Mrs Jenny Green1,2,3, Dr Heike Roth1,2,3, Dr Ben Harris-Roxas2,4, Professor Kathleen Baird1,2, Professor Amanda Henry2,4,5
1Collective for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia, 2Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia, 3School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales (UNSW), Sydney, Australia, 4School of Population Health, Faculty of Medicine & Health, University of New South Wales (UNSW), Sydney, Australia, 5The George Institute for Global Health, Sydney, Australia
Biography:
Jenny is a Registered Midwife and PhD Candidate at the University of Technology Sydney. Jenny's research is focused on improving the transition from hospital to primary care after pregnancy, particularly following complications. Specifically, she is addressing knowledge gaps amongst healthcare providers regarding long-term health risks associated with Hypertensive-Disorders-of-Pregnancy (HDP).
Abstract:
Background: Hypertensive Disorders of Pregnancy (HDP) affect 5-10% of pregnancies and are associated with approximately two-fold risk of developing cardiovascular disease and Type-2 diabetes, and 5-to-10-fold risk of developing chronic kidney disease, with risk onset <5 years postpartum and continuing lifelong. Early assessment and intervention after HDP is indicated to improve women’s life-course health trajectory, as well as outcomes for any subsequent pregnancies. Previous research demonstrates Australian women and their primary healthcare practitioners are largely unaware of ongoing health risks and appropriate assessment1. Furthermore, primary care practitioners report inadequate hospital-to-community handover and support to promote preventive health to women following pregnancy complications2.
Aim: To address knowledge gaps amongst healthcare providers regarding health post-HDP and improve General Practitioner (GP) capacity regarding post-HDP care. The study is assessing whether a pilot post-HDP education and follow-up services package (‘the package’) is acceptable to GPs, effective in improving their knowledge and perceived capacity regarding post-HDP care, and practical for implementation at scale.
Method: Utilising a collaborative process, the package has been designed with multidisciplinary stakeholders including GPs. Pilot implementation is occurring over a 12-month period with 16 GPs and 3 tertiary hospital sites across Central and Eastern Sydney Primary Health Network. Mixed-methods evaluation includes pre, midway and post-implementation surveys, post-implementation interviews with GPs and maternity hospital staff, and data on website/education pathway access.
Results: Pre-implementation surveys are complete and implementation has been underway since April 2024. The package includes a website and webinar series, a post-HDP HealthPathway, a HDP specific discharge referral letter with targeted hospital-to-community communication, and an additional funded six-month postpartum visit.
The collaborative design process and pre-implementation results will be presented.
Conclusion: Addressing healthcare providers preferences through a collaborative design enhances hospital and primary care integration promoting lifelong health following HDP. Upon completion, findings will inform potential for implementation at scale.
Keywords
"hypertensive disorders of pregnancy"
"long-term health risks",
"transitions-of-care"
References
1. Roth H, LeMarquand G, Henry A, Homer C. Assessing Knowledge Gaps of Women and Healthcare Providers Concerning Cardiovascular Risk After Hypertensive Disorders of Pregnancy—A Scoping Review. Frontiers in cardiovascular medicine. 2019;6:178–178.
2. Gusmeroli M, Perks S, Lanskey C, Bates N. Australian general practitioners’ views on qualities that make effective discharge communication: A scoping review. Australian journal of primary health. 2023;29(5):405–15.