Barriers and Facilitators to Early Postpartum Blood Pressure Follow-Up After Hypertensive Disorders of Pregnancy: An Integrative Review.
Jill C Doyle, Christopher S Lee, Lucinda Canty
PMID 41885193WHAT IT FOUND
For postpartum patients with hypertensive disorders of pregnancy, early blood pressure checks were often missed, especially among Black, Hispanic, younger, publicly insured, and multiparous patients.
Remote monitoring, nurse-led education, multilingual access, and continuity of care helped, but disparities remained.
Key findings
01Lower early postpartum blood pressure ascertainment was reported among non-Hispanic Black patients, and lower engagement was reported among Black and Hispanic patients.
02Remote blood pressure monitoring was associated with 92% versus 58% blood pressure ascertainment within 10 days, and among Black patients 93% versus 41%.
03Supportive provider communication and nurse-led interventions were reported as facilitators of blood pressure ascertainment and engagement.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only a single reviewer screened and extracted data, so selection and interpretation could be biased. Most included studies were observational cohorts, so they show associations more than treatment effects. The studies measured different outcomes, including blood pressure ascertainment, visit attendance, and remote monitoring engagement, making direct comparison difficult. Many studies did not report language inclusion, income, education, or employment, so the review could not fully assess accessibility for non-English speakers or economically disadvantaged patients. The review did not compare provider types directly, so it cannot say whether nurse-led or midwifery-led care is better than other provider models. Qualitative evidence was limited, and the included qualitative study had poorly defined methodology and limited generalizability.
Declared interests
The authors report no conflicts of interest to disclose.
The easy way to misread this
Do not conclude that remote blood pressure monitoring alone solves early postpartum blood pressure follow-up. In some studies, Black patients were less likely to enroll or stay engaged, and an intervention improved follow-up for White patients but not Black patients, so device access, digital support, and structural barriers must be addressed.