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LO-025 Increasing pre-eclampsia knowledge and higher prevalence of aspirin use in SLE with a specific educational tool: interim analyses of a randomized controlled trial
  1. Joo-Young (Esther) Lee1,
  2. Arielle Mendel1,
  3. Isabelle Malhamé2,
  4. Sasha Bernatsky1 and
  5. Evelyne Vinet1
  1. 1Department of Medicine, Division of Rheumatology, Research Institute of McGill University Health Centre, Canada
  2. 2Department of Medicine, Division of General Internal Medicine, McGill University Health Centre, Canada

Abstract

Background Pregnant SLE women are at high risk of pre-eclampsia. Aspirin reduces its risk but is used only in a minority of SLE pregnancies. This randomized controlled trial evaluated a specifically-designed educational tool on pre-eclampsia knowledge, aspirin use and adherence in SLE pregnancies. We present interim results.

Methods We recruited pregnant SLE women up to 16 gestational weeks at 5 Canadian SLICC centres. Participants were randomly assigned to the educational tool (intervention) or standard of care (control). At every pregnancy visit, participants completed pre-eclampsia questionnaire, aspirin survey, and modified Adherence to Refills and Medications Scale (ARMS). We performed Student’s t-test and univariate linear regression to assess pre-eclampsia knowledge, and estimated 95% CI for difference in proportion of aspirin users using the Wilson procedure. We evaluated mean ARMS score difference with Student’s t-test and Mann-Whitney U test.

Results Thirty-eight women were included, with 20 exposed to the intervention. Baseline characteristics were well-balanced. The difference in mean pre-eclampsia knowledge scores between 1st and 2nd trimester visits in the intervention group was 5.0 points (95% CI 1.4, 8.6) and 1.1 points (95% CI -3.1, 5.4) in the control group when all women were included regardless of fetal loss. The mean difference in scores for those receiving the educational tool was 4.1 points higher (95% CI 0.4, 7.9) than those receiving standard of care. There was a trend of higher aspirin use in the intervention group. Aspirin adherence was high regardless of intervention status.

Conclusions Midway into the trial, pre-eclampsia knowledge improved from 1st to 2nd trimester visits in pregnant SLE women who received the tool compared to those who did not. There was a trend of higher aspirin use in women receiving the educational tool. The trial is well-poised to provide a new evidence-based approach to improve pre-eclampsia knowledge and potentially optimize aspirin use and pregnancy outcomes.

  • Systemic lupus erythematosus pregnancy
  • placenta-mediated pregnancy complications
  • Patient education
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