SAFE@HOME: Digital health platform facilitating a new care path for women at increased risk of preeclampsia - A case-control study.

Autor: van den Heuvel JFM; Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands. Electronic address: J.f.m.vandenheuvel-11@umcutrecht.nl., Lely AT; Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands. Electronic address: a.t.lely@umcutrecht.nl., Huisman JJ; Department of Obstetrics and Gynaecology, Diakonessenhuis, Bosboomstraat 1, 3582 KE Utrecht, the Netherlands. Electronic address: jhuisman@diakhuis.nl., Trappenburg JCA; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: j.c.a.trappenburg@umcutrecht.nl., Franx A; Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands; Department of Obstetrics and Gynaecology, Erasmus Medical Center, Erasmus University, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Electronic address: a.franx@erasmusmc.nl., Bekker MN; Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands. Electronic address: m.n.bekker-3@umcutrecht.nl.
Jazyk: angličtina
Zdroj: Pregnancy hypertension [Pregnancy Hypertens] 2020 Oct; Vol. 22, pp. 30-36. Date of Electronic Publication: 2020 Jul 18.
DOI: 10.1016/j.preghy.2020.07.006
Abstrakt: Objective: In women at risk of developing preeclampsia, we evaluated the use of a digital health platform for telemonitoring blood pressure and symptoms combined with a minimal antenatal visit schedule.
Study Design: A case-control study for women with chronic hypertension, history of preeclampsia, or maternal cardiac or kidney disease. A care path was designed with reduced visits enhanced with a digital platform (SAFE@HOME) for daily blood pressure and symptom monitoring starting from 16 weeks of gestation. Home-measurements were monitored in-hospital by obstetric professionals, taking actions upon alarming results. This prospective SAFE@HOME group was compared to a retrospective control group managed without self-monitoring.
Main Outcome Measures: Primary: healthcare consumption (number of antenatal visits, ultrasounds, admissions and diagnostics), user experiences of the platform. Secondary: maternal and perinatal outcomes.
Results: Baseline characteristics of the SAFE@HOME (n = 103) and control group (n = 133) were comparable. In the SAFE@HOME group, antenatal visits (mean 13.7 vs 16.0, p < 0.001) and ultrasounds (6.3 vs 7.4, p = 0.005) were lower compared to the control group. Admissions for hypertension or suspected preeclampsia were significantly fewer in the SAFE@HOME group (2.9% versus 13.5%, p = 0.004). Telemonitoring participants were highly satisfied using the platform. No differences were observed for maternal and perinatal outcomes.
Conclusions: Our care path including blood pressure telemonitoring for women at risk of preeclampsia allows fewer antenatal visits, ultrasounds and hypertension-related admissions. We observed no differences in perinatal outcomes. These results suggest that telemonitoring of blood pressure is feasible in a high-risk pregnant population and has the potential to profoundly change antenatal care.
(Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: