Reduce Postpartum Hypertension With Remote Monitoring

TOPLINE:

Remote monitoring for postpartum hypertension is linked to fewer hospital readmissions and higher adherence to guidelines. Participants were more likely to have blood pressure recorded within 10 days of delivery and initiate antihypertensive medication.

METHODOLOGY:

• Researchers conducted a retrospective propensity-matched cohort study of 12,038 postpartum individuals with hypertensive disorders of pregnancy who delivered between March 2019 and June 2023 at Magee-Womens Hospital in Pittsburgh, Pennsylvania.
• Participants were enrolled in a remote hypertension management program that included home blood pressure measurement and centralized nursing team management.
• Outcome measures included postpartum readmission, office visit within 6 weeks post partum, blood pressure measurement within 10 days of delivery, and initiation of antihypertensive medication.
• Blood pressures were reported using text messaging, and elevated readings triggered automated alerts reviewed by nursing staff, prompting physician contact as needed.

TAKEAWAY:

• According to the authors, participation in the remote monitoring program was associated with a 1.5% reduction in 6-week postpartum readmission rates (adjusted risk ratio [aRR], 0.78; 95% CI, 0.65-0.93).
• Researchers found that 97.6% of participants in the remote monitoring program had a blood pressure recorded within 10 days post partum, compared to 11.5% in the control group (propensity score–matched adjusted risk difference [aRD], 85.4; 95% CI, 84.3-86.6).
• The study showed that 24.4% of participants in the remote monitoring program were started on antihypertensive medication post partum compared with 5.4% in the control group (propensity score–matched aRR, 4.44; 95% CI, 3.88-5.07).
• The authors state that remote monitoring was linked to higher attendance at 6-week postpartum office visits, with 77.0% of participants attending compared with 64.4% in the control group (propensity score–matched aRD, 5.7; 95% CI, 3.9-7.6).

IN PRACTICE:

“We found that participation in a postpartum remote blood pressure management program was associated with fewer postpartum hospital readmissions, higher attendance at postpartum visits, improved national guideline adherence, and higher rates of antihypertensive use,” wrote the authors of the study.

SOURCE:

The study was led by Lara S. Lemon, PhD, PharmD, and Alisse Hauspurg, MD, at the University of Pittsburgh School of Medicine in Pittsburgh. It was published online in Obstetrics & Gynecology.

LIMITATIONS:

The study’s limitations include its retrospective design, which may introduce selection bias. Additionally, the study was conducted at a single institution, limiting the generalizability of the findings. The reliance on self-reported blood pressure measurements may have also affected the accuracy of the data. Finally, the study population was predominantly White and commercially insured, which may not reflect the broader population. 

DISCLOSURES:

Lara S. Lemon, PhD, PharmD, and Alisse Hauspurg, MD, received grants from the National Institutes of Health. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.