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PloS one
2014;9 (1): e86204.

Improving ambulatory saliva-sampling compliance in pregnant women: a randomized controlled study.

Julian Moeller, Roselind Lieb, Andrea H Meyer, Katharina Quack Loetscher, Bettina Krastel, Gunther Meinlschmidt
Author Information
  1. Julian Moeller: University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland ; Diagnostic and Crisis Intervention Centre, Department of Psychiatry, University of Basel, Basel, Switzerland.
  2. Roselind Lieb: University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland.
  3. Andrea H Meyer: University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland.
  4. Katharina Quack Loetscher: Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland.
  5. Bettina Krastel: National Centre of Competence in Research (NCCR), Swiss Etiological Study of Adjustment and Mental Health (sesam), University of Basel, Basel, Switzerland.
  6. Gunther Meinlschmidt: University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland ; National Centre of Competence in Research (NCCR), Swiss Etiological Study of Adjustment and Mental Health (sesam), University of Basel, Basel, Switzerland ; Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany.
PMID: 24465958 DOI: 10.1371/journal.pone.0086204

Abstract

OBJECTIVE: Noncompliance with scheduled ambulatory saliva sampling is common and has been associated with biased cortisol estimates in nonpregnant subjects. This study is the first to investigate in pregnant women strategies to improve ambulatory saliva-sampling compliance, and the association between sampling noncompliance and saliva cortisol estimates.
METHODS: We instructed 64 pregnant women to collect eight scheduled saliva samples on two consecutive days each. Objective compliance with scheduled sampling times was assessed with a Medication Event Monitoring System and self-reported compliance with a paper-and-pencil diary. In a randomized controlled study, we estimated whether a disclosure intervention (informing women about objective compliance monitoring) and a reminder intervention (use of acoustical reminders) improved compliance. A mixed model analysis was used to estimate associations between women's objective compliance and their diurnal cortisol profiles, and between deviation from scheduled sampling and the cortisol concentration measured in the related sample.
RESULTS: Self-reported compliance with a saliva-sampling protocol was 91%, and objective compliance was 70%. The disclosure intervention was associated with improved objective compliance (informed: 81%, noninformed: 60%), F(1,60)  = 17.64, p<0.001, but not the reminder intervention (reminders: 68%, without reminders: 72%), F(1,60) = 0.78, p = 0.379. Furthermore, a woman's increased objective compliance was associated with a higher diurnal cortisol profile, F(2,64)  = 8.22, p<0.001. Altered cortisol levels were observed in less objective compliant samples, F(1,705)  = 7.38, p = 0.007, with delayed sampling associated with lower cortisol levels.
CONCLUSIONS: The results suggest that in pregnant women, objective noncompliance with scheduled ambulatory saliva sampling is common and is associated with biased cortisol estimates. To improve sampling compliance, results suggest informing women about objective compliance monitoring but discourage use of acoustical reminders.

References

  1. Psychosom Med. 2011 Jul-Aug;73(6):469-74 [PMID: 21700714]
  2. Ann N Y Acad Sci. 2007 Mar;1098:122-44 [PMID: 17332070]
  3. Am J Geriatr Psychiatry. 2006 Apr;14(4):325-33 [PMID: 16582041]
  4. Circulation. 2009 Jun 16;119(23):3028-35 [PMID: 19528344]
  5. Pharm Stat. 2008 Apr-Jun;7(2):93-106 [PMID: 17351897]
  6. Neurosci Biobehav Rev. 2005 Apr;29(2):295-312 [PMID: 15811500]
  7. Psychoneuroendocrinology. 2008 Jan;33(1):77-82 [PMID: 17996380]
  8. Nutrition. 2000 Oct;16(10):924-36 [PMID: 11054598]
  9. Psychoneuroendocrinology. 2008 Oct;33(9):1225-35 [PMID: 18692319]
  10. Biol Psychol. 2011 Jan;86(1):50-6 [PMID: 20955759]
  11. Sports Med. 2006;36(1):19-38 [PMID: 16445309]
  12. Annu Rev Psychol. 2011;62:531-58 [PMID: 21126184]
  13. Eur J Clin Nutr. 2006 Mar;60(3):393-400 [PMID: 16306930]
  14. Stress. 2010 May;13(3):258-68 [PMID: 20067400]
  15. Psychol Trauma. 2010 Dec 1;2(4):326-334 [PMID: 21423846]
  16. Psychosom Med. 2010 May;72(4):419-26 [PMID: 20410245]
  17. Psychoneuroendocrinology. 1994;19(4):313-33 [PMID: 8047637]
  18. Psychoneuroendocrinology. 2004 Jun;29(5):636-50 [PMID: 15041086]
  19. Int J Behav Med. 2010 Mar;17(1):74-8 [PMID: 19597997]
  20. Psychoneuroendocrinology. 2005 Aug;30(7):647-56 [PMID: 15854781]
  21. Psychoneuroendocrinology. 2010 Jun;35(5):644-52 [PMID: 19889503]
  22. Life Sci. 2005 Apr 8;76(21):2431-43 [PMID: 15763075]
  23. Psychoneuroendocrinology. 2005 Sep;30(8):724-43 [PMID: 15919579]
  24. BMC Pregnancy Childbirth. 2002 Nov 19;2(1):8 [PMID: 12437774]
  25. AIDS Patient Care STDS. 2008 Jun;22(6):495-504 [PMID: 18462071]
  26. Psychosom Med. 2012 May;74(4):418-31 [PMID: 22582339]
  27. J Psychosom Res. 1995 Jul;39(5):563-95 [PMID: 7490693]
  28. Psychoneuroendocrinology. 2011 May;36(4):540-6 [PMID: 20863625]
  29. Psychoneuroendocrinology. 2009 Feb;34(2):163-171 [PMID: 19095358]
  30. Am J Obstet Gynecol. 2009 Oct;201(4):398.e1-8 [PMID: 19716542]
  31. Ann Behav Med. 2007 Oct;34(2):209-16 [PMID: 17927559]
  32. Life Sci. 1997;61(26):2539-49 [PMID: 9416776]
  33. Environ Health Perspect. 2011 Nov;119(11):1647-52 [PMID: 21775267]
  34. Eur J Clin Nutr. 2011 Dec;65(12):1295-301 [PMID: 21792212]
  35. PLoS Med. 2011 Mar;8(3):e1000422 [PMID: 21390262]
  36. Psychoneuroendocrinology. 2007 Sep-Nov;32(8-10):1013-20 [PMID: 17855000]
  37. Psychosom Med. 2003 Mar-Apr;65(2):313-9 [PMID: 12652000]
  38. Ann Behav Med. 2003 Oct;26(2):139-48 [PMID: 14534031]
  39. Annu Rev Clin Psychol. 2008;4:1-32 [PMID: 18509902]
  40. Stress. 2010 Mar;13(2):163-71 [PMID: 20214437]

MeSH Term

Adult
Ambulatory Care
Biomarkers
Female
Humans
Hydrocortisone
Patient Acceptance of Health Care
Pregnancy
Saliva
Self Report
Specimen Handling
Stress, Psychological

Chemicals

Biomarkers
Hydrocortisone
Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Word Cloud

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