Abstract
BackgroundOur aim was to conduct a post participation survey of respondent experiences with in-home remote patient monitoring via telehealth for blood pressure monitoring of women with postpartum hypertension. We hypothesized that the in-home remote patient monitoring application will be implemented with strong fidelity and have positive patient acceptability.MethodsThis analysis was a planned secondary analysis of a non-randomized controlled trial of telehealth with remote blood pressure patient monitoring for postpartum hypertension compared to standard outpatient monitoring in women with a hypertension-related diagnosis during pregnancy. In collaboration with survey experts, we developed a 41-item web-based survey to assess 1) perception of quality of care received, 2) ease of use/ease to learn the telehealth program, 3) effective orientation of equipment, 4) level of perceived security/privacy utilizing telehealth and 5) problems encountered. The survey included multiple question formats including Likert scale responses, dichotomous Yes/No responses, and free text. We performed a descriptive analysis on all responses and then performed regression analysis on a subset of questions most relevant to the domains of interest. The qualitative data collected through open ended responses was analyzed to determine relevant categories. Intervention participants who completed the study received the survey at the 6-week study endpoint.ResultsSixty six percent of respondents completed the survey. The majority of women found the technology fit easily into their lifestyle. Privacy concerns were minimal and factors that influenced this included age, BMI, marital status, and readmissions. 95% of women preferred remote care for postpartum follow-up, in which hypertensive type, medication use and ethnicity were found to be significant factors in influencing location of follow-up. Most women were satisfied with the devices, but rates varied by hypertensive type, infant discharge rates and BMI.ConclusionsPostpartum women perceived the telehealth remote intervention was a safe, easy to use method that represented an acceptable burden of care and an overall satisfying method for postpartum blood pressure monitoring.Trial registrationClinicalTrials.gov identification number: NCT03111095 Date of registration: April 12, 2017.
Highlights
Our aim was to conduct a post participation survey of respondent experiences with in-home remote patient monitoring via telehealth for blood pressure monitoring of women with postpartum hypertension
With respect to the ease of use domain, only 1.6% (2/ 128) of women felt the instructions for use were very or extremely difficult, 0.9% (1/128) of women felt the technology required an extreme amount of mental effort, 59% (75/127) reported the technology fit in their lifestyle, 80% (34/43) felt help was readily accessible when needed, and 80% (101/127) of women felt confident using the devices
This study demonstrated that most respondents feel secure using remote blood pressure monitoring and that privacy and security concerns did not appear to be influenced by type of hypertension, healthcare utilization, maternal demographics, medications and infant parameters are not associated with perceptions of privacy or security concerns
Summary
Our aim was to conduct a post participation survey of respondent experiences with in-home remote patient monitoring via telehealth for blood pressure monitoring of women with postpartum hypertension. 50 to 70% of women do not follow up postpartum [6,7,8] To address this gap we developed a telehealth with remote monitoring intervention devised for daily home BP monitoring. We conducted a single-site non-randomized controlled trial of telehealth with remote monitoring and linked interventions for management of postpartum hypertension. Postpartum women prior to hospital discharge were assigned to and dispensed a remote monitoring unit that securely transmitted individual data to a central monitoring platform via Bluetooth technology leveraged by Honeywell ( Resideo) Lifestream Clinical Monitoring solution. Registered nurses trained in the research protocol assessed participant data daily and used nurse-driven BP algorithms for initiation, titration and cessation of anti-hypertensive medication as indicated [6]
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