Postpartum Hypertension: Remote Patient Monitoring
Remote Patient Monitoring - Telehealth for Management of Women With Postpartum Hypertension
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Wisconsin
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Madison, Wisconsin, United States, 53715
- UnityPoint Health- Meriter Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Hypertensive disorders of pregnancy including gestational, chronic, or preeclampsia diagnosed in the antenatal (primary admission for delivery of the baby (planned or due to hypertension) or postpartum period as determined by systolic blood pressure (SBP) greater than 140 or diastolic blood pressure (DBP) greater than 90 on two occasions 4 hours apart.
- Gestational age at time of delivery greater than 23 weeks gestation
- Postpartum with persistent SBP greater than 140 or DBP greater than 90 on two occasions 4 hours apart (to enroll would be prior to discharge from initial postpartum hospital stay).
- Primary hospital admission for the delivery of the neonate(s).
Exclusion Criteria:
- Inability to obtain informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Mobile Health Participants
Subjects will use the mobile health device to record their blood pressure and weight measurements everyday for 6 weeks postpartum.
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Subjects will submit blood pressure and weight measurements daily for 6 weeks postpartum.
Subjects will have a video telehealth visit with the mobile health nurse at 48 hours and 7 days after discharge from the hospital.
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No Intervention: Standard of Care
This arm is a chart review done on hypertensive women who do not participate in using the mobile health device.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Aim 1: Number of Participants Enrolled
Time Frame: up to 3 months
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A goal of 55 participants enrolled into the mobile health program was set as a feasibility target.
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up to 3 months
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Aim 1: Number of Participants Who Completed the Study
Time Frame: up to 6 weeks
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To assess retention, the number of participants who completed the study will be reported.
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up to 6 weeks
|
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Aims 2-5: Number of Participants Enrolled in 1 Year
Time Frame: up to 1 year
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Aims 2-5 primary endpoint is enrollment of up to 40 participants at all times (for a total of 42 days) over one year (220 experimental and 220 matched controls for chart review).
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up to 1 year
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Aims 2-5: Number of Participants With Hypertension-Related Hospital Readmissions
Time Frame: up to 6 weeks postpartum
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Comparison of hypertension-related hospital readmissions between home telehealth with remote BP monitoring group and standard outpatient care during the first 6 weeks postpartum in women with hypertensive disorders of pregnancy (HDP).
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up to 6 weeks postpartum
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Aim 1: 6-week Hospital Readmission
Time Frame: up to 6 weeks
|
up to 6 weeks
|
|
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Aim 1: Number of Participants With Severe Postpartum Hypertension After Discharge
Time Frame: up to 6 weeks
|
Defined using American College of Obstetricians and Gynecologists (ACOG) criteria blood pressure values of ≥160mmHg (systolic) or ≥110 mmHg (diastolic)
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up to 6 weeks
|
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Aim 1: Number of Participants With Hypertension-Related Emergency Room Visits
Time Frame: up to 6 weeks postpartum
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Comparison of hypertension-related emergency room visits between home telehealth with remote BP monitoring group and standard outpatient care during the first 6 weeks postpartum in women with HDP (hypertensive disorders of pregnancy).
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up to 6 weeks postpartum
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Aim 1: Number of Participants With Need for Blood Pressure Treatment After Discharge
Time Frame: up to 6 weeks
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Defined as participants having blood pressures exceeding the ACOG recommendations for blood pressure treatment (150/100 mmHg).
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up to 6 weeks
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Aims 2-5: Number of Participants With Hypertension-Related Emergency Room Visits
Time Frame: up to 6 weeks postpartum
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Comparison of hypertension-related emergency room visits between home telehealth with remote BP monitoring group and standard outpatient care during the first 6 weeks postpartum in women with HDP (hypertensive disorders of pregnancy).
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up to 6 weeks postpartum
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Aims 2-5: Number of Participants With at Least One Blood Pressure Review Within 10 Days of Delivery
Time Frame: up to 10 days of delivery
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Comparison of number of participants with at least one blood pressure review within 10 days of delivery between home telehealth with remote BP monitoring group and standard outpatient care during the first 6 weeks postpartum in women with HDP (hypertensive disorders of pregnancy).
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up to 10 days of delivery
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Aims 2-5: Number of Participants on Antihypertensive Treatment Regimes
Time Frame: up to 6 weeks postpartum
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Comparison of number of participants on antihypertensive treatments between home telehealth with remote BP monitoring group and standard outpatient care during the first 6 weeks postpartum in women with HDP (hypertensive disorders of pregnancy).
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up to 6 weeks postpartum
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Aims 2-5: Maximum Systolic Blood Pressure Intrapartum
Time Frame: Admission to delivery (up to 96 hours)
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Admission to delivery (up to 96 hours)
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Aims 2-5: Maximum Diastolic Blood Pressure Intrapartum
Time Frame: Admission to delivery (up to 96 hours)
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Admission to delivery (up to 96 hours)
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Aims 2-5: Systolic Blood Pressure at Discharge
Time Frame: Up to 96 hours postpartum
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Up to 96 hours postpartum
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Aims 2-5: Diastolic Blood Pressure at Discharge
Time Frame: Up to 96 hours postpartum
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Up to 96 hours postpartum
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Aims 2-5: Medication at Discharge
Time Frame: up to 96 hours postpartum
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up to 96 hours postpartum
|
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Aims 2-5: Postpartum Day of Discharge
Time Frame: up to 4.5 days
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up to 4.5 days
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Aims 2-5: Inpatient Nonsteroidal Anti-inflammatory Drug (NSAID) Use
Time Frame: up to 4 days post-partum
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up to 4 days post-partum
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Aims 2-5: Change in Weight From First Prenatal Care Visit to Delivery
Time Frame: first prenatal care visit (on average 8-14 weeks of pregnancy, delivery (on average 37-40 weeks of pregnancy)
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first prenatal care visit (on average 8-14 weeks of pregnancy, delivery (on average 37-40 weeks of pregnancy)
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Self-Administered Questionnaire Satisfaction Survey Scores
Time Frame: up to 6 weeks postpartum
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In collaboration with the University of Wisconsin Survey Center, the investigators developed a 37-question self-administered questionnaire (SAQ) satisfaction survey to all participants at the 6-week postpartum clinic visit.
The survey utilized a variety of question formats including Likert scales with response ranging from 1 to 5 ("Not at all"; "A little"; "Somewhat"; "Quite a bit"; "A great deal" or "Never"; "Rarely"; "Sometimes"; "Very often"; "Extremely often"), dichotomous questions with a Yes/No response, and free text.
A summary of mean scores (1-5) are reported here.
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up to 6 weeks postpartum
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Participant Counts for Relevant SAQ Satisfaction Survey Questions
Time Frame: up to 6 weeks postpartum
|
In collaboration with the University of Wisconsin Survey Center, the investigators developed a 37-question self-administered questionnaire (SAQ) satisfaction survey to all participants at the 6-week postpartum clinic visit.
The survey utilized a variety of question formats including Likert scales with response ranging from 1 to 5 ("Not at all"; "A little"; "Somewhat"; "Quite a bit"; "A great deal" or "Never"; "Rarely"; "Sometimes"; "Very often"; "Extremely often"), dichotomous questions with a Yes/No response, and free text.
A summary of questions with participant counts is reported here.
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up to 6 weeks postpartum
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cost Effective Analysis on Remote Patient Monitoring for Postpartum Hypertension.
Time Frame: Up to 12 months
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Cost effectiveness modeling will be performed to determine whether it is cost effective to use remote patient modeling for women with postpartum hypertension in comparison to standard outpatient care in women with hypertension-related disorders of pregnancy.
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Up to 12 months
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Mode of Delivery
Time Frame: at delivery (on average 37-40 weeks of pregnancy)
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at delivery (on average 37-40 weeks of pregnancy)
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Neonatal Birthweight
Time Frame: at time of birth
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at time of birth
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Neonatal Intensive Care Unit Admissions
Time Frame: at birth
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at birth
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Kara Hoppe, DO, Clinical Assistant Professor
Publications and helpful links
General Publications
- Hoppe KK, Thomas N, Zernick M, Zella JB, Havighurst T, Kim K, Williams M, Niu B, Lohr A, Johnson HM. Telehealth with remote blood pressure monitoring compared with standard care for postpartum hypertension. Am J Obstet Gynecol. 2020 Oct;223(4):585-588. doi: 10.1016/j.ajog.2020.05.027. Epub 2020 May 19. No abstract available.
- Thomas NA, Drewry A, Racine Passmore S, Assad N, Hoppe KK. Patient perceptions, opinions and satisfaction of telehealth with remote blood pressure monitoring postpartum. BMC Pregnancy Childbirth. 2021 Feb 19;21(1):153. doi: 10.1186/s12884-021-03632-9.
- Hoppe KK, Williams M, Thomas N, Zella JB, Drewry A, Kim K, Havighurst T, Johnson HM. Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study. Pregnancy Hypertens. 2019 Jan;15:171-176. doi: 10.1016/j.preghy.2018.12.007. Epub 2018 Dec 31.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2017-003
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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