Educating antenatal patients about cytomegalovirus infection: An e-learning package improves general practitioners’ knowledge and intention to implement clinical guidelines

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Background and objectiveThe Australian Government's Living Evidence for Australian Pregnancy and Postnatal Care guideline recommend all pregnant women be informed about cytomegalovirus (CMV) infection risk-reduction strategies.The aim of this paper was to determine the effectiveness of the 'Infections in Pregnancy' e-learning module in improving general practitioner (GP) knowledge, confidence in counselling and intended practice regarding CMV patient education. MethodsThis study used a pre-post quasi-experimental design.GPs undertaking the module in March to December 2023 completed questionnaires before and after completing the module.An adjusted linear mixed effects model was used to evaluate change in scores. ResultsOf 164 study participants, 94% had not previously received CMV prevention education.Total adjusted mean CMV knowledge scores and confidence in CMV counselling were significantly higher after completing the module (P<0.001).The proportion of GPs intending to counsel pregnant patients about CMV increased from 24% to 97% after completing the module. DiscussionTargeted e-learning can improve GP knowledge and confidence, and can support the implementation of the national congenital CMV risk-reduction guidelines.CONGENITAL CYTOMEGALOVIRUS (CMV) is a major cause of life-long neurodevelopmental disabilities such as sensorineural hearing loss, epilepsy, learning difficulties and cerebral palsy.[1][2][3] Although the prevalence of congenital CMV in Australia is not known, data from comparable high-income countries suggest that around one in 200 infants are born with congenital CMV, making it the most common congenital infection.2,4 Hygiene precautions, including avoiding contact with a child's saliva or urine and handwashing after such exposure, reduce the risk of CMV in pregnancy and are acceptable to women.[5][6][7] The Australian Government's 'Living Evidence for Australian Pregnancy and Postnatal Care' guideline recommends advising 'all pregnant women about hygiene measures to help reduce the risk of cytomegalovirus infection'.8 This advice is in line with recommendations from both the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, international consensus guidelines and a recently published evidence-based European guideline.[9][10][11] Educating all pregnant women and those planning a pregnancy as early as possible and at each pregnancy is important, as a primary maternal infection in the first trimester of pregnancy holds the greatest risk of poor fetal outcomes.3 However, most pregnant women in Australia do not know about CMV or how to reduce their risk of infection in pregnancy.12 Maternity health professionals including general practitioners (GPs) have a pivotal role in providing preconception and early antenatal care, including education about preventive measures to reduce the risk of perinatal infections.13,14 However, less than 20% of GPs feel confident giving advice about CMV, with a 'lack of knowledge about CMV' identified as a major barrier to providing patient education about reducing their risk of infection.15 Previous research by this author group has found that an e-learning course significantly improved midwives' knowledge about CMV and confidence in providing antenatal counselling; however, to our knowledge, no studies to date have evaluated the impact of CMV education for GPs.16 The objectives of this study were to evaluate the effectiveness of the education module in improving GPs' knowledge and confidence in CMV counselling and their intention to provide CMV prevention advice to pregnant women. Educating antenatal patients about cytomegalovirus infection: An e-learning package improves general practitioners' knowledge and intention to implement clinical guidelines

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