Facilitated Transition to Primary Care for Postpartum

Overseen By Mark A Clapp, MD, MPH

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Substance use disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

1320 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment Facilitated Transition to Primary Care for Postpartum?

The research suggests that patient navigation, which is part of the facilitated transition, has been effective in improving care coordination and patient engagement in other healthcare areas, particularly for those with low income. Additionally, programs like MOMI PODS, which integrate postpartum care into existing healthcare structures, have shown promise in increasing access to primary care and improving postpartum health outcomes. ^{1 2 3 4 5}

Is the Facilitated Transition to Primary Care for Postpartum generally safe for humans?

The research articles reviewed do not provide specific safety data for the Facilitated Transition to Primary Care for Postpartum. They focus on improving care coordination and engagement rather than evaluating safety. ^{1 2 3 6 7}

How does the Facilitated Transition to Primary Care treatment differ from other postpartum care treatments?

The Facilitated Transition to Primary Care treatment is unique because it focuses on creating a seamless transition from obstetric to primary care after childbirth, addressing the fragmented and incomplete postpartum care system in the U.S. It emphasizes individualized care plans and multidisciplinary collaboration to improve postpartum care engagement, especially for marginalized communities. ^{1 2 3 5 6}

What is the purpose of this trial?

The lack of postpartum primary care coordination is a missed opportunity to increase primary care engagement and manage chronic conditions early in life, especially for the \>30% of pregnant people who have or are at risk for these conditions. This study aims to increase postpartum primary care engagement, quality, and experience by strengthening postpartum transitions to primary care using a behavioral economics-informed, multi-component intervention integrated into usual inpatient postpartum care. Using a randomized controlled trial and repeated outcome assessments through administrative and survey data, this study will generate rigorous, actionable evidence to ensure primary care coordination becomes standard postpartum care practice, potentially catalyzing sustained primary care engagement throughout life.

Research Team

Mark A Clapp, MD, MPH

Principal Investigator

Massachusetts General Hospital

Eligibility Criteria

This trial is for postpartum individuals with chronic conditions such as high blood pressure, diabetes, depression, anxiety, or obesity. It aims to help those who have just given birth and are at risk of or already dealing with these health issues.

Inclusion Criteria

Admitted to Mass General Hospital on a postpartum care unit after delivery

Currently are or willing to be enrolled in the secure patient messaging portal affiliated with the health system's electronic health record

I have a history of anxiety, depression, hypertension, diabetes, or obesity noted in my medical records.

Exclusion Criteria

Admitted after stillbirth or neonatal death

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a behavioral economics-informed intervention integrated into routine inpatient postpartum care, including default PCP visit scheduling and tailored nudge messages.

Immediate postpartum period

Follow-up

Participants are monitored for primary care engagement, quality, and experience, with repeated outcome assessments through administrative and survey data.

548 days

Long-term Follow-up

Observation of sustained primary care engagement and health outcomes over an extended period.

584 days

Treatment Details

Interventions

• Facilitated Transition to Primary Care

Trial Overview The study tests a new way to improve the transition from postpartum care to regular primary care. Participants will receive extra support through a program designed using behavioral economics principles to see if it enhances their engagement and management of chronic conditions.

Participant Groups

Group I: Routine Care Active Control 1 Intervention

Routine postpartum care

Group II: Facilitated Transition Group Active Control 1 Intervention

The intervention is integrated into routine inpatient postpartum care and includes the following components: default PCP visit scheduling, tailored nudge messages to patients, ongoing care recommendations sent to the PCP, and a summary of recommendations after pregnancy given to the patient.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Harvard School of Public Health (HSPH)

Collaborator

Trials

283

Recruited

17,030,000+

Findings from Research

A study involving 28 primary care clinicians revealed strong support for implementing a postpartum patient navigation program to improve care coordination for individuals transitioning from obstetric to primary care.

Clinicians identified key navigation services that could enhance postpartum care, such as personalized support, effective visit management, and education on common postpartum health issues, highlighting the importance of tailored navigator training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary Care Clinician Perspectives on Patient Navigation to Improve Postpartum Care for Patients with Low Income. Filicko, A., Huennekens, K., Davis, K., et al.[2023]

The MOMI PODS program aims to improve postpartum care by integrating it into pediatric care systems, specifically targeting publicly insured individuals to enhance access to primary care and community resources.

This innovative approach has shown promise in increasing healthcare utilization and addressing maternal morbidity risk factors, although challenges such as provider capacity and data tracking were encountered during implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a multimodal maternal infant perinatal outpatient delivery system: the MOMI PODS program. Bose Brill, S., Juckett, LA., D'Amico Gordon, R., et al.[2023]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Predicting Postpartum Transition to Primary Care in Community Health Centers. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Mobilizing the fourth trimester to improve population health: interventions for postpartum transitions of care. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Primary Care Clinician Perspectives on Patient Navigation to Improve Postpartum Care for Patients with Low Income. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Team Approach: Organizing and Empowering Multidisciplinary Teams in Postfragility Fracture Care. [2023]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Developing a multimodal maternal infant perinatal outpatient delivery system: the MOMI PODS program. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Retention in Care of HIV-Positive Postpartum Females in Kumasi, Ghana. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Improving the quality of written communication at patient discharge: triangulation of qualitative analyses and intervention co-design. [2023]