Rachel S Ruderman, Ashish Premkumar, Jungeun Lee, Melinique Walls, Grace Keegan, Olivert Mbah, Sunitha C Suresh
Care team members serving prenatal patients of low socioeconomic status are open to universal prescription of LDA in pregnancy, though important barriers to provider and patient knowledge and workflow must be addressed to result in successful quality improvement initiatives.
OBJECTIVE: To assess clinical care team perceptions of universal low-dose aspirin (LDA) in a prenatal care clinic serving patients of low socioeconomic status.
METHODS: This was a theory-based rigorous qualitative study of clinical care team members in an urban, tertiary care center prenatal clinic. Participants were recruited between April and July 2023 and participated in focus groups. Focus groups employed a semi-structured guide using the Consolidated Framework for Implementation Research (CFIR).
RESULTS: A total of 25 care team members met for 19-36 min, of which the majority (n = 10, 40%) were obstetrics and gynecology resident providers. Participants generally responded favorably to the idea of a universal prescription system, though some cited concerns regarding health equity and LDA adherence with a universal protocol. Multiple barriers to both prescribing and taking LDA were identified, including educational deficits, language barriers, and issues with transportation and cost. Consistent communication, optimization of workflow, and iterative educational material development were suggested to improve prescription and adherence of LDA.
CONCLUSION: Care team members serving prenatal patients of low socioeconomic status are open to universal prescription of LDA in pregnancy, though important barriers to provider and patient knowledge and workflow must be addressed to result in successful quality improvement initiatives.