Jones Rebecca D, Peng Cheng, Jones Crystal D, Long Brianna, Helton Victoria, Eswaran Hari
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Cardiovasc Digit Health J. 2024 Mar 15;5(3):156-163. doi: 10.1016/j.cvdhj.2024.03.001. eCollection 2024 Jun.
Unmanaged hypertension in pregnancy is the second most common cause of direct maternal death and disproportionately affects women in rural areas. While telehealth technologies have worked to reduce barriers to healthcare, lack of internet access has created new challenges. Cellular-enabled remote patient monitoring devices provide an alternative option for those without access to internet.
This study aimed to assess maternal and neonatal clinical outcomes and patient acceptability of an integrated model of cellular-enabled remote patient monitoring devices for blood pressure supported by a 24/7 nurse call center.
In a mixed-methods study, 20 women with hypertension during pregnancy were given a cellular-enabled BodyTrace blood pressure cuff. Participants' blood pressures were continuously monitored by a nurse call center. Participants completed a baseline survey, post-survey, and semi-structured interview after 8 weeks of device use.
Participants reported a significant decrease in perceived stress after device use ( = .0004), high satisfaction with device usability (mean = 78.38, SD = 13.68), and high intention to continue device use (mean = 9.05, SD = 1.96). Relatively low hospitalization and emergency department rates was observed (mean = 0.35, SD = 0.59; mean = 0.75, SD = 0.91). Participant-perceived benefits of device use included convenience, perceived better care owing to increased monitoring, and patient empowerment. Perceived disadvantages included higher blood pressure readings compared to clinical readings and excessive calls from call center.
Remote patient monitoring for women whose pregnancies are complicated by hypertension can reduce barriers and improve health outcomes for women living in rural and low-health-resource areas.
妊娠期未控制的高血压是孕产妇直接死亡的第二大常见原因,对农村地区妇女的影响尤为严重。虽然远程医疗技术致力于减少医疗保健障碍,但互联网接入不足带来了新的挑战。具备蜂窝网络功能的远程患者监测设备为无法接入互联网的人群提供了另一种选择。
本研究旨在评估由全天候护士呼叫中心支持的、采用具备蜂窝网络功能的远程患者监测设备进行血压监测的综合模式对孕产妇和新生儿临床结局的影响以及患者的接受度。
在一项混合方法研究中,20名妊娠期高血压妇女被配备了具备蜂窝网络功能的BodyTrace血压袖带。护士呼叫中心持续监测参与者的血压。参与者在使用设备8周后完成了基线调查、随访调查和半结构化访谈。
参与者报告称,使用设备后感知压力显著降低(P = .0004),对设备易用性满意度较高(均值 = 78.38,标准差 = 13.68),且继续使用设备的意愿较高(均值 = 9.05,标准差 = 1.96)。观察到住院率和急诊科就诊率相对较低(均值 = 0.35,标准差 = 0.59;均值 = 0.75,标准差 = 0.91)。参与者认为使用设备的好处包括方便、因监测增加而感觉得到了更好的护理以及患者自主性增强。感知到的缺点包括与临床读数相比血压读数较高以及呼叫中心来电过多。
对妊娠期并发高血压的妇女进行远程患者监测可以减少障碍,改善农村和卫生资源匮乏地区妇女的健康结局。