911 Readmission for hypertension among women in a postpartum remote blood pressure monitoring program

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The effect of remote postpartum blood pressure (BP) monitoring on readmission has been variable, with studies reporting 0-15% of women being readmitted. Our objective was to describe patterns in postpartum hospital visits and readmission among women enrolled in a remote postpartum BP monitoring program. Retrospective longitudinal evaluation of a text-based blood pressure program (9/2018-8/2019). The program used twice daily reminders and two-way communication on BP for 10 days after hospital discharge. BP was triaged by a Maternal-Fetal Medicine physician. Women diagnosed with chronic hypertension (HTN) or a hypertensive disorder of pregnancy at the time of delivery discharge were included. Clinical data were abstracted from the electronic medical record. The primary outcome was readmission for HTN within 6 weeks of discharge. Bivariate analyses were performed to analyze factors associated with readmission. Monthly readmissions were assessed with a p chart. Of 877 women discharged with remote monitoring, 60 (6.8%) were seen in the obstetric (OB) triage for BP or symptoms of preeclampsia. Twelve (20%) were sent through the program and 48 (80%) presented independently or at the direction of an OB nurse or physician. Eighteen (30.0%) were readmitted, resulting in a readmission rate of 2.1% per year. Median time from delivery to readmission was 6 days (range 3-18). Demographic and clinical factors were not associated with readmission (Table). Triage evaluations initiated through the program were more likely to result in readmission (58.3% vs. 22.9%, RR 2.54 [95%CI 1.26-5.15]). Readmission rates ranged from 0-4.9% per month without significant change over time (Figure). Readmission was infrequent among postpartum women with remote blood pressure monitoring. The majority of triage visits initiated outside the program did not result in readmission, possibly representing unnecessary hospital encounters. Education for providers and patients on triaging BP through the program may result in fewer triage visits, which in turn may lead to fewer readmissions.View Large Image Figure ViewerDownload Hi-res image Download (PPT)