SAFE@HOME: Digital health platform facilitating a new care path for women at increased risk of preeclampsia – A case-control study

Heuvel, Josephus F.M. van den; Lely, A. Titia; Huisman, Jolijn; Trappenburg, Jaap C.A.; Franx, Arie; Bekker, Mireille N.

doi:10.1016/j.preghy.2020.07.006

Cited by 34 publications

(47 citation statements)

References 22 publications

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“…Seven studies reported in 8 articles [ 40 – 47 ] conducted in North America, Europe, and Oceania (all high-income countries) provided values and preferences data on SMBP for pregnant individuals with hypertensive disorders (Table 3 ). Two of these studies also reported data on providers’ perspectives [ 40 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“… Hinton et al, 2020 [ 40 ] United Kingdom Obstetricians, hospital and community midwives, pharmacists, and physicians-in-training. N = 147 Semi-structured interview, focus groups N/A (providers reported their views on various topics surrounding the patients’ self-monitoring of blood pressure during pregnancy) Jongsma et al, 2020 [ 42 ] van den Heuvel et al, 2020a [ 46 , 47 ] (SAFE@HOME) Netherlands Pregnant women with singleton pregnancy and at least one of the predetermined risk factors of preeclampsia including chronic hypertension and maternal cardiac or renal diseases. Participants had to have a “good understanding of either the Dutch or English language”, but authors provided no further report of educational or health literacy level.…”

Section: Resultsmentioning

confidence: 99%

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Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review

Yeh

Rhee

Kennedy

et al. 2022

BMC Pregnancy Childbirth

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Background The World Health Organization (WHO) recommends self-monitoring of blood pressure (SMBP) for hypertension management. In addition, during the COVID-19 response, WHO guidance also recommends SMBP supported by health workers although more evidence is needed on whether SMBP of pregnant individuals with hypertension (gestational hypertension, chronic hypertension, or pre-eclampsia) may assist in early detection of pre-eclampsia, increase end-user autonomy and empowerment, and reduce health system burden. To expand the evidence base for WHO guideline on self-care interventions, we conducted a systematic review of SMBP during pregnancy on maternal and neonatal outcomes. Methods We searched for publications that compared SMBP with clinic-based monitoring during antenatal care. We included studies measuring any of the following outcomes: maternal mortality, pre-eclampsia, long-term risk and complications, autonomy, HELLP syndrome, C-section, antenatal hospital admission, adverse pregnancy outcomes, device-related issues, follow-up care with appropriate management, mental health and well-being, social harms, stillbirth or perinatal death, birthweight/size for gestational age, and Apgar score. After abstract screening and full-text review, we extracted data using standardized forms and summarized findings. We also reviewed studies assessing values and preferences as well as costs of SMBP. Results We identified 6 studies meeting inclusion criteria for the effectiveness of SMBP, 6 studies on values and preferences, and 1 study on costs. All were from high-income countries. Overall, when comparing SMBP with clinic-monitoring, there was no difference in the risks for most of the outcomes for which data were available, though there was some evidence of increased risk of C-section among pregnant women with chronic hypertension. Most end-users and providers supported SMBP, motivated by ease of use, convenience, self-empowerment and reduced anxiety. One study found SMBP would lower health sector costs. Conclusion Limited evidence suggests that SMBP during pregnancy is feasible and acceptable, and generally associated with maternal and neonatal health outcomes similar to clinic-based monitoring. However, more research is needed in resource-limited settings. Systematic review registration PROSPERO CRD42021233839.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review

Yeh

Rhee

Kennedy

et al. 2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…A mixed methods study, alongside a prospective blended care study (SAFE@home study) [ 16 , 17 ], was performed to explore the understanding of patients’ experiences with mHealth [ 18 , 19 ]. Data were collected by means of validated questionnaires and semistructured in-depth interviews with patients that had experience with mHealth for remote monitoring of HDP, to explore their experiences and motivations.…”

Section: Methodsmentioning

confidence: 99%

“…The data collected within this study were sent by the patient to the digital monitoring team, who reviewed the data each day except for the weekend days. The mHealth technology consisted of an automated blood pressure monitor with Bluetooth connection to a smartphone app for iOS users and a web-based portal for Android users ( Figure 1 ) [ 16 , 17 ]. Digital monitoring started from 16 weeks gestational age and was continued until delivery, with interruption in case of hospital admission .…”

Section: Methodsmentioning

confidence: 99%

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User Experiences With and Recommendations for Mobile Health Technology for Hypertensive Disorders of Pregnancy: Mixed Methods Study

Jongsma¹,

Heuvel²,

Rake³

et al. 2020

JMIR Mhealth Uhealth

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Background Hypertensive disorders of pregnancy (HDP) are a primary cause of adverse maternal and neonatal outcomes worldwide. For women at risk of hypertensive complications, guidelines recommend frequent surveillance of blood pressure and signs of preeclampsia. Clinic visits range from every 2 weeks to several times a week. Given the wide ubiquity of smartphones and computers in most countries and a growing attention for self-management, digital technologies, including mobile health (mHealth), constitute a promising component of monitoring (self-measured) blood pressure during pregnancy. Currently, little is known about the experiences of women using such platforms and how mHealth can be aligned with their needs and preferences. Objective The objectives were twofold: (1) to explore the experiences of Dutch women who had an increased risk of HDP with a blended care approach (mHealth combined with face-to-face care) for remote self-monitoring of blood pressure and preeclampsia symptoms and (2) to formulate recommendations for the use and integration of mHealth in clinical care. Methods Alongside a prospective blended care study (SAFE@home study) that monitors pregnant women at increased risk of HPD with mHealth technology, a mixed methods study was conducted, including questionnaires (n=52) and interviews (n=11). Results were analyzed thematically. Results Of the 4 themes, 2 themes were related to the technologies themselves (expectations, usability), and 2 themes were related to the interaction and use of mHealth (autonomy and responsibilities of patients, responsibilities of health care professionals). First, the digital platform met the expectations of patients, which contributed to user satisfaction. Second, the platform was considered user-friendly, and patients favored different moments and frequencies for measuring their blood pressure. Third, patient autonomy was mentioned in terms of increased insight about their own condition and being able to influence clinical decision making. Fourth, clinical expertise of health care professionals was considered essential to interpret the data, which translates to subsequent responsibilities for clinical management. Data from the questionnaires and interviews corresponded. Conclusions Blended care using an mHealth tool to monitor blood pressure in pregnancy was positively evaluated by its users. Insights from participants led to 7 recommendations for designing and implementing similar interventions and to enhance future, morally sound use of digital technologies in clinical care.

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Preeclampsia: Effects on Cardiovascular Outcomes

Avula

Thakkar

Sharma

2023

Contemporary Cardiology

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SAFE@HOME: Digital health platform facilitating a new care path for women at increased risk of preeclampsia – A case-control study

Cited by 34 publications

References 22 publications

Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review

Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review

User Experiences With and Recommendations for Mobile Health Technology for Hypertensive Disorders of Pregnancy: Mixed Methods Study

Preeclampsia: Effects on Cardiovascular Outcomes

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