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Hypertensive disorders of pregnancy (HDP) management pathways: results of a Delphi survey to contextualise international recommendations for Indonesian primary care settings
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  • Fitriana Ekawati,
  • Shaun Brennecke,
  • Sharon Licqurish,
  • Jane Gunn,
  • Phyllis Lau
Fitriana Ekawati
Gadjah Mada University
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Shaun Brennecke
The University of Melbourne
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Sharon Licqurish
University of Melbourne Melbourne Medical School
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Jane Gunn
The University of Melbourne
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Phyllis Lau
The University of Melbourne
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Abstract

Objectives: To reach consensus on evidence-based recommendations to develop HDP management pathways for Indonesian primary care. Design: A three-round Delphi survey Setting: N/A Population: Maternal health practitioners and experts, including GPs, midwives, nurses and health policy researchers from Indonesia and international background. Methods: Participants were asked to rate their agreement on whether each of 125 statements about HDP and HDP managements extracted from international guidelines were feasible in Indonesian primary care settings in a mix of quantitative and qualitative questions in three-rounds Delphi survey. A minimum of 70% agreement among participants was needed for a statement to be included for the HDP pathways that the pathways drafts were presented at the third-round survey. The participants’ free text questions responses and suggestions were analysed thematically. Main Outcome Measures: Agreement scores of the statements. Results: A total of 52 participants participated, 48, 45, and 37 of them completed the first, second and third-round survey respectively. The consensus was reached for 115 of the 125 statements on HDP definition, screening, management and long-term follow-up. The agreement scores ranged from 70.8-100.0% and potential implementation barriers were also identified. Drafts of HDP management pathways were also agreed upon and received suggestions from the participants. Conclusions: Most evidence-based HDP management recommendations achieved consensus represented in the developed HDP management pathways can be implemented in Indonesian settings. Further investigations are needed to explore the acceptability and feasibility of the pathways in practice.