Using mHealth in postpartum women with pre‐eclampsia: Lessons learned from a qualitative study

Payakachat, Nalin; Rhoads, Sarah; McCoy, Hannah; Dajani, Nafisa K.; Eswaran, Hari; Lowery, Curtis L.

doi:10.1002/ijgo.13134

Cited by 8 publications

(13 citation statements)

References 24 publications

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“…Using apps to support pregnant women enhances the traditional pregnancy care model by providing additional educational information and empowering women to look after their own health [ 21 , 23 - 26 ]. Sensors and monitoring technologies that automatically track specific health indicators have been integrated into mHealth solutions to support pregnant women’s self-care behaviors [ 22 , 27 - 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…Even with emerging evidence on the potential benefits, barriers to the implementation of mHealth technologies in pregnancy care persist [ 19 , 24 , 27 , 28 , 38 ]. Various factors can impact an individual’s feeling toward sharing and tracking health data, including stress associated with mHealth monitoring, the availability of reliable educational information, and ineffective communication with clinicians [ 22 , 25 , 27 , 30 ]. Further research is needed to understand pregnant women’s motivation to use technologies to better support their engagement, data collection compliance, and daily use [ 27 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Users’ Perceptions Toward mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Interview Study

Li¹,

Silvera-Tawil²,

Varnfield³

et al. 2021

JMIR Form Res

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Background Mobile health (mHealth) technologies, such as wearable sensors, smart health devices, and mobile apps, that are capable of supporting pregnancy care are emerging. Although mHealth could be used to facilitate the tracking of health changes during pregnancy, challenges remain in data collection compliance and technology engagement among pregnant women. Understanding the interests, preferences, and requirements of pregnant women and those of clinicians is needed when designing and introducing mHealth solutions for supporting pregnant women’s monitoring of health and risk factors throughout their pregnancy journey. Objective This study aims to understand clinicians’ and pregnant women’s perceptions on the potential use of mHealth, including factors that may influence their engagement with mHealth technologies and the implications for technology design and implementation. Methods A qualitative study using semistructured interviews was conducted with 4 pregnant women, 4 postnatal women, and 13 clinicians working in perinatal care. Results Clinicians perceived the potential benefit of mHealth in supporting different levels of health and well-being monitoring, risk assessment, and care provision in pregnancy care. Most pregnant and postnatal female participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians were monitoring their data. Although it was acknowledged that some pregnancy-related medical conditions are suitable for an mHealth model of remote monitoring, the clinical and technical challenges in the introduction of mHealth for pregnancy care were also identified. Incorporating appropriate health and well-being measures, intelligently detecting any abnormalities, and providing tailored information for pregnant women were the critical aspects, whereas usability and data privacy were among the main concerns of the participants. Moreover, this study highlighted the challenges of engaging pregnant women in longitudinal mHealth monitoring, the additional work required for clinicians to monitor the data, and the need for an evidence-based technical solution. Conclusions Clinical, technical, and practical factors associated with the use of mHealth to monitor health and well-being in pregnant women need to be considered during the design and feasibility evaluation stages. Technical solutions and appropriate strategies for motivating pregnant women are critical to supporting their long-term data collection compliance and engagement with mHealth technology during pregnancy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Users’ Perceptions Toward mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Interview Study

Li¹,

Silvera-Tawil²,

Varnfield³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…Patients reported a reduction in the frequency of routine follow-up or urgent visits. This was particularly relevant for those who lived in remote areas, had mobility issues, or lacked resources and time—“Having (blood pressure device) at home would be a lot less stressful than having to go out and have it monitored.” 39 Others reported discomfort in sitting in the waiting room—“It was really uncomfortable to sit for half an hour, so by the time I got upstairs, my blood pressure was high.” 19 …”

Section: Resultsmentioning

confidence: 99%

“…Some believed that daily monitoring of blood pressure was redundant because blood pressure was already being managed by their GPs. Patients felt that continuous monitoring could make people “hypochondriac.” 19 Some thought that self-monitoring of blood pressure added more responsibilities in their daily lives and “it would be overwhelming.” 39 Some felt “bored” 25 with continuous monitoring. Some remarked that if patients “are adherent to medications, there was no need to check blood pressure.” 15 …”

Section: Resultsmentioning

confidence: 99%

Perspectives and Experiences of Self-monitoring of Blood Pressure Among Patients With Hypertension: A Systematic Review of Qualitative Studies

Natale

Martínez-Martín

et al. 2023

American Journal of Hypertension

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Background Self-monitoring of blood pressure is a key strategy in managing hypertension but may be challenging and burdensome for patients. The aim of the study was to describe the perspectives and experiences of self-monitoring of blood pressure in patients with hypertension. Methods MEDLINE, Embase, PsycINFO, CINAHL were searched from database inception to March 2022. We used thematic synthesis to analyze the data. Results Thirty-five studies involving 872 patients aged 18–95 years were included. Four themes were identified: enabling autonomy and empowerment of own health (allowing access to comprehensive and accurate data, bolstering motivation for lifestyle changes, encouraging diligence in medication taking, gaining interest in self-management, and increasing awareness of health status); providing reassurance and convenience (instilling a sense of security, readiness for troubleshooting, and reducing the frequency of clinical appointments); triggering confusion and stress (anxiety and panic over “bad” numbers, constant reminder of illness identity, disregarded by clinicians, lack of confidence in interpreting and responding to results, redundancy of continuous monitoring, and uncertainties around targets and frequency of measures, concerns of unreliability); financial and operational burden of device (vulnerability preventing use, or unsustainable cost). Conclusions Inadequate knowledge about the benefits of lowering blood pressure, home blood pressure monitoring, blood pressure goals, and interpretation of blood pressure values, limited access to home blood pressure monitoring devices, and psychological burden with home blood pressure monitoring limit home blood pressure monitoring.

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“…Further perceived advantages and disadvantages associated with the RPM BP device were explored in a semi-structured interview. Previous research on RPM for hypertension has focused on postpartum women (Payakachat et al, 2020 ; Hoppe et al, 2019 ) or used Bluetooth devices that require a smartphone and app (Ganapathy et al, 2016 ; Marko et al, 2016 ). In a small pilot study that aimed to assess the feasibility of using Bluetooth RPM BP devices for prenatal care, it was found that patients demonstrated high satisfaction with the device (Marko et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Use of Cellular-Enabled Remote Patient Monitoring Device for Hypertension Management in Pregnant Women: A Feasibility Study

Jones

Allison

Moody

et al. 2023

Matern Child Health J

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Introduction Hypertension affects 5–10% of pregnancies in the United States. Chronic hypertension during pregnancy can have a significant impact on maternal and neonatal outcomes, especially in rural populations. Pregnancies complicated by hypertension are currently managed through frequent clinic visits or extended hospital stays. Cellular-enabled remote patient monitoring devices provide an alternative treatment method for women in rural areas. Research Aim This study aimed to measure the feasibility of and patient satisfaction with using an integrated model of cellular-enabled remote patient monitoring devices for blood pressure supported by a 24/7 nurse call center. Methods In a mixed methods pilot study, twelve women with chronic hypertension during pregnancy were given cellular-enabled BodyTrace™ blood pressure cuffs and weight scales. Participants’ blood pressures were continuously monitored by a nurse call center. Participants completed a survey and a brief semi-structured interview after two weeks. Results Participants scored low on stress and anxiety with mean scores of 5.45 (SD = 3.56) and 8.09 (SD 3.62), respectively. Participants scored high on behavioral intention, system usability, and perceived benefits with mean scores of 8.73 (SD = 2.53), 75.91 (SD = 23.70), and 19.64 (SD = 5.92), respectively. Participants perceived benefits to using the device, including increased monitoring by health professionals, increased self-awareness, decreased number of clinic visits, and convenience of use. Perceived disadvantages included higher readings when compared to clinical readings. Discussion Cellular-enabled remote patient monitoring devices for blood pressure are a valuable tool for managing treatment of pregnancies complicated by hypertension.

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Using mHealth in postpartum women with pre‐eclampsia: Lessons learned from a qualitative study

Cited by 8 publications

References 24 publications

Users’ Perceptions Toward mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Interview Study

Users’ Perceptions Toward mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Interview Study

Perspectives and Experiences of Self-monitoring of Blood Pressure Among Patients With Hypertension: A Systematic Review of Qualitative Studies

Use of Cellular-Enabled Remote Patient Monitoring Device for Hypertension Management in Pregnant Women: A Feasibility Study

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