Article Text

Download PDFPDF

Establishing cross-discipline consensus on contraception, pregnancy and breast feeding-related educational messages and clinical practices to support women with rheumatoid arthritis: an Australian Delphi study
  1. Andrew M Briggs1,2,
  2. Joanne E Jordan3,
  3. Ilana N Ackerman4,5,
  4. Sharon Van Doornum5,6
  1. 1School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  2. 2Move: Muscle, Bone and Joint Health, Melbourne, Victoria, Australia
  3. 3HealthSense (Aust) Pty Ltd, Melbourne, Victoria, Australia
  4. 4Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. 5Department of Medicine, Melbourne EpiCentre, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  6. 6Department of Rheumatology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Andrew M Briggs; a.briggs{at}curtin.edu.au

Abstract

Objective Recognising the need for a best-practice and consistent approach in providing care to women with rheumatoid arthritis (RA) in relation to (1) general health, (2) contraception, (3) conception and pregnancy, (4) breast feeding and (5) early parenting, we sought to achieve cross-discipline, clinical consensus on key messages and clinical practice behaviours in these 5 areas.

Design 3-round eDelphi study. In round 1, panellists provided free-text responses to open-ended questions about care for women with RA across the 5 areas. Subsequently, panellists refined and scored the synthesised responses, presented as metathemes, themes and detailed elements. Where ≥5% of panellists did not support a theme in a given round, it was removed.

Setting Panel of practicing Australian rheumatologists (n=22), obstetricians/obstetric medicine physicians (n=9) and pharmacists (n=5).

Results 34 (94.4%) panellists participated in all 3 rounds. The panel supported 18 themes across the 5 areas (support/strongly support: 88.2–100%) underpinned by 5 metathemes. Metathemes focused on coordination in information delivery, the mode and timing of information delivery, evidence underpinning information, engagement of the right health professionals at the right time and a non-judgemental approach to infant feeding. Themes included practices for primary prevention of chronic disease and their sequelae, the importance of contraception and planning pregnancy and breast feeding, close monitoring of medications, supporting mental well-being, managing disease activity and providing practical support for early parenting.

Conclusions A cross-disciplinary clinical panel highly supported key information and clinical practices in the care for women with RA across the continuum of contraception to early parenting within a whole-person, chronic disease management approach.

  • MEDICAL EDUCATION & TRAINING

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles