Impact of early preeclampsia prediction on medication adherence and behavior change: a survey of pregnant and recently-delivered individuals

Abstract

Abstract Background: Behavior change and medication adherence represent potential barriers to optimal prevention of pregnancy complications including preeclampsia. We sought to evaluate baseline sentiments on pregnancy care and medication amenability, and how these measures would be impacted by early predictive testing for preeclampsia. Methods: We developed a digital survey to query participants’ baseline sentiments on pregnancy care, knowledge about pregnancy complications, and views on a hypothetical test to predict preeclampsia. The survey was administered online to pregnant and recently-delivered individuals in the United States. Survey data were analyzed using pooled two-sample proportion z-tests with adjustment for multiple comparisons. Results: 1022 people completed the survey. 84% reported they were satisfied with their pregnancy care. Self-assessed knowledge about preeclampsia was high, with 75% of respondents reporting they have a “good understanding” of preeclampsia, but measured knowledge was low, with only 10% able to identify five common signs/symptoms of preeclampsia. 91% of participants desired early pregnancy predictive testing for preeclampsia. 88% reported they would be more motivated to follow their provider’s medication recommendations and 94% reported they would desire home blood pressure monitoring if found to be at high risk for preeclampsia. Increased motivation to follow clinicians’ medication and monitoring recommendations was observed across the full spectrum of medication amenability. Individuals who are more medication-hesitant still reported high rates of motivation to change behavior and adhere to medication recommendations if predictive testing showed a high risk of preeclampsia. Conclusion: While satisfaction with care is high, participants desire more information about their pregnancy health, would value predictive testing for preeclampsia, and report they would act on this information. Participants across the spectrum of medication amenability reported that they would be more likely to adhere to medication and behavioral changes if they had an early predictive test for preeclampsia.