OP 32 Hypertension self-management postpartum – The SNAP-HT pilot study – Can women do it better?

Question We performed an initial evaluation of a novel self-management intervention for the titration of antihypertensive therapy by hypertensive women following delivery aiming to assess both feasibility and effect on blood pressure. Methods Postnatal women, with gestational hypertension or pre-eclampsia requiring antihypertensive treatment, were randomised to self-management or usual care and attended five follow-up visits over six months. Self-management entailed daily self-monitoring of blood pressure (BP) and measurement submission via a mobile phone-based telemonitoring system. The primary outcome was feasibility. A repeated measures mixed-effects regression model was used to analyse differences in BP during follow-up. Results 91 of 188 (48%) women approached were randomised (45 intervention, 46 control), with 9/91 (10%) withdrawals. Amongst the 82 complete cases, 403/410 (98%) follow-up visits were completed. The groups had similar baseline characteristics. BP at follow-up tended to be lower in those self-managing: This was most marked at 6 weeks [adjusted mean differences, self-management lower: systolic BP −5.2 mmHg (−9.3 to −1.2); diastolic BP −5.8 mmHg (−9.1 to −2.5)] and the difference in diastolic readings persisted to six months [−4.5 mmHg (−8.1 to −0.8)] despite all but one woman completing therapy. Conclusions This first randomised controlled evaluation of BP self-management postpartum showed the intervention was feasible and secondary outcome measures indicate that self-management may achieve better BP control; These results support evaluation on a larger scale.