Implementation of a Cell‐Enabled Remote Blood Pressure Monitoring Program During the Postpartum Period at a Safety‐Net Hospital

Abstract

Background Postpartum hypertension is a risk factor for severe maternal morbidity; however, barriers exist for diagnosis and treatment. Remote blood pressure (BP) monitoring programs are an effective tool for monitoring BP and may mitigate maternal health disparities. We aimed to describe and evaluate engagement in a remote BP monitoring program on BP ascertainment during the first 6‐weeks postpartum among a diverse patient population. Methods and Results A postpartum remote BP monitoring program, using cell‐enabled technology and delivered in multiple languages, was implemented at a large safety‐net hospital. Eligible patients are those with hypertensive disorders before or during pregnancy. We describe characteristics of patients enrolled from January 2021 to May 2022 and examine program engagement by patient characteristics. Linear regression models were used to calculate mean differences and 95% CIs between characteristics and engagement metrics. We describe the prevalence of patients with BP ≥140/or >90 mm Hg. Among 1033 patients, BP measures were taken an average of 15.2 days during the 6‐weeks, with the last measurement around 1 month (mean: 30.9 days), and little variability across race or ethnicity. Younger maternal age (≤25 years) was associated with less frequent measures (mean difference, −4.3 days [95% CI: −6.1 to −2.4]), and grandmultiparity (≥4 births) was associated with shorter engagement (mean difference, −3.5 days [95% CI, −6.1 to −1.0]). Prevalence of patients with BP ≥140/or >90 mm Hg was 62.3%, with differences by race or ethnicity (Black: 72.9%; Hispanic: 52.4%; White: 56.0%). Conclusions A cell‐enabled postpartum remote BP monitoring program was successful in uniformly monitoring BP and capturing hypertension among a diverse, safety‐net hospital population.

Keywords

• home blood pressure monitoring
• hypertension
• postpartum
• pregnancy