Key result
Remote monitoring for postpartum hypertension proves feasible with ~77% achieving high satisfaction and adherence.
Why the study?
Hypertensive disorders of pregnancy cause readmissions postpartum, but the feasibility of a standardized remote patient monitoring program for these patients had not been determined.
Is a standardized remote patient monitoring program feasible for postpartum patients with hypertensive disorders of pregnancy?
Observational (n=30)
Is a standardized remote patient monitoring program feasible for postpartum patients with hypertensive disorders of pregnancy?
p-value: p=0.0027
A standardized remote patient monitoring program for postpartum hypertensive disorders of pregnancy is highly feasible, achieving 91% adherence and 92% satisfaction with zero hospital readmissions.
Supports feasibility of remote postpartum hypertension monitoring in small cohorts; hypothesis-generating and requires RCTs before practice change.
INTRODUCTION: Hypertensive disorders of pregnancy (HDP) account for 2.5–4.6% of readmissions within 6 weeks postpartum (PP); 60% occur in the first 7 days. A standardized approach to HDP management can improve outcomes through optimized PP blood pressure (BP) management. Remote patient monitoring (RPM) has established safety, outcomes, financial benefit, and increased compliance. The primary outcome of this study was to determine the feasibility of a standardized RPM program for PP patients with HDP. METHODS: Participants (n=30) received a phone application and BP monitor that automatically uploaded data to a nurse practitioner (NP)-monitored dashboard. Participants were asked to record a single BP twice daily (6 am –11 am and 6 pm –11 pm ) until 10 days PP. Telehealth visits with an NP occurred at 48 hours postdischarge. Feasibility was measured using a one-sided t test of the proportion of participants with satisfaction (via validated Likert-style post-participation surveys) and adherence of 80% or higher (recorded BPs/expected BPs). Secondary outcomes included readmissions, elevated BPs (mild, 140–159/90–109 mm Hg; severe, ≥160/110 mm Hg), and antihypertensive medication up-titration. RESULTS: One hundred percent of participants completed the program. Overall adherence rate was 91%, and overall satisfaction rate was 92%. Of 450 recorded BP measurements, 88 (19.6%) were mild and 2 (0.4%) were severe, with 0 hospital readmissions. Medication up-titration occurred seven times in six participants (20%). We demonstrated feasibility with a proportion of 0.767 participants ( P =.0027; CI: 0.577, 0.885). CONCLUSION: A standardized RPM program for PP HDP utilizing early telemedicine visits with an NP successfully demonstrated feasibility in a pilot sample of PP patients. Compliance with PP follow-up recommendations was high. Future work to improve systems innovation for BP optimization in PP patients is needed.
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Spiro et al. (2023) conducted an observational in Postpartum Hypertensive Disorders of Pregnancy (n=30). Remote patient monitoring (RPM) program was evaluated on Feasibility (proportion of participants with satisfaction and adherence of 80% or higher) (95% CI 0.577-0.885, p=0.0027). A remote patient monitoring program for postpartum hypertensive disorders of pregnancy was feasible, with 76.7% of participants achieving high satisfaction and adherence (P=0.0027).
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