Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study

Hoppe, Kara K.; Williams, Makeba; Thomas, Nicole A.; Zella, Julia B.; Drewry, Anna; Kim, KyungMann; Havighurst, Thomas C.; Johnson, Heather M.

doi:10.1016/j.preghy.2018.12.007

Cited by 85 publications

(92 citation statements)

References 25 publications

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“…Other forms of distance care, e.g. evidence-based mobile health apps or other remote monitoring [26,27], may also offer a more accessible way to delivery ongoing postpartum care, particularly for elements of care that do not require facetime with a provider, e.g. education about resuming sexual activities or diet and weight trajectory.…”

Section: Discussionmentioning

confidence: 99%

Competing demands in postpartum care: a national survey of U.S. providers’ priorities and practice

Krishnamurti

Simhan

Borrero

2020

BMC Health Serv Res

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Background: A new movement towards improved postpartum care calls for restructuring how that care is provided. As professional guidelines evolve, understanding how providers prioritize and practice postpartum care can offer insights about elements of care that may be currently performed more routinely than providers deem a priority to do so, as well as those that may warrant more routine practice. Methods: We surveyed 600 randomly-sampled U.S. postpartum care providers about their priorities for and the frequency with which specific elements of care are provided, as well as the feasibility of remote delivery of postpartum care provision (i.e., telemedicine). Results: The survey response rate was 43% across medical specialties. Providers reported an average of only 24.4 ± 11.7 min available to spend on the postpartum visit. Certain types of postpartum care were highly prioritized and routinely performed, such as depression screening. Yet, there were also noted discrepancies between prioritized and performed care, revealing competing demands on providers' time. For example, pelvic exams were performed more often than similarly prioritized care, whereas screening for intimate partner violence and substance use were performed less often than similarly-prioritized care. Certain types of care were identified as important that are not explicitly addressed by national practice guidelines (e.g. transitioning to parenthood). Approximately 25% of respondents regarded telemedicine as a feasible remote care delivery alternative to much of the care currently provided in-person. Conclusions: The time providers have available to offer comprehensive postpartum care is constrained. Understanding how certain elements of care may be competing with one another at a single postpartum visit highlights those elements of care, which may be currently underperformed, as well as those elements of care that may warrant evaluation for future inclusion in standard care. For some providers experiencing time constraints, complementary remote care represents a potentially viable approach to implementing recommendations for transitioning the traditional visit to a more frequent, ongoing postpartum care process. In calling for a new approach to postpartum care delivery, professional organizations should consider the practices and priorities of their constituency as they revise guidelines and shape future research about the value of specific postpartum services.

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Section: Discussionmentioning

confidence: 99%

Competing demands in postpartum care: a national survey of U.S. providers’ priorities and practice

Krishnamurti

Simhan

Borrero

2020

BMC Health Serv Res

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“…17,18 It has also been observed that home blood pressure monitoring in cases with hypertension in pregnancy was acceptable to most patients and could detect elevation in blood pressure. 19,20 Home monitoring, in addition allows for active participation of patients in their self-care and promotes self-efficacy especially during hard times of COVID-19 pandemic .…”

Section: Telemedicine For Antenatal Carementioning

confidence: 99%

Optimizing telemedicine for providing obstetric and reproductive health care services during COVID-19 pandemic

Sharmila

Babu

Balakrishnan³

2020

Int J Community Med Public Health

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The coronavirus disease (COVID-19) outbreak was first declared in China in December 2019, and WHO declared the outbreak as a pandemic on 11 March 2020. A fast-rising number of confirmed cases has been observed in countries across all continents over the past few months. This pandemic is forcing government of nations to take strict measures such as complete lockdown and curfews to ensure that citizens stay at home, as a measure to contain the spread of infection. Health sector is facing challenges such as high demand for doctors, limited resources of personal protective equipment and challenges in providing in-person consultation due to fear of spread of infection. Telemedicine is making positive contribution to healthcare during this pandemic, as it caters to health care of people in wide geographical area without risk of acquiring COVID-19. Telemedicine is defined as the provision of health care services by health care professionals, using technology to exchange information. A broad range of obstetric and reproductive health services can be offered via telemedicine. Telemedicine can help pregnant women to maintain high quality of care during this pandemic without compromising on the perinatal outcome. It allows for constant interaction between patient and doctor throughout pregnancy, thereby ensuring that the goals of antenatal care are fulfilled, while limiting unnecessary travel and time away from work and family. This article mainly concentrates on the essential obstetric and reproductive health care services that can be provided by telemedicine during COVID-19 pandemic.

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“…Specifically, most women reported that they found the technologies easy to use, would recommend them to other women, and preferred this model of hypertension management to in-person clinic visits. [8][9][10] One study found remote postpartum blood pressure monitoring increased in-person care engagement, with 88% of women who used remote monitoring attending their in-person 6-week postpartum visit, compared with a baseline attendance rate of 66%. 10 Furthermore, 82% of patients expressed relief in knowing that a nurse was monitoring their blood pressure on a daily basis.…”

Section: Current Evidence For Postpartum Remote Blood Pressure Monitomentioning

confidence: 99%

“…Similarly, the majority of studies on remote blood pressure monitoring were conducted in English-speaking populations, and phone-accessible translation services and multilanguage text messaging options will be critical to establishing more robust evidence for deploying remote monitoring universally and equitably. [8][9][10][11] The impact of changes in insurance coverage for telehealth and blood pressure cuffs during COVID-19 is also a critical area for research. Prior to the pandemic, limited insurance coverage during the postpartum period, as well as for telehealth visits, presented a major barrier to scaling up remote hypertension monitoring.…”

Section: Future Research Directions For Postpartum Remote Monitoringmentioning

confidence: 99%

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Establishing Better Evidence on Remote Monitoring for Postpartum Hypertension: A Silver Lining of the Coronavirus Pandemic

Jaffe

Naqvi

Sarma

et al. 2020

AJP Rep

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The transformation of our health care system in response to coronavirus disease 2019 (COVID-19) provides a unique opportunity to examine the use of telehealth for postpartum care. The postpartum period can pose significant risks and challenges, particularly for women with hypertensive disorders of pregnancy. Remote blood pressure monitoring has proven feasible and acceptable among women and providers but has not been widely implemented or researched. Early studies have identified improved outcomes with use of telehealth, including increased compliance with care and decreased disparity in hypertension follow-up. Preliminary data make a compelling case for remote monitoring as a promising treatment strategy to manage postpartum hypertension. Remote monitoring technology should be incorporated as a standard component for the comprehensive management of postpartum hypertension during COVID-19. As a consequence of the pandemic, we now have an opportunity to research the impact of postpartum remote blood pressure monitoring on maternal outcome and disparities within these outcomes.

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Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study

Cited by 85 publications

References 25 publications

Competing demands in postpartum care: a national survey of U.S. providers’ priorities and practice

Competing demands in postpartum care: a national survey of U.S. providers’ priorities and practice

Optimizing telemedicine for providing obstetric and reproductive health care services during COVID-19 pandemic

Establishing Better Evidence on Remote Monitoring for Postpartum Hypertension: A Silver Lining of the Coronavirus Pandemic

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