Pregnant women with diabetes and their clinician's experience of participating in a pilot randomised controlled trial of corticosteroid administration in late pregnancy: A qualitative study

Linda Sweet; Vidanka Vasilevski; Lee-Anne Lynch; Joanne M Said

doi:10.1111/hex.13930

Pregnant women with diabetes and their clinician's experience of participating in a pilot randomised controlled trial of corticosteroid administration in late pregnancy: A qualitative study

Health Expect. 2023 Dec 6;27(1):e13930. doi: 10.1111/hex.13930. Online ahead of print.

Authors

Linda Sweet^{1

2}, Vidanka Vasilevski^{1

2}, Lee-Anne Lynch^{3

4}, Joanne M Said^{3

4}

Affiliations

¹ School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia.
² Centre for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Melbourne, Victoria, Australia.
³ Maternal Fetal Medicine, Joan Kirner Women's and Children's Hospital, Western Health, Melbourne, Victoria, Australia.
⁴ Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.

Abstract

Background: Little research exists to support the administration of corticosteroids to pregnant women with diabetes. Pregnant women are often excluded from clinical trials due to concerns of harm to the foetus.

Aim: This study aimed to understand the experiences of women and clinicians of participating in the Prevention of neonatal Respiratory distress with antenatal corticosteroids before Elective Caesarean section in women with Diabetes pilot randomised controlled trial to determine the acceptability of the study protocol.

Methods: Women and clinicians participating in the pilot trial were invited to complete a telephone interview regarding their experiences of participating. Qualitative data were collected and subsequently analysed using thematic analysis.

Results: A total of 13 women and nine clinicians were recruited between June 2020 and May 2022 for a telephone interview. Participating in the study was deemed acceptable by women and clinicians. Women chose to participate in the study due to the perceived low risk of harm associated with the intervention and for altruistic reasons. The high level of clinical support and information provided for the duration of the pilot trial was valued by women and clinicians. All clinicians highlighted the importance of conducting the trial to inform evidence-based practice.

Conclusions: Pregnant women are more likely to participate in clinical trials when perceived risks are low and they are well-informed during decision-making. Clinicians will support clinical trials when they perceive a benefit to practice and feel assured that women receive extensive monitoring and support. Incorporating these factors into study protocols is more likely to be successful in recruiting pregnant women and maintaining the engagement of clinical staff for the duration of clinical trials.

Patient or public contributions: Patients were invited to be participants in this study. A consumer has been included in the planning and oversite of the large multicentre trial.

Keywords: acceptability; clinical trial; corticosteroids; endocrinology; feasibility; gestational diabetes; pregnancy.