Self-management of Postnatal Anti-hypertensive Treatment: a Trial Development Pilot Study (SNAP-HT)
Pre-Eclampsia, Hypertension, Pregnancy-Induced
About this trial
This is an interventional treatment trial for Pre-Eclampsia focused on measuring Pregnancy, Postnatal Care, Blood Pressure Monitoring, Home, Self Care, Pregnancy Complications, Cardiovascular, Qualitative Research, Antihypertensive Agents
Eligibility Criteria
Inclusion Criteria:
- Participant is willing and able to give informed consent for participation in the study.
- Female, aged 18 years or above.
- Women with gestational hypertension (new-onset BP > 140/90mmHg) or pre-eclampsia (new onset BP > 140/90mmHg and significant proteinuria > 300mg/24hr), prior to their discharge from hospital post-delivery.
- Require antihypertensive medication during pregnancy, which needs to continue in the postpartum period.
Exclusion Criteria:
- Hypertension prior to pregnancy.
- Poor English language skills.
- More than three anti-hypertensive agents at discharge from hospital postpartum.
Sites / Locations
- Royal Berkshire NHS Foundation Trust
- Northampton General Hospital NHS Trust
- Oxford University Hospitals NHS Foundation Trust
- Stoke Mandeville Hospital
- Horton General Hospital
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Usual care
Self-management
Women randomised to usual care will have their blood pressure monitored by their community midwife, and will have their anti-hypertensive medication adjusted by their general practitioner. There will be no intervention in this group. All women will be followed up at ten days, four and six weeks, then three and six months postpartum and have their blood pressure measured by one of the study team.
Self-management of postnatal anti-hypertensive treatment. Women will be provided with, and taught to use, a validated home blood pressure monitor, and perform daily BP readings. When treatment is discontinued we will ask them to continue daily BP measurements for 1 week. Provided these are <140/90 mmHg they will be asked to check their BP weekly for the remainder of the trial period. The self-monitoring BP data will be collated centrally through the use of a smart phone app or SMS based system. This service will respond to participants regarding the level of their BP and what action is required. Women in the self-management group will have an individualised medication adjustment schedule developed by the research team in conjunction with the participant's obstetric team.