Clinician and patient perceptions around implementing remote blood pressure monitoring for hypertensive disorders of pregnancy: A survey-based study

Abstract

Objective: Remote blood pressure monitoring (RBPM) is a promising method for surveilling hypertensive disorders of pregnancy (HDP). This refers to an organised framework in which clinicians can review and manage patient-obtained blood pressure recordings. Successful integration of RBPM into routine antenatal care necessitates understanding patient and clinician perspectives of its use. This study sought to evaluate the perceptions of high-risk pregnant women and clinicians regarding RBPM's use in HDP surveillance.

Methods: A web-based questionnaire was distributed to pregnant women in South Western Sydney and clinicians across Australia and New Zealand. Quantitative Likert scales and qualitative open-ended questions were used to ascertain perceptions about RBPM for the surveillance of HDP.

Results: Seventy-six women responded to the patient survey, with a response rate of 74.5%. A total of 65 clinicians responded to the healthcare professional survey. Almost all women (97.4%) supported RBPM's potential to aid healthcare decisions, with 96.1% willing to incorporate RBPM into antenatal care. Linear regression revealed implementation of RBPM was particularly supported by women who had less time off from paid employment during their pregnancy (p < 0.001). Conversely, women from non-English-speaking backgrounds and lower-income groups perceived RBPM as more challenging to use (p = 0.011 and p = 0.017, respectively). Most clinicians were concerned about the security of data transfer and storage interfaces. Poor accuracy or reliability of the technology emerged as a common barrier amongst both women and clinicians. Free-text responses revealed novel themes including accountability of care and medicolegal ramifications.

Conclusion: Though socioeconomic status, ethnicity and language influenced perceptions towards RBPM; overall, Australian pregnant women and clinicians are broadly receptive to its use in antenatal care. Successful implementation of RPBM requires careful evaluation of design and workflow to accommodate for patient diversity, ease of use, compliance, privacy and clinical utility to optimise the user experience.

Keywords: Antenatal; hypertensive disorders of pregnancy; pregnant women; questionnaire; remote blood pressure monitoring; survey.

Figure 1.

RBPM survey responses – pregnant women.

Figure 2.

Pregnant women's perceived barriers to RBPM implementation.

Figure 3.

RBPM survey responses – clinicians.

Figure 4.

Clinicians’ perceived barriers to RBPM implementation.