Department of Obstetrics, Gynecology and Reproductive Sciences, UPMC Magee-Womens Hospital, University of Pittsburgh School of Medicine, and UPMC Magee-Womens Hospital and the Departments of Clinical Analytics and Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Obstet Gynecol. 2019 Oct;134(4):685-691. doi: 10.1097/AOG.0000000000003479.
To evaluate the feasibility, acceptability, and compliance of a remote blood pressure monitoring protocol implemented as a quality improvement measure at the hospital level for management of hypertension in postpartum women after hospital discharge.
This is an ongoing quality improvement project that included women admitted to the postpartum unit of a single tertiary care hospital. We designed nursing call center-driven blood pressure management and treatment algorithms, which were initiated after hospital discharge until 6 weeks postpartum. Women are eligible to participate if they have a diagnosis of chronic hypertension, superimposed preeclampsia, gestational hypertension, preeclampsia, or postpartum hypertension and have access to a text messaging-enabled smartphone device. After identification by an obstetric care provider, women are enrolled into the program, which is automatically indicated in the electronic medical record. Maternal, obstetric, and sociodemographic data were obtained from the electronic medical record.
Between February 2018 and January 2019, we enrolled 499 patients. Here we report on the first 409 enrolled patients. Participants include 168 (41%) with gestational hypertension, 179 (44%) with preeclampsia with no history of chronic hypertension, 49 (12%) with chronic hypertension with superimposed preeclampsia, and 13 (3%) with postpartum preeclampsia. One hundred seventy-one (42%) participants had antihypertensives initiated or titrated through the program. Three hundred forty women (83%) continued the program beyond 3 weeks postpartum, and 360 (88%) attended an in-person 6-week postpartum visit. Two hundred thirty-five out of 250 women who completed a postprogram survey (94%) reported satisfaction with the program.
In this study, we detail results from an ongoing remote blood pressure monitoring program. We demonstrate high compliance, retention, and patient satisfaction with the program. This is a feasible, scalable remote monitoring program connected to the electronic medical record.
评估作为医院层面质量改进措施实施的远程血压监测方案的可行性、可接受性和依从性，以管理产后出院后高血压女性。
这是一项正在进行的质量改进项目，纳入了单家三级保健医院产后病房的女性。我们设计了护理呼叫中心驱动的血压管理和治疗算法，这些算法在出院后直至产后 6 周开始实施。如果女性患有慢性高血压、子痫前期叠加、妊娠高血压、子痫前期或产后高血压，并且可以使用支持短信的智能手机设备，则有资格参与该计划。在产科护理提供者识别后，女性将被纳入该计划，该计划会自动在电子病历中显示。从电子病历中获取产妇、产科和社会人口统计学数据。
在 2018 年 2 月至 2019 年 1 月期间，我们共纳入了 499 名患者。在这里，我们报告了前 409 名纳入患者的情况。参与者包括 168 名（41%）患有妊娠高血压、179 名（44%）患有无慢性高血压史的子痫前期、49 名（12%）患有慢性高血压合并子痫前期和 13 名（3%）患有产后子痫前期。171 名（42%）参与者通过该计划开始或调整了降压药。340 名女性（83%）在产后 3 周后继续该计划，360 名（88%）参加了 6 周产后面对面就诊。250 名完成方案后调查的女性中有 235 名（94%）报告对该方案满意。
在这项研究中，我们详细介绍了正在进行的远程血压监测计划的结果。我们展示了该计划的高依从性、保留率和患者满意度。这是一个可行的、可扩展的与电子病历连接的远程监测计划。
