Implementation of Telemedicine in the Basel Postpartum Hypertension Cohort (Basel- Ppht): A Comparison of Telemonitoring Approaches Using Patient Reported Outcome Measures (Proms)

Objective: Digital technologies are expanding in hypertension and can support management and especially in the postpartum period. One catalyst was the SARS-COVID-19-Pandemic, which steered alternative ways to manage patients. This analysis compares two telemonitoring strategies within the Basel Postpartum Hypertension Cohort – a smartphone App for structured home BP measurement and a programmed Excel spreadsheet. Design and method: Two telemonitoring strategies—a connected smartphone home BP measurement (HBPM) application (App group) and a programmed Excel spreadsheet (Excel group) —were compared using Patient-Reported Outcome Measures (PROMs) to assess, satisfaction, attrition, and BP control in women with PPHT. PROMs were evaluated, focusing on patient satisfaction, sense of safety, technical issues, and effectiveness of the tools. Satisfaction was based on a scale of 1-5, 5 = maximal satisfaction. 24-hour ambulatory BP measurements were performed 3 months after delivery. BP control was mean awake <135/85mmHg. Results: 356 participants were enrolled until August 2023. The majority of participants chose HBPM 96.3%(n=343): 65.6%(n=225) (used the connected smartphone HBPM App, and 116 (33.8%) used the Excel tool. Mean age was 33.9 ± 5.4 years, median BMI of 24.4 kg/m2(IQR: 16.9–66.7). Etiology of PPHT was preexisting hypertension 10.1%, 31.2% gestational hypertension and 53.1% preeclampsia (overlaps were seen). Antihypertensive medication at baseline was prescribed in 87%. Mean systolic/diastolic BP of 136.4 ± 13.5 mmHg and 85.3 ± 8.6 mmHg respectively. App users had higher satisfaction levels (Table 1), with 94% reporting scores of 4–5/5 compared to 72.2% in the Excel group. Safety was reported in 98.2% of App users and 96.3% of Excel users. The App was associated with fewer technical issues (20.48% vs. 25.93%) and higher perceived utility (89.76% vs. 79.63%). Control was achieved in most patients by the first follow-up (App:29.33%, Excel: 20.7%). Conclusions: Both telemonitoring strategies were highly accepted and the patients reported a feeling of safety in the management of PPHT, with the App showing greater patient satisfaction, better-perceived utility, and fewer technical difficulties. These findings demonstrate the feasibility and acceptance of telemonitoring in postpartum hypertension care, offering insights into optimizing remote management strategies for this high-risk population.