Gestational Hypertension, Pre-Eclampsia; Complicating Pregnancy
Conditions
Brief summary
The goal of this clinical trial is to learn if patient education and regular text reminders are a feasible intervention to engage patients and reduce post partum hypertension. The main questions it aims to answer are: Is a structured postpartum remote blood pressure monitoring intervention with education and individualized medication initiation/adjustment follow-up by televisit feasible? Does a structured program reduce the occurrence of postpartum hypertension, ED visits, hospital readmissions, and adverse outcomes? Participants will: View an educational video on HDP post-delivery Receive 1-2 times daily text messages for 6 weeks postpartum Have their blood pressure medications adjusted to lower targets post partum
Interventions
OTHERVideo
Those in the intervention arm will watch a short educational video.
OTHERText Reminder
Those in the intervention group will receive regular text message reminders to check their blood pressures
OTHERBlood pressure threshold
Those in the intervention group will have a lower blood pressure threshold to titrate their BP medications towards
Sponsors
Ochsner Health System
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age of at least 18 years. 2. Postpartum status. 3. Experience new-onset hypertension during pregnancy. 4. Enrollment in Connected MOM. 5. Ability to provide informed consent. 6. Establish medical care within the Ochsner System to facilitate data collection.
Exclusion criteria
1. History of preeclampsia or gestational hypertension during previous pregnancy 2. History of chronic hypertension 3. History of coronary artery disease (myocardial infarction, coronary stent placement, coronary artery bypass grafting, spontaneous coronary artery dissection) 4. History of ischemic CVA 5. History of Congestive heart failure 6. Renal dysfunction 7. Liver dysfunction 8. Left ventricular dysfunction 9. Congenital heart disease 10. Still birth at delivery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Engagement | 6 weeks | Engagement will be defined by frequency of use: number of remote BP measurements ascertained during the 6 week postpartum period. |
| Acceptability | 6 weeks | Post program survey questions using 5-item Likert response scale at 6 weeks postpartum |
| Duration of Participation | 6 weeks | Duration of participation is defined by the last day of recorded remote BP measurement |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Inpatient re-admissions | 1 year | Number of inpatient re-admissions over the following year after discharge from delivery encounter |
| Post partum Blood pressure | 1 year | Proportion of patients with BP \<130/80 at 6 weeks Mean SBP, DBP at 6 weeks, 6 months, 1 year postpartum |
| Post partum visit follow up | 6 weeks | Proportion of 4-6 week postpartum follow up visit attendance with OB provider |
| Number of ED visits | 1 year | Number of ED visits recorded after discharge from her delivery encounter over the following year. |
| Severe Maternal Morbidity | 1 year | Incidence of death, postpartum stroke, congestive heart failure, myocardial infarction, eclampsia |
Countries
United States
Contacts
Primary ContactSalima Qamruddin, MD
Outcome results
None listed