OP 36 Home blood pressure monitoring in pregnancy – A cost analysis

Introduction Hypertensive disorders complicate 10% of pregnancies and are associated with an increased risk of maternal and fetal morbidity and mortality. Traditional monitoring requires frequent hospital visits and investigations, which are time-consuming and stressful for patients, as well as a burden on maternity services. Home blood pressure monitoring (HBPM) offers an accurate and safe means of monitoring blood pressure and could provide cost-savings. We have introduced HBPM with the adjunct of an innovative smartphone app to record results and give advice to women with hypertension in pregnancy. Patients and methods We conducted a cost analysis for a cohort of hypertensive pregnant women using HBPM with our app using 2 techniques: process modelling and a direct case-control comparison with a cohort of women on traditional monitoring. Models were derived from common scenarios and costs obtained from NICE tariffs and NHS Practice Reports. For the direct comparison, data was collected from case notes and hospital databases. Variables included number of outpatient attendances, inpatient bed days and number of investigations. Results There were 108 patients in the HBPM cohort and 58 patients on the traditional pathway. Using process modelling we estimated that by using HBPM and thereby reducing the number of DAU visits required, costs per patient per week could be reduced from £196.64-£294.96 to £49.16-£98.32. The direct comparison demonstrated average savings of £200.85 per patient, per week of monitoring using HBPM compared to the traditional pathway with savings of £286.59 in some scenarios. There was no statistical difference in adverse outcomes between the groups. Conclusion This pilot study suggests that HBPM is a cost-saving initiative which is acceptable to patients in a hypertensive pregnant population. A larger study is required to confirm these findings.