Identification of increased risk of perinatal anxiety: a multi-perspective qualitative study.

Abstract

Perinatal anxiety (PNA) is experienced by about 21% of women throughout the perinatal period. Identifying women at risk of PNA through primary care patient records could enable early intervention to improve treatment outcomes. The acceptability of doing this, however, is unknown. To explore patients' and practitioners' views on identifying women at risk of developing PNA using primary care patient records. Qualitative data are presented from a mixed-methods study, which used online and in-person interviews that were conducted in England. Semi-structured interviews were held with 19 women with lived experience of PNA and 27 healthcare professionals (HCPs). Data were analysed thematically. A patient and public involvement and engagement group were involved throughout the study. Both women and practitioners thought it was acceptable to identify women at increased risk of PNA using medical records, providing that sufficient acceptable help and support was in place. All participants also highlighted that an increased risk of PNA needed to be communicated sensitively, with women preferring phrasing such as 'more vulnerable' or 'more susceptible' than 'high risk'. Challenges with identifying risk factors within patient records, such as limited sharing between HCPs and poor coding, were discussed by practitioners. There are challenges to identifying risk factors within patient records. It was felt that not all possible risk factors would be recorded in primary care records. The issues of limited sharing between HCPs and poor coding were discussed by practitioners, many of whom thought that clinical intuition was a more appropriate way to assess risk.