JMIR Publications

ABSTRACT

Background:

Medical complications of pregnancy provide a window into a woman’s future health risk. Hypertensive disorders of pregnancy (HDP) affect one in ten pregnant women and elevate the risk for women of experiencing long-term health complications within five years of the affected pregnancy, continuing lifelong. These risks include a doubled to tripled risk of developing cardiovascular disease (CVD), a doubled risk of developing Type 2 diabetes, and five-to-ten-fold risk of developing chronic kidney disease. Early assessment and intervention following HDP are therefore crucial to improving women’s life-course health trajectory, as well as outcomes for any subsequent pregnancies. However, previous research has shown that Australian women and their primary healthcare practitioners are largely unaware of ongoing health risks and the necessary follow-up screening and assessments. Primary care practitioners also receive inadequate hospital-to-community handover and support to promote preventive health measures to women following pregnancy complications. Consequently, post-HDP care remains insufficient for optimising long-term health.

Objective:

This research will: 1. Explore whether a post-Hypertensive Disorders of Pregnancy (HDP) education and a follow-up service package can be designed, developed and implemented amongst targeted General Practitioners (GPs) and maternity hospitals across Sydney, Australia. 2. Evaluate whether the post-HDP education and follow-up services package can address knowledge gaps amongst healthcare providers regarding the long-term health risk after HDP and build capacity amongst GPs to implement recommended care.

Methods:

This pilot study will design, develop and implement a post-HDP education and follow-up services package (‘the package’) adopting a collaborative and implementation methodological approach. The package, designed by expert healthcare providers and informed by prior evidence-based research, will include education materials, improved hospital-to-community handover, and an additional funded six-month postpartum visit.

Results:

Data collection will occur over an 18-month implementation and follow-up period between April 2024 and October 2025. GPs across the Central and Eastern Primary Health Network (CESPN) will be recruited along with their Antenatal Shared Care (ANSC) affiliated, tertiary referral hospital(s) in Sydney.

Conclusions:

Mixed methods evaluation will assess the efficacy, acceptability and utility of the post-HDP package amongst healthcare providers and inform its suitability for deployment at scale.