Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: a randomised clinical trial
Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: a randomised clinical trial
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DOI：
10.1136/bmjqs-2018-007837
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发表时间：
2018-11-01
影响因子：
5.4
通讯作者：
Srinivas, Sindhu
中科院分区：
文献类型：
--
作者：
Hirshberg, Adi;Downes, Katheryne;Srinivas, Sindhu
背景对高血压病妇女在产后72小时和7-10天进行血压监测可降低发病率。然而，目前还没有关于如何实现这一目标的建议。Objective比较基于文本的血压监测与产后即时就诊对妊娠期高血压疾病患者的有效性。方法随机临床试验，对206名产后妇女进行了2016年8月至2017年1月期间分娩入院时诊断为妊娠相关高血压的研究。妇女被随机分配到2周的基于文本的监测，使用家庭血压袖带和先前测试的自动化平台或常规护理血压检查，在他们的产前诊所出院后4-6天。主要研究结果是产后前10天的单次记录血压。在短信组中评估了满足美国妇产科医师大会（ACOG）指南的能力，该指南定义为在产后3-4天和7-10天记录血压。这项研究的动力是检测使用短信的单次记录血压增加1.4倍。所有结果进行了分析，意向treat.Results 206名妇女随机（103在每个手臂）。基线特征相似。产后前10天，发短信组的单次血压与办公室组相比有统计学显著性增加（92.2% vs 43.7%;调整后OR 58.2（16.2-208.1），p
Background Monitoring blood pressure at 72hours and 7-10 days post partum in women with hypertensive disorders is recommended to decrease morbidity. However, there are no recommendations as to how to achieve this.Objective To compare the effectiveness of text-based blood pressure monitoring to in-person visits for women with hypertensive disorders of pregnancy in the immediate postpartum period.Methods Randomised clinical trial among 206 postpartum women with pregnancy-related hypertension diagnosed during the delivery admission between August 2016 and January 2017. Women were randomised to 2weeks of text-based surveillance using a home blood pressure cuff and previously tested automated platform or usual care blood pressure check at their prenatal clinic 4-6 days following discharge. The primary study outcome was a single recorded blood pressure in the first 10 days post partum. The ability to meet American Congress of Obstetricians and Gynecologists (ACOG) guidelines, defined as having a blood pressure recorded on postpartum days 3-4 and 7-10 was evaluated in the text message group. The study was powered to detect a 1.4-fold increase in a single recorded blood pressure using text messaging. All outcomes were analysed as intention to treat.Results 206 women were randomised (103 in each arm). Baseline characteristics were similar. There was a statistically significant increase in a single blood pressure obtained in the texting group in the first 10 days post partum as compared with the office group (92.2% vs 43.7%; adjusted OR 58.2 (16.2-208.1), p