Evaluating multidisciplinary integrated perinatal mental healthcare versus monodisciplinary care: a multicentre mixed-methods study protocol
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Celine K Klatter1, Leontien M van Ravesteyn2, Hanna M Heller3
1Department of Health Sciences, University Medical Centre Groningen/University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands; Department of Obstetrics and Gynecology, Frisius MC, Henri Dunantweg 2, 8934, AD, Leeuwarden, the Netherlands.
Background:
Perinatal mental health problems are common and may negatively affect mother and (unborn) child. Given the intersection of psychiatric, obstetric, paediatric and social factors, a multidisciplinary approach is needed. In the Netherlands, multidisciplinary integrated perinatal mental healthcare (MIP) outpatient clinics provide individual treatment plans. Two MIP-models exist, differing in whether healthcare providers provide monodisciplinary or multidisciplinary consultations. To date, the added value of multidisciplinary compared to monodisciplinary approaches is unknown and the optimal model has not yet been identified.
Methods:
This mixed-methods research uses a parallel convergent design to investigate pregnant women1 up to 32 weeks' gestation who visit MIP-outpatient clinics of 8 hospitals across the Netherlands. Using a quantitative approach, depressive and anxiety symptoms (primary outcome) and neonatal outcomes (secondary outcomes) of current MIP will be evaluated against earlier monodisciplinary care (PROMISES-cohort: GP-care or cognitive behavioural therapy) based on a sample of 167 women. Primary outcome is decrease in psychiatric symptoms (EPDS: Edinburgh Postnatal Depression Scale) at 6 weeks postpartum compared to baseline, analyzed using linear mixed-models. Additionally, maternal and neonatal outcomes, compliance with the agreed-upon treatment plan, and experience with care, of both MIP-models will be evaluated separately and compared exploratively. Also, using a qualitative approach, experiences with care of women, partners, and healthcare providers are explored by thematic analysis of semi-structured interviews.
Discussion:
This research will provide novel quantitative and qualitative data on MIP-outcomes and experiences among pregnant women with mental health problems. The results will offer initial insights into MIP-practices and inform recommendations to improve perinatal mental healthcare.