ABSTRACT :
Background: Cardiovascular disease is the leading cause of death among women. Sex-specific risk factors for cardiovascular disease include history of a hypertensive disorder of pregnancy.
Problem : After diagnosis of a hypertensive disorder of pregnancy, professional societies recommend follow-up with a primary care provider for preventive knowledge of the association between a hypertensive disorder of pregnancy and cardiovascular disease. That gap has negative effect on patients receiving recommended follow-up.
Methods : An electronic registry was created to identify those who gave birth on our health system and had a diagnosis of hypertensive disorder of pregnancy .From this , information outreach was sent electronically to the patient and their primary care provider.
Interventions: Communication in the outreach included education on the association between hypertensive disorders of pregnancy and cardiovascular disease, the importance of follow-up, cardio preventative strategies and biochemical assessment. Medical records were audited at approximately 6 months postpartum to determine if patients completed a visit with their primary care provider to discuss cardiovascular risks.
Results : Between May 2021 and June 2022, 15% (n=1,131) patients who gave birth in our health system had a diagnosis of hypertensive disorder of pregnancy. Ninety percent of those patients who received outreach communication viewed the letter. At baseline, 16% of patients during postpartum with a hypertensive disorder of pregnancy saw their primary care provider to discuss cardio-preventative strategies. After implementation of our program, 26% of those with hypertensive disorder of pregnancy saw their primary care provider for follow-up and discussed cardiopreventative strategies.
Clinical Implications : Nurses should ensure that women during postpartum and their primary care providers are educated about the association of hypertensive disorders of pregnancy and long-term cardiovascular risk. The electronic health record may be an optimal way to ensure education is provided and follow-up scheduled.