Electronic Questionnaires in the Postpartum Period (eQuiPP)
Research type
Research Study
Full title
A pilot study evaluating the utility of an electronic questionnaire to assess pelvic floor problems in the postpartum period.
IRAS ID
257505
Contact name
Thomas Gray
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 4 months, 17 days
Research summary
Research Summary:
Pregnancy and childbirth are important risk factors for pelvic floor problems including urinary and fecal incontinence and prolapse in women. This affects more than 1 in 5 women after childbirth. These symptoms place a burden on women’s health and impact on physical, mental and social quality of life with associated pressure on NHS resources. Many women do not seek help for these common problems. \nCurrently women are not routinely assessed in the postnatal period to identify these problems. \nThis electronic questionnaire data collection pilot study is being undertaken as part of a program of research which aims to identify methods to increase detection of pelvic floor problems after childbirth, so that affected women can be directed to help and support.\n\nThis study will involve 800 eligible women who have given birth in a defined period in one NHS Trust. They will receive a letter inviting them to complete an online questionnaire will contain questions about bladder and bowel incontinence, pelvic floor muscle exercises and quality of life at 16-24 weeks postnatal.The questions asked are similar to those discussed during routine antenatal\nappointments that the women will have attended during their pregnancy. An accompanying cover letter will explain the research and state that completion and return of the questionnaire will also give permission to the researchers to read\ntheir hospital notes and collect relevant information about their labour and birth.\nData will be collected from the completed questionnaires.
Lay summary of study results:
Pelvic floor dysfunction, including symptoms such as accidental leakage of urine, bladder urgery, or pelvic organ prolpase in the postnatal period is common, but often under-reported.
In the UK there is currently no standardised assessment to identify those affected by pelvic floor symptoms such as these postpartum.
ePAQ-Pelvic Floor is an online, self-completed patient reported outcome measure (PROM) with good evidence of validity, reliability and functionality for assessing pelvic floor symptoms across 20 scored domains (symptom areas). The aim of this pilot study was to evaluate the potential use of ePAQ-PF in the postnatal period, to enable women to self-assess their pelvic floor symptoms and prompt access to healthcare.Following ethical approval, eight hundred consecutive women with term livebirths were invited by post to complete ePAQ-PF at 16-20 weeks postpartum. A single reminder was sent at four weeks to non-responders. Data on obstetric variables (including parity, mode of delivery, epidural and perineal trauma) was collected for the 800 participants. In addition to descriptive statistics, ANOVA, student T tests and Pearson correlation were used to compare domain scores with obstetric variables.
In total, 126 women (16%) completed ePAQ-PF. Responders had a higher rate of instrumental delivery (21% vs. 12%) and a lower rate of caesarean section (25% vs. 31%). The average completion time was 21 minutes.
Overall, 49% percent reported stress urinary incontinence, 76% reported overactive bladder symptoms, 23% reported prolapse, 29% reported anal incontinence, 31% reported body image concerns and 73% reported poor quality of sexual life. There was no meaningful statistically significant difference between the domain scores and the obstetric variables in this study.
Whilst further research is required, including qualitative studies of patient perceptions of electronic PROMs in this context and development of initiatives to improve response rates prior to larger studies; electronic PROMs show potential for identifying women with pelvic floor dysfunction postpartum and may represent an accessible and cost-effective approach.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
19/YH/0122
Date of REC Opinion
8 May 2019
REC opinion
Further Information Favourable Opinion