Mobile app could help address hypertension in pregnancy, study suggests

Hypertension disorders in pregnancy and other high-risk conditions could be addressed with a mobile app to bridge the communication gap between providers and patients, a new study suggests.

In a study published Friday in JAMA Network Open, researchers evaluated patient risk for a hypertension disorder in pregnancy called preeclampsia as well as medication guidelines for its treatment. The authors suggest engagement with the mobile app MyHealthyPregnancy, developed by UPMC, University of Pittsburgh and Carnegie Mellon researchers, could improve the identification of risk factors and medication adherence.

Preeclampsia, a pregnancy condition marked by hypertension and damage to the mother’s organs, can lead to restricted fetal growth and increase the risk of preterm delivery and stillbirth.

Taking a low dose of aspirin every day can help reduce the risks, but identifying risk factors in patients and ensuring they adhere to medication recommendations can be difficult, according to the authors of the study.

Of the 411 patients surveyed through the app with two or more moderate-risk factors, only 46% said they’d been advised to take a low dose of aspirin. Of the 124 patients surveyed with at least one high-risk criterion, more than a quarter said they hadn’t been recommended aspirin.

Researchers gained access to the medical records of 90 patients surveyed that had at least one high-risk factor for preeclampsia, all of which had a recommendation from their provider for a low daily dose of aspirin on record. But only 63% of those patients said they were aware of the recommendation, and 37% said they didn’t recall the advice at all.

“The finding that many patients didn’t recall an aspirin recommendation highlights that there is huge opportunity to improve information-sharing,” said Tamar Krishnamurti, Ph.D., assistant professor of medicine and clinical and translational science at the Pitt School of Medicine and one of the app’s lead researchers, in a statement. “We had incredibly high engagement with participant responses to voluntary questions through the MyHealthyPregnancy app, so there is real opportunity to leverage this engagement to bridge communication gaps between providers and patients.”

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Researchers said the MyHealthyPregnancy app, a patient-facing mobile app with a provider-facing portal, could identify users with preeclampsia risk factors to providers and remind patients to take their recommended medication, potentially also helping address health disparities in preeclampsia diagnoses.

“We see this app as a way to augment the patient-provider dyad,” said senior author Hyagriv Simhan, M.D., professor and executive vice chair of obstetrical services at Pitt and director of clinical innovation for the Women’s Health Service Line at UPMC Magee-Womens Hospital. “This digital tool has potential to offer additional support and information for patients to navigate on their own and also facilitate further conversation with their providers about aspirin eligibility. This could empower patients to make more informed decisions for a healthy pregnancy.”

The app is currently available only to patients in the UPMC system upon prescription, with plans for future testing in more healthcare systems.