1. Implementing non-invasive prenatal testing for aneuploidy in a national healthcare system: global challenges and national solutions.
- Author
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van Schendel, Rachèl V., van El, Carla G., Pajkrt, Eva, Henneman, Lidewij, and Cornel, Martina C.
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NATIONAL health services , *PRENATAL care , *PRENATAL diagnosis , *MEDICAL personnel , *ANEUPLOIDY , *COST effectiveness , *DECISION making , *DIFFUSION of innovations , *FETAL ultrasonic imaging , *HEALTH attitudes , *INTERNATIONAL relations , *HEALTH policy , *GENETIC testing , *QUALITATIVE research , *PATIENTS' attitudes - Abstract
Background: Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands.Methods: A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings.Results: Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices.Conclusions: This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation. [ABSTRACT FROM AUTHOR]- Published
- 2017
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