Women's preferences for inpatient and outpatient priming for labour induction: a discrete choice experiment

Kirsten Howard, Karen Gerard, Pamela Adelson, Robert Bryce, Chris Wilkinson, Deborah Turnbull, Kirsten Howard, Karen Gerard, Pamela Adelson, Robert Bryce, Chris Wilkinson, Deborah Turnbull

Abstract

Background: In many countries a high proportion of births begin as induced labours. Induction can be lengthy if cervical priming is required prior to induction. This usually occurs as an inpatient, however, an alternative is to allow women to go home after satisfactory fetal monitoring. The aim of this study was to assess the preferences of women for cervical priming for induction of labour in an outpatient or inpatient setting.

Method: A discrete choice experiment (DCE) was conducted alongside a randomised trial of inpatient and outpatient cervical priming (the OPRA trial) in two maternity hospitals in South Australia. 362 participants were included, and women's preferences for cervical priming for induction of labour were assessed.

Results: Women were willing to accept an extra 1.4 trips to hospital (2.4 trips total) and a total travel time of 73.3 minutes to be able to return to their own home while waiting for the priming to work. For enhanced inpatient services, women were willing to accept a total travel time of 54.7 minutes to have a private room with private bathroom while waiting for the priming to work. The overall benefit score for outpatient priming was 3.63, 3.59 for enhanced inpatient care and 2.89 for basic inpatient care, suggesting slightly greater preferences for outpatient priming. Preferences for outpatient priming increased when women could return to their own home (compared to other offsite accommodation), and decreased with more trips to hospital and longer travel time.

Conclusions: Our results suggest that outpatient priming was slightly more preferred than either enhanced inpatient priming or basic care; these results should be confirmed in different clinical settings. There may be merit in providing women information about both options in the future, as preferences varied according to the characteristics of the services on offer and the sociodemographic background of the woman.

References

    1. Kelly AJ, Alfirevic Z, Dowswell T. Outpatient versus inpatient induction of labour for improving birth outcomes. Cochrane Database Syst Rev. 2009;14:CD007372.
    1. Kundodyiwa TW, Alfirevic Z, Weeks AD. Low-dose oral misoprostol for induction of labor: a systematic review. Obstet Gynecol. 2009;14:83.
    1. Laws PJ, Hilder L. Australia’s Mothers and Babies 2006. Sydney, Australia: AIHS National Perinatal Statistics Unit; 2008.
    1. Biem SR, Turnell RW, Olatunbosun O, Tauh M, Biem HJ. A randomized controlled trial of outpatient versus inpatient labour induction with vaginal controlled-release prostaglandin-E2: effectiveness and satisfaction. J Obstet Gynaecol Canada JOGC. 2003;14:23–31.
    1. Stitely ML, Browning J, Fowler M, Gendron RT, Gherman RB. Outpatient cervical ripening with intravaginal misoprostol. Obstet Gynecol. 2000;14:8.
    1. Awartani KA, Turnell RW, Olatunbosun OA. A prospective study of induction of labor with prostaglandin vaginal gel: ambulatory versus in-patient administration. Clin Exp Obstet Gynecol. 1999;14:162–165.
    1. McKenna DS, Costa SW, Samuels P. Prostaglandin E2 cervical ripening without subsequent induction of labor. Obstet Gynecol. 1999;14:11–14.
    1. Farmer KC, Schwartz WJ III, Rayburn WF, Turnbull G. A cost-minimization analysis of intracervical prostaglandin E2 for cervical ripening in an outpatient versus inpatient setting. Clin Ther. 1996;14:747–756.
    1. O’Brien JM, Mercer BM, Cleary NT, Sibai BM. Efficacy of outpatient induction with low-dose intravaginal prostaglandin E2: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol. 1995;14:1855–1859.
    1. Dowswell T, Kelly AJ, Livio S, Norman JE, Alfirevic Z. Different methods for the induction of labour in outpatient settings. Cochrane Database Syst Rev. 2010;14:CD007701.
    1. National Collaborating Centre forWomen’s and Children’s Health. Induction of Labour. Clinical Guideline. London, UK: RCOG Press at the Royal College of Obstetricians and Gynaecologists; 2012. July 2008. .
    1. Turnbull D, Adelson PL, Oster C, Bryce R, Fereday J, Wilkinson C. Psychosocial outcomes of a randomized controlled trial of outpatient cervical priming for induction of labor. Birth. 2012;14:75–80.
    1. Entwistle VA, France EF, Wyke S, Jepson R, Hunt K, Ziebland S, Thompson A. How information about other people’s personal experiences can help with healthcare decision-making: a qualitative study. Patient Educ Couns. 2011;14:e291–e298.
    1. France EF, Wyke S, Ziebland S, Entwistle VA, Hunt K. How personal experiences feature in women’s accounts of use of information for decisions about antenatal diagnostic testing for foetal abnormality. Soc Sci Med. 2011;14:755–762.
    1. Bridges JF, Hauber AB, Marshall DA, Lloyd A, Prosser LA, Regier DA, Johnson FR, Mauskopf JA. Conjoint Analysis applications in health-a checklist: a report of the ISPOR good research practices for conjoint analysis task force. Value Health. 2011;14(4):403–413.
    1. Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: a user’s guide. Pharmacoeconomics. 2008;14:661–677.
    1. Bridges JF, Kinter E, Kidane L, Heinzen R, McCormick C. Things are looking up since we started listening to patients: Recent trends in the application of conjoint analysis in health 1970–2007. Patient Patient Centred Outcomes Res. 2008;14:273–282.
    1. de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ. 2012;14:145–172.
    1. Scotland GS, McNamee P, Cheyne H, Hundley V, Barnett C. Women’s preferences for aspects of labor management: results from a discrete choice experiment. Birth. 2011;14:36–46.
    1. Hundley V, Ryan M. Are women’s expectations and preferences for intrapartum care affected by the model of care on offer? BJOG Int J Obstet Gynaecol. 2004;14:550–560.
    1. Hundley V, Ryan M, Graham W. Assessing women’s preferences for intrapartum care. Birth. 2001;14:254–263.
    1. Pitchforth E, Watson V, Tucker J, Ryan M, Van TE, Farmer J, Ireland J, Thomson E, Kiger A, Bryers H. Models of intrapartum care and women’s trade-offs in remote and rural Scotland: a mixed-methods study. BJOG Int J Obstet Gynaecol. 2008;14:560–569.
    1. Wilkinson C, Bryce R, Adelson P, Turnbull D. A randomised trial of outpatient compared with inpatient cervical ripening with prostaglandin e2 (OPRA Study) BJOG. 2014. doi:10.1111/1471-0528.12846.
    1. Ryan M, Ubach C. Testing for an experience endowment effect in health care. Applied Economic Lett. 2003;14:407–410.
    1. Oster C, Adelson PL, Wilkinson C, Turnbull D. Inpatient versus outpatient cervical priming for induction of labour: therapeutic landscapes and women’s preferences. Health Place. 2011;14:379–385.
    1. Bliemer MCJ, Rose JM. Construction of experimental designs for mixed logit models allowing for correlation across choice observations. Transp Res B. 2010;14:720–734.
    1. Hendrix M, Pavlova M, Nieuwenhuijze MJ, Severens JL, Nijhuis JG. Differences in preferences for obstetric care between nulliparae and their partners in the Netherlands: a discrete-choice experiment. J Psychosom Obstet Gynecol. 2010;14:243–251.
    1. Turnbull D, Adelson P, Oster C, Coffey J, Coomblas J, Bryce R, Wilkinson C. The impact of outpatient cervical priming for induction of labour on midwives’ work demand, work autonomy and satisfaction. Women Birth. 2013;14(3):201–212.
    1. Henry A, Madan A, Reid R, Tracy SK, Austin K, Welsh A, Challis D. Outpatient Foley catheter versus inpatient prostaglandin E2 gel for induction of labour: a randomised controlled trial. BMC Pregnancy Childbirth. 2013;14:25.
    1. Samuelson W, Zeckhauser R. Status Quo bias in decision making. J Risk Uncertain. 1988;14:7–59.
    1. Adelson PL, Wedlock G, Wilkinson C, Howard K, Bryce R, Turnbull D. A cost analysis of inpatient compared to outpatient prostaglandin E2 cervical priming for induction of labour: results from the OPRA Trial. Aust Health Rev. 2013;14:467–473.

Source: PubMed

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