Cardiovascular Health After Preeclampsia: Patient and Provider Perspective
Cardiovascular Health After Preeclampsia: Patient and Provider Perspective
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DOI：
10.1089/jwh.2020.8384
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发表时间：
2021-03-01
影响因子：
3.5
通讯作者：
Rich-Edwards, Janet W.
中科院分区：
文献类型：
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作者：
Seely, Ellen W.;Celi, Ann C.;Rich-Edwards, Janet W.
背景：先兆子痫可预测未来的心血管疾病（CVD），但先兆子痫后的护理项目很少。方法：子痫前期患者和提供者参与网络研讨会于2018年6月在拉德克利夫高级研究所召开。研讨会旨在确定：1）患者对降低CVD风险的障碍和促进因素的看法; 2）专门从事先兆子痫后护理的临床计划; 3）国家组织对降低风险的建议; 4）下一步。利益相关者包括先兆子痫基金会，患者，为先兆子痫妇女启动CVD风险降低计划的临床医生，研究人员和国家工作队成员。结果：参与者一致认为，在先兆子痫后预防CVD的意识和行动不足。患者建议临床医生检查表，以确保CVD风险的沟通，加强对临床医生关于先兆子痫和CVD之间联系的培训，并与了解此联系的临床医生进行产后预约。临床项目主要为产后第一年的患者提供服务，连接产科和初级保健。他们建议通过定期血压、体重、血脂和糖尿病筛查来调整心血管疾病风险。障碍包括缺乏为这一群体设计的方案以及分娩后保险覆盖面的缺口。美国心脏协会、美国妇产科医师学会和先兆子痫基金会为患者和提供者制定了指导方针和材料，以指导先前患有先兆子痫的妇女的管理。结论：需要患者，护理人员，研究人员和国家组织的综合努力来改善先兆子痫后CVD的预防。本次会议的建议可以作为这一努力的资源和催化剂。
Background:Preeclampsia predicts future cardiovascular disease (CVD) yet few programs exist for post-preeclampsia care. Methods:The Health after Preeclampsia Patient and Provider Engagement Network workshop was convened at the Radcliffe Institute for Advanced Study in June 2018. The workshop sought to identify: 1) patient perspectives on barriers and facilitators to CVD risk reduction; 2) clinical programs specialized in post-preeclampsia care; 3) recommendations by national organizations for risk reduction; and 4) next steps. Stakeholders included the Preeclampsia Foundation, patients, clinicians who had initiated CVD risk reduction programs for women with prior preeclampsia, researchers, and national task force members. Results:Participants agreed there is insufficient awareness and action to prevent CVD after preeclampsia. Patients suggested a clinician checklist to ensure communication of CVD risks, enhanced training for clinicians on the link between preeclampsia and CVD, and a post-delivery appointment with a clinician knowledgeable about this link. Clinical programs primarily served patients in the first postpartum year, bridging obstetrical and primary care. They recommended CVD risk modification with periodic blood pressure, weight, lipid and diabetes screening. Barriers included the paucity of programs designed for this population and gaps in insurance coverage after delivery. The American Heart Association, the American College of Obstetricians and Gynecologists, and the Preeclampsia Foundation have developed guidelines and materials for patients and providers to guide management of women with prior preeclampsia. Conclusions:Integrated efforts of patients, caregivers, researchers, and national organizations are needed to improve CVD prevention after preeclampsia. This meeting's recommendations can serve as a resource and catalyst for this effort.