CLAssification, outcomeS and interventions for Perinatal anxiety
CLASP
Research to improve identification, management and quality of care for women with perinatal anxiety (PNA).
Chief Investigator: | Professor Carolyn Chew-Graham, |
Funder name/reference number: | National Institute for Health Research Society for Primary Care Research (SPCR) Grant Reference 565 |
Background
Perinatal anxiety (PNA), experienced during pregnancy and up to one year after childbirth, impacts on the mother, infant, family and society. This mixed methods study explored whether primary care electronic health records (EHRs) could be utilised to identify women at increased risk of PNA and perspectives on the acceptability of identifying women at higher risk of PNA.
Quantitative study
Quantitative data were analysed from the Clinical Practice Research Datalink (CPRD) Aurum and the IQVIA Medical Research Database (IMRD) to explore diagnoses, symptoms, care processes, and outcomes.
Qualitative study
Semi-structured interviews with women who experienced PNA, healthcare professionals (HCPs) from primary, community and specialist care, and community organization practitioners.
Key findings
Quantitative
- Women in the PNA cohorts experienced higher levels of socioeconomic deprivation and were more likely to have a history of smoking.
- Women with PNA showed greater healthcare usage, including more frequent consultations, referrals, and prescriptions, compared to women in the only-anxiety or only-pregnancy groups.
- Mothers with PNA were more likely to take their infants for vaccinations, such as the 5-in-1 vaccination.
Qualitative
- Limitations of accessing Electronic Health Records (EHRs): Participants noted gaps in EHRs. Only some pre-disposing factors for PNA are coded in primary care records – other factors are not coded or are inconsistently coded in primary care records.
- Service gaps: Women may not access primary care until the post-natal check. Patient records are not shared across different services.
- Perspectives on Risk Identification: Women were positive about being identified as ‘higher risk’ for PNA, but only if appropriate support and resources were available to them.
Advisory groups
A Patient Advisory Group (PAG) and a Clinical Advisory Group (CAG) provided input and guidance at every stage of the study.
Outputs
Conference - poster presentations
- Identification of women at high risk of perinatal anxiety: a mixed methods study (CLASP SAPC ASM 2024.pdf)
- Challenges and opportunities of using primary care electronic health records (EHRs) to identify increased risk of perinatal anxiety (PNA): a mixed methods study (CLASP SAPC- North 2024.pdf)
Conference - oral presentations
- Identification of women at high risk of perinatal anxiety: a mixed methods study. | SAPC
- Fisher T., Archer C., Bailey J., Evans J., Kessler D., Kingstone T., Petersen I., Proctor J., Shivji N., Spruce A., Silverwood V., Smith H., Turner K., Wu P., Yu D. and Chew-Graham, C. A. Could primary care records be used to identify women at risk of perinatal anxiety? A mixed-methods study. British Journal of General Practice 2024; 74 (suppl1): bjgp24X737673. DOI:3399/bjgp24X737673
- Maternal perinatal anxiety and infant primary care use in 1998-2016: a UK cohort study: Approved for publication. URL Pending.
Publications
- Maternal perinatal anxiety and infant primary care use in 1998-2016: a UK cohort study: Accepted, BMJ Mental Health – URL pending
- Blog on ‘What’s new in Perinatal Anxiety?’ as an output from an online PNA webinar: https://www.spcr.nihr.ac.uk/news/blog/whats-new-in-perinatal-anxiety?ref=image
- Additional publications – Watch this space
Other outputs
- Infographic: Watch this space
- Video/s: Watch this space
- Podcast: Watch this space