Quality of Blood Pressure Monitoring During Telehealth Visits for Pregnant Patients at Risk of Preeclampsia.

Abstract

Introduction: Preeclampsia is a significant cause of morbidity and mortality. The United States Preventative Services Task Force released 2023 recommendations encouraging more research on telehealth's role in facilitating blood pressure monitoring for patients with hypertensive disorders of pregnancy, including preeclampsia. This study evaluates the integration of self-measured blood pressure (SMBP) into telehealth obstetric visits during the COVID-19 pandemic for pregnant patients at risk of preeclampsia. Methods: A retrospective chart review was conducted of patients with one or more preeclampsia risk factors who delivered at a tertiary hospital from January to March 2021. Information pertaining to patients' number of antepartum, postpartum, and telehealth visits, blood pressure cuff access, and documentation of SMBP readings was recorded. Analyses were conducted in RStudio version 2022.12.0 + 353 (R Foundation for Statistical Computing). Results: Of 721 eligible patients, 244 (33.8%) had 2 or more ante- or postpartum telehealth visits. Of these 244 patients, 142 (58.2%) had chart documentation of owning a home blood pressure cuff. Only 106 (43.4%) had 1 or more SMBP documented in their telehealth visit notes, and they were more likely to have received care at federally qualified health centers than maternal fetal medicine clinics (p = 0.018) or private clinics (p < 0.001). Charts revealed no explanation for lack of blood pressure documentation during telehealth visits for most cases (n = 129, 93.5%). Conclusions: Opportunities exist to standardize blood pressure recording and documentation during telehealth visits, especially for patients with risk factors for preeclampsia, and to advocate for greater access to home blood pressure cuffs for all pregnant patients.