Identification of increased risk of perinatal anxiety: a multi-perspective qualitative study.

Perinatal anxiety (PNA) is experienced by about 20% of women throughout the perinatal period. Identifying women at risk of PNA through using routinely collected patient data could enable early intervention to improve treatment outcomes. The acceptability of doing this, however, is unknown. To explore patients' and practitioners' views on identifying women at risk of developing PNA using routinely collected data. Semi-structured interviews were held with 19 women with lived experience of PNA, 27 health care practitioners (HCPs) and 4 community practitioners from Voluntary, Community and Social Enterprise (VCSE) Perinatal Mental Health (PMH) organisations in England. Interviews were analysed thematically. A patient and public involvement and engagement group were involved throughout the study. Both women and practitioners thought it was acceptable to identify women at increased risk of PNA using medical records providing sufficient support was in place. Interviewees also highlighted that risk of PNA needed to be communicated sensitively, with phrasing such as 'more vulnerable' or 'more susceptible' preferred. Issues with identifying risk factors within patient records, such as limited sharing between HCPs and poor coding were discussed by practitioners. There are challenges to identifying risk factors within patient records. It was felt that not all possible risk factors would be recorded in primary care records and there is limited sharing between HCPs and poor coding were discussed by practitioners, many of whom thought that clinical intuition was a more appropriate way to assess risk.