Background
Hypertensive disorders of pregnancy (HDP) affect 5-10% of pregnant women and are associated with long-term maternal health consequences. However, post-HDP-health knowledge gaps among healthcare providers (HCPs) and poor communication across care transition contribute to inadequate postpartum care. This study aimed to evaluate a co-designed post-HDP education and follow-up services package (“the package”), including assessing changes in HCP knowledge, confidence and perceptions of care delivery.
Methods
Antenatal shared-care GP practices and maternity care teams from three Sydney tertiary hospitals participated in the package. Pre-, mid- and post-implementation surveys assessed GP knowledge, practices, and perceptions of the package. Google Analytics data captured educational website usage and were analysed descriptively. Post-HDP health-risk knowledge scores were compared over time using repeated-measures ANOVA.
Results
Of 16 consented participants, 13 completed pre-, mid- and post-implementation surveys. Mean post-HDP health-risk knowledge improved from 32.5±3.5 out of 40 pre-implementation, to 33.7±4.0 post-implementation, although was not statistically significant (p=0.25). GPs averaged 3 minutes and 11 seconds on the website: most viewed topics were cardiovascular health in women, resources for post-HDP care, and HDP definitions. Perceived barriers included not enough evidence-based management specific to HDP, practitioner-related factors such as time per consult, and patient factors including reluctance to change and forgetting of advice due to busy postnatal lives.
Conclusion
The post-HDP education package was feasible and practical. Knowledge improvement was modest, likely as baseline knowledge was high. Dedicated website usage was limited. HCP identified several barriers to post-HDP care needing to be addressed for scale-up of the package.