Home blood-pressure monitoring in a hypertensive pregnant population: cost minimisation study

Xydopoulos, G., Perry, H., Sheehan, E., Thilaganathan, B., Fordham, R. and Khalil, A. (2019) Home blood-pressure monitoring in a hypertensive pregnant population: cost minimisation study. Ultrasound in Obstetrics and Gynecology, 53 (4). pp. 496-502. ISSN 0960-7692

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Background: Traditional monitoring of blood pressure in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood‐pressure monitoring (HBPM) could offer a cost‐saving alternative that is acceptable to patients. The main objective of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. Methods: This was a case–control study. Cases were pregnant women with hypertension who had HBPM with or without the adjunct of a smartphone app, via a specially designed pathway. The control group were managed as per existing hospital guidelines. Specific outcome measures were the number of outpatient visits, inpatient bed stays and investigations performed. Maternal, fetal and neonatal adverse outcomes were also recorded. Health economic analysis was performed using two methods: direct cost comparison of the study dataset and process scenario modelling. Results: There were 108 women in the HBPM group, of whom 29 recorded their results on the smartphone app (App‐HBPM) and 79 in their notes (Non‐app HBPM). The control group comprised of 58 patients. There were significantly more women with chronic hypertension in the HBPM group (49.1% vs 25.9%, P = 0.004). The HBPM group had significantly longer duration of monitoring (9 weeks vs 5 weeks P = 0.004) and started monitoring from an earlier gestation (30 weeks vs 33.6 weeks, P = 0.001). Despite these differences, the mean saving per week for HBPM compared with the control group was £200.69. For the App‐HBPM cohort, the saving per week compared with the control group was £286.53. The process modelling method predicted savings of between £98.32 and £245.80 per week using HBPM compared to the traditional monitoring. Conclusion: HBPM in hypertensive pregnancies appears to be cost‐saving compared with traditional monitoring, without compromising maternal, fetal or neonatal safety. Larger studies are required to confirm these findings.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: Pure Connector
Date Deposited: 11 Apr 2018 11:30
Last Modified: 04 Apr 2020 00:38
URI: https://ueaeprints.uea.ac.uk/id/eprint/66741
DOI: 10.1002/uog.19041

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