JMIR Publications

ABSTRACT

Background:

Hypertensive disorders of pregnancy (HDP) affect up to 10% pregnancies, and can have adverse short and long-term implications for women and their babies. eHealth interventions includes any health service or treatment delivered using the Internet and related technology that aims to facilitate, capture or exchange knowledge. Given the current trend towards positive outcomes for the use of eHealth interventions in disease management and behaviour modification, review of the literature in obstetrics and HDP is justified.

Objective:

We conducted a systematic review to examine all eHealth interventions targeted at patients at risk of or with HDP and the feasibility and acceptability of these interventions.

Methods:

The data sources include Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Google scholar databases. We included all types of studies published in English. The searches included two main concepts: ehealth interventions and HDP. Subject headings for the terms ‘telehealth’, ‘ehealth’, ‘digital health’, ‘telemedicine’ and ‘preeclampsia’, ‘pregnancy induced hypertension’ ‘gestational hypertension’, ‘high blood pressure’ were used. The search was conducted on all papers published from database inception to 24 August 2024. Meta-analysis of RCT findings were conducted where possible. Other outcomes were reported in a narrative style with summation of findings. The systematic review was registered with the International Prospective Register of Systematic Reviews (registration number: CRD42023483948)

Results:

100 publications were identified with 61,539 participants. Interventions were primarily targeted at self-monitoring of BP with reminders for BP checks, as well as transmission of blood pressure and HDP symptom data and two-way communication between patients and care providers. eHealth interventions reduced healthcare utilisation with associated cost savings with generally positive participant feedback. All interventions were feasible to implement and acceptable to patients.

Conclusions:

The current evidence for the use of eHealth interventions targeted at patients at risk of or with HDP is of low quality and insufficient to make a recommendation regarding their routine use in clinical care. Our findings indicate that eHealth interventions are feasible, safe and acceptable to patients and there is limited evidence that it can reduce healthcare utilisation, improve follow up and BP ascertainment, reduce admissions as well as confer some economic benefit compared to usual care with a generally positive patient experience with minimal concerns.