Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study
Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study
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DOI：
10.1016/j.preghy.2018.12.007
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发表时间：
2019-01-01
影响因子：
2.2
通讯作者：
Johnson, Heather M.
中科院分区：
文献类型：
--
作者：
Hoppe, Kara K.;Williams, Makeba;Johnson, Heather M.
目的：调查远程血压监测的可行性管理产后妇女的高血压在医院discharge.Methods的风险，严重的高血压的远程健康：在一个单中心，前瞻性单队列的可行性研究，妇女在怀孕期间参加了产后远程健康干预出院后的血压管理。主要可行性结局指标为产后6周内的招募和保留。次要结局包括严重产后高血压的发生率和/或出院后血压治疗的需要、参与者满意度和6周的再入院率。参与者每天收到一个平板电脑和一个设备，用于将生命体征传输到一个中央监测点。参与者参加了远程保健或电话访问护士在48小时，并根据需要。结果：在1413交付263（19%）的妇女有高血压在怀孕期间和55/124（47%）的妇女接近同意。留存率为95%。在研究参与者中，出院后重度高血压的发生率为9例（16%）。29例（53%）受试者因出院后血压恶化而需要治疗，其中9例（16%）为重度。没有再入院。整体39（86%）的参与者感到满意的远程monitoring.Conclusions：可行性和参与者的满意度得到证明。出院后和产后6周内严重高血压和需要血压治疗的发生率分别为16%和53%。我们的研究结果表明，远程保健是一个有前途的战略产后高血压管理，以减少产妇发病率和再入院。
Objective: Investigate feasibility of telehealth with remote blood pressure monitoring for management of hypertension in postpartum women at risk of severe hypertension after hospital discharge.Methods: In a single-center, prospective single-cohort feasibility study, women with hypertension in pregnancy participated in a postpartum telehealth intervention for blood pressure management after discharge. The primary feasibility outcome measures were recruitment and retention through 6 weeks postpartum. Secondary outcomes included the incidence of severe postpartum hypertension and/or need for blood pressure treatment after discharge, participant satisfaction, and 6-week hospital readmission. Participants received a tablet and equipment to transmit vital signs to a central monitoring site daily. Participants participated in telehealth or telephone visits with a nurse at 48 h and as needed.Results: Among 1413 deliveries 263 (19%) women had hypertension in pregnancy and 55/124 (47%) of women approached were consented. The retention rate was 95%. Among study participants, the incidence of severe hypertension after discharge was 9 (16%). 29 (53%) of participants required treatment due to exacerbations in blood pressure after discharge, in which 9(16%) were severe. There were no hospital readmissions. Overall 39 (86%) participants were satisfied with the remote monitoring.Conclusions: Feasibility and participant satisfaction were demonstrated. The incidence of severe hypertension and need for blood pressure treatment after discharge and during 6 weeks postpartum was 16% and 53%. Our results indicate telehealth is a promising strategy for postpartum hypertension management to decrease maternal morbidity and hospital readmission.