New mother’s experiences of being offered postnatal thromboprohylaxis
Research type
Research Study
Full title
An interpretative phenomenological study of new mother’s experiences of being offered information and advice regarding postnatal thromboprophylaxis.
IRAS ID
167327
Contact name
Jaqualyn Moore
Contact email
Duration of Study in the UK
0 years, 3 months, 0 days
Research summary
In the United Kingdom venous thromboembolism (VTE) is the third cause of direct maternal death (Royal College of Obstetricians and Gynaecologists, 2009). Mandatory national risk assessment algorithms to guide prophylactic use of low molecular weight heparin in pregnancies were introduced in 2009 (RCOG, 2009). Algorithms are however, based upon expert opinion only with no clinical risk benefit analysis available. A recent Cochrane systematic review identified insufficient evidence exists to determine the unique risks of obstetric VTE, best treatment regimes or benefit of pharmaceutical thromboprophylaxis (Bain et al, 2014).
Obstetric VTE risk assessments increase medical intervention and may lead to physical and emotional harm and reduced treatment options (Bennett-Day, 2011). Principles of informed choice and patient autonomy identify when evidence is lacking regarding those “at risk” and benefits of treatment, clinicians have a duty to inform patients and support decision making. Patient involvement in clinical decision making influences treatment preferences, patient satisfaction and medication adherence (Coulter, 2012).
Knowledge of women’s informed preferences, values and decision making processes regarding postnatal VTE are currently unknown. The proposed interpretative phenomenological study therefore aims to explore women’s lived experiences of being offered information about postnatal pharmaceutical thromboprophylaxis. Potential benefits of research may include development of patient decision aids.
Semi-structured interviews will be conducted by a midwife undertaking a masters degree and completed in a twelve month period. Women who meet national guidelines for being at risk of a venous thromboembolism postnatally within a single NHS trust will be invited to take part.
References
Bain E at al. (2014) Prophylaxis for venous thromboembolic disease in pregnancy and the postnatal period. Cochrane Systematic Review.
Bennett-Day S. (2011) Universal risk assessments to guide thromboprophylaxis. British Journal of Midwifery 19 (12) 778-785.
Coulter A. (2012) Leadership for patient engagement.
RCOG (2009) Reducing the risk of thrombosis and embolism during pregnancy and the puerperium, London.
REC name
Wales REC 4
REC reference
15/WA/0039
Date of REC Opinion
26 Feb 2015
REC opinion
Further Information Favourable Opinion