The impact of a remote monitoring program on the prenatal follow-up of women with gestational hypertensive disorders

Background: The first clinical results of remote monitoring (RM) in gestational hypertensive disorders (GHD), which was called the Pregnancy Remote Monitoring (PREMOM) study, obtained retrospectively during the year in which remote communication between hospital doctors or midwives and pregnant women at home was technically installed, were published in 2016. The added value of this technology was shown. A second pilot project was performed in which more patients were included in both the prenatal RM follow-up program and in the conventional care (CC) program during a study period of 2 years.

Objectives: To confirm or refute the conclusions drawn in 2015, by including data from 2016.

Materials and methods:
A two years retrospective cohort study was conducted in 90 patients with GHD, who where enrolled in the RM follow-up program of the Clinical Call Centre of Ziekenhuis Oost-Limburg.
Using commercialised automated devices, they sent twice daily blood pressure measurements and once weekly weight measurements to the hospital.
Those patients were compared with 230 patients with confirmed GHD in conventional care (CC).
Inclusion started the first of January 2015 and ended 31 December 2016.
All the interchanged data were analysed in detail.

Results:
In both uni- and multivariate analyses, the RM group had fewer prenatal admissions than the CC group (51.62% versus 71.63%), fewer prenatal admissions until the moment of delivery (31.40% versus 57.67%), fewer induced births (43.00% versus 32.09%), and more spontaneous births (32.86% versus 46.51%).
In the multivariate analysis, the total number of prenatal visits was much lower in the RM group than in the CC group (β = −1.76; CI = −2.74-0.77).
These conclusions were almost the same as for the analysis in 2015, except
(1) there was no difference in the NIC unit admissions between the RM and CC groups in 2015-2016; and
(2) the total number of visits was significantly lower in the RM group than in the CC group in 2015-2016, which was not observed in the 2015 dataset


Conclusion: This study demonstrates that RM provides opportunities to offer timely interventions to pregnant women who require them. A further follow-up study is necessary to confirm or to disprove those data: the PREMOM II project. In this PREMOM II project participate five hospitals (Ziekenhuis Oost-Limburg - Genk, UZA, UZLeuven, AZ Sint Jan Brugge - Oostende en AZ Sint Lucas Brugge), and is supported by the FWO - TBM.

Authors

Dorien Lanssens (1,2,3), Inge M Thijs (1,3), Lars Grieten (1), Wilfried Gyselaers (1,2,3,4)

Organisations

Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium (1), Departement of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium, (3) Future Health, Ziekenhuis-Oost Limburg, Schiepse Bos 6, 3600 Genk, Belgium, (4) UHasselt - Hasselt University, Faculty of Medicine and Life Sciences, Department of Physiology, Limburg Clinical Research Center, 3590 Diepenbeek Belgium.

Presenting author

Dorien Lanssens, Post-doc, UHasselt
dorien.lanssens@uhasselt.be
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