Understanding the rapid implementation of self-monitoring of blood pressure during pregnancy due to the Covid-19 pandemic
The recent COVID-19 pandemic has led to the rapid implementation of self-monitoring of blood pressure, in order to reduce face-to-face consultations for pregnant women whilst maintaining adequate safety for the woman and her baby. This research aims to understand how this was done and to use this experience to understand the barriers and facilitators for successful implementation of self-monitoring of blood pressure into antenatal care.
Part of our Helping Patients to Manage Their Own Conditions research theme
Raised blood pressure is a common problem during pregnancy. Pilot work in pregnancy has shown that self-monitoring of both blood pressure and proteinuria (increased levels of protein in the urine) is feasible and acceptable. (Tucker et al., 2017, Hinton et al., 2017 & Tucker et al., 2017 ) Furthermore, following hypertensive pregnancy postpartum women were able to self-manage their anti-hypertensive medication based on their home readings. (Cairns et al., 2018 & 2020)
We know from a recent survey of over 5000 pregnant women that around half of pregnant women with hypertension already informally self-monitor their blood pressure, although many do not share their readings with health care professionals (Tucker et al., 2020 ).
Our work exploring antenatal staff attitudes demonstrated they are generally in favour of self-monitoring of blood pressure but had concerns about its impact on women and staff workload and the reliability and accuracy of readings (Hinton et al., 2020 ). No concerns have been raised to date over the safety of self-monitoring (Kalafat et al., 2020).
Self-monitoring of blood pressure was rapidly introduced into antenatal care during the Spring of 2020 due to a need to reduce face-to-face contact. This experience of real life implementation will be valuable in our understanding of how clinical teams and women adapt to using self-monitoring, allowing us to identify barriers and facilitators of successful implementation.
This is a mixed methods research project that will collect the following data:
- Routinely collected data from hospitals and self-monitored readings will be analysed to understand how the remote blood pressure monitoring was used during the pandemic by health care teams and by women.
- Interviews with women and staff about their experiences of self-monitoring.
- Surveys of women and health care professionals.
How we are involving patients and the public
Patient and public collaborators are integral to this research. The research team includes PPI representatives and we work with the charity Action on Pre-eclampsia to ensure our research is sensitive, suitable, and fits with the attitudes and needs of women.
How we are planning to implement the research outputs
It is important that our findings are shared with healthcare professionals, the general public and the academic community. We will :
- Work with all collaborators to enable dissemination to health care professionals and within academia
- Work with the charity Action of Pre-Eclampsia to communicate findings to women and clinical teams
- Publish our findings in peer reviewed journals and conference presentations
Partners on this project
Project end date
- Examine the real-life use of self-monitoring of blood pressure that took place during the Covid-19 pandemic
- Understand more about how women were able to take on self-monitoring
- We will identify the advantages and disadvantages for women and health professionals of implementing self-monitoring of blood pressure in pregnancy. This will enable more widespread and successful implementation of self-monitoring of blood pressure going forward.
- These findings provide a timely insight into the perspectives of pregnant women and health care professionals about the use of self-monitoring of blood pressure in antenatal care to reduce in face to face consultations, whilst maintaining patient safety.