Remote postpartum BP program reduces hospital readmissions, improves guideline adherence

Key takeaways:

• The postpartum BP program relied on patient home measurements.
• The program was tied to lower readmission and more recorded BPs, postpartum visits and antihypertensive medication initiations vs. usual care.

A remote postpartum blood pressure management program led to fewer hospital readmissions, greater postpartum visit attendance, improved guideline adherence and higher rates of antihypertensive prescriptions, researchers reported.

“Remote monitoring of postpartum hypertension is an impactful program benefiting both the delivering patient and the health system,” Lara S. Lemon, PhD, PharmD, research assistant professor in the department of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, told Healio. “Remote monitoring of BP was associated with fewer postpartum readmissions, more engagement with care and higher rates of medication initiation.”

Lemon and colleagues conducted a retrospective cohort study, published in Obstetrics & Gynecology, with data from 12,038 women with hypertensive disorders of pregnancy who gave birth from March 2019 to June 2023 at UPMC Magee-Womens Hospital. Of all women, 54.5% enrolled in a remote postpartum hypertension management program relying on patient home BP measurement. Researchers compared data from women in the program with those from the 45.5% of women who received usual care.

Primary outcomes included postpartum hospital readmission, office visits within 6 weeks postpartum, BP measurement within 10 days and initiation of antihypertensive medication.

Women who enrolled in the remote postpartum hypertension management program were more likely to be white and commercially insured, have a preeclampsia diagnosis and have higher prenatal and inpatient postpartum BPs.

Enrollment in the program was associated with lower 6-week postpartum hospital readmission rates with one fewer readmission per 100 individuals in the program compared with usual care (adjusted RR = 0.78; 95% CI, 0.65-0.93). Compared with usual care, per 100 individuals in the program, 85 more had a BP recorded within 10 days (RR = 8; 95% CI, 7.35-8.71) and six more had a 6-week postpartum visit (RR = 1.08; 95% CI, 1.06-1.11).

In addition, women enrolled in the program also had higher antihypertensive medication initiation compared with those with usual care (RR = 4.44; 95% CI, 3.88-5.07).

According to Lemon, there are three important next steps in this research.

“With an aim to decrease disparities in maternal health, we need to learn how to expand these programs and reach marginalized groups who choose not to participate. We plan to investigate best treatment practices in this period,” Lemon said. “And we need to evaluate the long-term impact of BP control in the postpartum period.”

For more information:

Lara S. Lemon, PhD, PharmD, can be reached at lemonl@upmc.edu.