Knowledge, attitude and practices of obstetric care providers towards maternal red-blood-cell immunization during pregnancy

Background and objectives A successful routine RBC alloantibody screening programme should not lead to unnecessary emotional burden during pregnancy due to inadequate counselling on the risk of severe haemolytic disease of the foetus and the newborn (HDFN). Rareness of this disease may result in insufficient knowledge and subsequent inadequate information transfer to women, diagnosed with RBC antibodies. We investigated the current knowledge, views and experiences of Dutch obstetric care providers regarding RBC alloimmunization during pregnancy. Materials and methods We performed a quantitative cross-sectional study, using a structured digital questionnaire to measure knowledge, attitude and practices (KAP) regarding maternal RBC alloimmunization among Dutch obstetric care providers in 2016. Results About 10% of obstetric care providers completed the questionnaire. A sufficient level of knowledge was found in 7% of all participants (N = 329). Knowledge about RhD immunisation and prophylaxis was sufficient in 60% of the responders. Knowledge gaps were found concerning the relevance of non-RhD RBC antibodies, the indications for giving extra RhD prophylaxis and the interpretation of laboratory test results. Healthcare providers estimated their own level of knowledge 'sufficient' (primary/secondary care) to 'good' (tertiary care), and all participants considered their professional role important within the screening programme. Conclusion Dutch obstetric care providers showed a lack of knowledge regarding maternal RBC immunization. Awareness of the lack of knowledge is necessary to help obstetric care providers to be careful in giving information and even to decide to contact the expert centre before counselling the patient

Heeft het preventieconsult de toekomst?

Wyers ce, walg cb, evers smaa, ruwaard d. The cardiometabolic prevention consultation. Huisarts wet 2014;57(6):286-9. While prevention programmes contribute to better health, they are also often applied to contain healthcare costs. As a result of the strong growth in the availability of commercial screening and intervention programmes, many of which are available via internet, the dutch college of general practitioners (nhg) published, in 2011, the guideline the cardiometabolic prevention consultation (prevention consultation), to facilitate the early detection of cardiovascular disease, type 2 diabetes, and kidney failure. This guideline is consistent with the aim, formulated in the report ‘primary care in 2022’, of the national association of general practitioners (lhv) and the nhg that general practitioners will focus on neighbourhood health prevention. However, implementation of these programmes is slow, due to the absence of structural funding and collaboration with other parties, and to the lack of evidence for the feasibility and cost effectiveness of these interventions. Further investigation of the cost effectiveness of the prevention consultation is needed