths from preeclampsia/eclampsia (PE/E) represent one-third of maternal deaths reported at tertiary care hospitals. To reduce the morbidity and mortality associated with PE/E, an accessible strategy is to support pregnant women at high risk for preeclampsia (HRPE) by closely monitoring their blood pressures at home (i.e., telemonitoring) for the earliest signs of preeclampsia. This could lead to the earliest possible detection of high blood pressure, resulting in early intervention such as through medications, hospitalization, or delivery of the baby. The study aims to explore the perspectives, preferences and needs of telemonitoring (TM) for pregnant women at HRPE in Karachi, to inform future implementation strategies. Methods The study will employ an exploratory qualitative research design. The study will be conducted at the Jinnah Postgraduate Medical Centre (JPMC) hospital and Aga Khan University Hospital (AKUH) in Karachi, Sindh, Pakistan. Data will be collected through key-informant interviews (KIIs) and in-depth patient interviews (IDPIs). IDPIs will be conducted with the pregnant women at HRPE who are visiting the out-patient department/ antenatal clinics of JPMC hospital for antenatal check-ups and immunizations. KIIs will be conducted with the obstetricians, Maternal, neonatal and child health (MNCH) specialists and health care providers at JPMC, as well as TM experts from Karachi. Study data will be analyzed through conventional content analysis. Interviews are anticipated to begin in April 2020 and to be completed during the summer of 2020. Discussion This is the first study to explore the use of TM program for pregnant women at HRPE in a tertiary health facility in Karachi. The research will help explore perceived benefits associated with the use of a TM program alongside potential facilitators and barriers that may help inform the future implementation of a TM program for pregnant women at HRPE in Karachi.

[Retracted] A Survey Research on the Willingness of Gynecologists to Employ Mobile Health Applications

“…Health promotion, illness prevention, diagnosis, treatment, monitoring, and assistance of health services were highlighted as the six primary aims of mobile interventions. For example, 51.5 percent of mHealth apps were developed to assist healthcare services, while 33.3 percent were developed to monitor healthcare services [14][15][16].…”

Exploring digital health interventions for pregnant women at high risk for pre-eclampsia and eclampsia in low-income and-middle-income countries: a scoping review

“…The articles reported varying eligibility criteria for selecting high-risk pregnant women for different DHIs. Some articles selected high-risk pregnant women based on the NICE guidelines, 20 specific age groups such as pregnant women aged 15–49 years, 22 while a few articles selected pregnant women based on their residential area such as women living in study catchment area, 23 permanent resident of the particular area, or non-resident who delivered in the study area. 18 Most DHIs collected blood pressure, heart rate and pulse oximetry, with some innovations collecting data on additional indicators such as demographic data, haemoglobin, urine dipstick test to detect proteinuria and glucose, other urinary markers and PE symptoms.…”

“…Finally, 19 articles were identified after the full-text screening that met the inclusion criteria for this review. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Fifty-three articles were excluded for the following reasons: (1) the study was not reported in the English language; (2) the publication did not talk about pregnant women at HRPE; (3) the research did not include any of the DHIs; (4) the publication was a conference abstract, review, editorial, commentary or (5) the study implemented the DHIs for pregnant women at HRPE in high-income countries. The study selection procedure was recorded according to the PRISMA-ScR flow diagram (figure 1).…”

“…A total of four articles reported research work of CRADLE vital sign alert (VSA) trial led by Nathan et al, which aimed to evaluate the ability of the device to accurately detect abnormalities in women's vital signs during pregnancy. 26-28 34 The remaining five publications reported five unique DHIs to support pregnant women at HRPE including the Congo Red Dot test, 21 a hypothetical telemonitoring programme, 20 a new hypertension detector, 32 an integrated diagnostic and clinical decision support system named 'Bliss4Midwives' (B4M), 16 and a smart wristwatch (called the F1 smart wristwatch) for blood pressure monitoring of expectant mother. 25 Following PRISMA-ScR guidelines, each of the abovementioned included article was reviewed to identify emerging themes related to the use of DHIs to support pregnant women at HRPE in LMICs.…”

How is the effect of planned training given to women with preeclamptic pregnancy on oxidative stress and anxiety levels?: non-randomised controlled-study

“…Healthcare providers play a key role in adapting women with preeclampsia to hospital settings, connecting with family members, and connecting with people who can provide them with information (40). As pointed out in the studies, when information and counselling about their disorder is given to inpatient women who are in the hospital for preeclampsia treatment, their anxiety levels decrease.…”