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Understanding Patient Perspectives on Specialized, Longitudinal, Postpartum, Cardiovascular Risk-Reduction Clinics
Kimberley M Nix1, T Lee-Ann Hawkins1,2, Meghan Vlasschaert1,2
1Division of General Internal Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Insights
Women with hypertensive disorders of pregnancy (HDP) face higher cardiovascular disease risk. A specialized clinic improved patient knowledge, behaviors, and satisfaction with postpartum cardiovascular risk reduction care.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Public Health
Background:
- Hypertensive disorders of pregnancy (HDP) significantly increase long-term cardiovascular disease (CVD) risk in females.
- Canadian guidelines recommend postpartum CVD risk reduction follow-up for patients with HDP.
- Specialized clinics offer tailored cardiovascular risk management strategies for this high-risk population.
Purpose of the Study:
- To examine patient experiences within a specialized, longitudinal postpartum cardiovascular risk reduction clinic (PreVASC) for women with HDP.
- To assess the impact of the PreVASC clinic on patient cardiovascular health knowledge, behaviors, and satisfaction.
- To identify patient preferences regarding clinic visit modalities.
Main Methods:
- A multimethod approach combining quantitative surveys and qualitative semistructured interviews.
- Quantitative data summarized using descriptive statistics.
- Qualitative data analyzed thematically and triangulated with survey results.
Main Results:
- High patient satisfaction (79%) reported with the specialized longitudinal care model.
- Significant adoption of preventive health behaviors (95%) following individualized counseling.
- Improvements noted in patient-reported cardiovascular health knowledge and reduced health anxiety.
- Preference for in-person clinic visits emerged.
Conclusions:
- An in-person, specialist-led, longitudinal model of postpartum CVD preventive care for HDP patients yields positive outcomes.
- The PreVASC clinic model enhances patient experience, knowledge, and health behaviors.
- Findings provide novel insights into patient preferences for specialized care, advancing CVD risk reduction strategies for high-risk individuals post-HDP.
Background:
Females who experience hypertensive disorders of pregnancy (HDP) have an increased lifelong risk of cardiovascular disease. Thus, Canadian clinical practice guidelines recommend cardiovascular risk reduction follow-up after a patient has HDP. This study examined the experiences of patients with HDP who attended a specialized, longitudinal general internal medicine postpartum cardiovascular risk reduction clinic called PreVASC. PreVASC focuses on comprehensive cardiovascular risk reduction through cardiovascular risk factor screening and management tailored specifically for female patients after they have HDP.
Methods:
This multimethod study examined the experiences of female patients with HDP via the following: (i) a quantitative survey (summarized with descriptive statistics); (ii) semistructured qualitative patient phone interviews (results grouped thematically); and (iii) triangulation of qualitative themes with quantitative survey results.
Results:
Overall, 37% of eligible clinic patients (42 of 115) participated; 79% of participants (n = 33) reported being "very satisfied" with the PreVASC clinic's specialized longitudinal model of care, and 95% (n = 40) reported making at least one preventive health behaviour change after receiving individualized counselling on cardiovascular risk reduction. Qualitative results found improvements in patient-reported cardiovascular health knowledge, health behaviours, and health-related anxiety. A preference for in-person vs phone clinic visits was reported by participants.
Conclusions:
An in-person, general internal medicine specialist-led, longitudinal model of cardiovascular disease preventive care focused specifically on cardiovascular risk reduction after HDP had positive impacts on patient experience, health knowledge, and preventive health behaviours. This novel knowledge on patient preferences for a longitudinal, specialized model of care advances cardiovascular risk reduction tailored specifically for high-risk people after HDP.
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