Postpartum Follow-Up Card for Enhancing Postpartum Care

Overseen By Victoria Greenberg, MD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Medstar Health Research Institute

Disqualifiers: Non-Medstar care

Compensation: Varies

Number of Visits: 1

157 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The aim of this study is to evaluate the impact of personalized postpartum follow-up cards on completion of postpartum health related tasks. The intervention will consist of a card given to patients at time of discharge. One side of the card will list the patient's name and a list of recommended postpartum follow-up appointments based on their diagnoses at the time of discharge. Participants will be randomized to this intervention or the control group, which will consist of standard education routinely given at discharge. The primary endpoint will be the rate of completion of a postpartum blood pressure check or two hour glucose tolerance test, or both, depending on the patient's discharge diagnosis within the first year after discharge. The secondary endpoints will include establishing care with a primary care provider within the first year after delivery, or completion of postpartum pap smear or colposcopy, as indicated.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What safety data exists for the Postpartum Follow-Up Card treatment?

The provided research does not directly address safety data for the Postpartum Follow-Up Card or its variants. The studies focus on postpartum visit adherence, correlates of postpartum care attendance, satisfaction with a text messaging intervention, postpartum visit checklists, and discharge education. None of these specifically evaluate the safety of the Postpartum Follow-Up Card treatment. ^{1 2 3 4 5}

Is the Postpartum follow-up card a promising treatment for enhancing postpartum care?

Yes, the Postpartum follow-up card is a promising treatment because it offers a low-cost way to provide important follow-up care to new mothers and their families. It helps ensure the well-being of both mother and infant by providing early assessment and support, which is especially important as hospital stays after childbirth are getting shorter. This approach is also efficient, allowing healthcare providers to assist more families in a day compared to home visits. ^{2 6 7 8 9}

What data supports the idea that Postpartum Follow-Up Card for Enhancing Postpartum Care is an effective treatment?

The available research does not provide specific data directly supporting the effectiveness of the Postpartum Follow-Up Card for Enhancing Postpartum Care. Instead, it highlights the importance of postpartum visits and the challenges in ensuring attendance. For example, one study discusses the development of a tool to identify those at risk of missing postpartum visits, which are crucial for addressing health concerns. Another study emphasizes the complexity of postpartum care and the need for comprehensive checklists to ensure all health needs are met. While these studies underline the importance of postpartum care, they do not specifically measure the effectiveness of the Postpartum Follow-Up Card compared to other treatments. ^{1 2 4 7 10}

Are You a Good Fit for This Trial?

This trial is for individuals who are at least 18 years old, can consent for themselves, and can read English or Spanish. They must have delivered a baby via vaginal delivery or c-section within the past 48 hours at a Medstar facility and plan to continue their care within the same system.

Inclusion Criteria

I gave birth in the last 48 hours.

I can read English or Spanish.

Able to consent for themselves

Exclusion Criteria

Received antepartum care at a facility outside of the Medstar system or plans to continue care with a facility outside of the Medstar system

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive either a personalized postpartum health card or standard education at discharge

At discharge

1 visit (in-person)

Follow-up

Participants are monitored for completion of postpartum health-related tasks such as blood pressure check, glucose tolerance test, and cervical cancer screening

12 months

Multiple visits as per postpartum follow-up schedule

What Are the Treatments Tested in This Trial?

Interventions

• Control
• Postpartum follow up card

Trial Overview The study tests if personalized postpartum follow-up cards given at discharge improve completion of health tasks like blood pressure checks and glucose tolerance tests. Participants will be randomly assigned to receive either this card with tailored appointments or standard education provided upon discharge.

How Is the Trial Designed?

Group I: Follow up cards Experimental Treatment 1 Intervention

Subjects will receive a personalized postpartum health card with recommendations for follow up based on their comorbid conditions in pregnancy. They will receive education about these comorbid conditions when they receive their cards.

Group II: Standard education Placebo Group 1 Intervention

Subjects will receive standard postpartum education as it is routinely performed by nurses prior to discharge.

Who Is Running the Clinical Trial?

Medstar Health Research Institute

Lead Sponsor

Trials

202

Recruited

187,000+

Published Research Related to This Trial

A study of 587 postpartum patients identified five key factors that increase the risk of not attending the 6-week postpartum visit, including being on Medicaid, starting prenatal care late, and being under 24 years old.

The developed risk scoring system effectively predicts nonadherence to the 6WPP, allowing healthcare providers to target interventions for at-risk patients, with significant predictive power demonstrated in both test and validation groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a Clinical Risk Assessment Tool for 6-Week Postpartum Visit Nonadherence. Qafiti, F., Kaur, S., Bahado-Singh, R.[2019]

The postpartum care model is evolving from a single visit to a comprehensive continuum of care aimed at improving long-term health outcomes for mothers, addressing rising morbidity and mortality rates.

To support this new model, specific checklists have been developed for both uncomplicated and medically complex postpartum patients, ensuring that essential health needs and future risks are systematically addressed during follow-up visits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Society for Maternal-Fetal Medicine Special Statement: Postpartum visit checklists for normal pregnancy and complicated pregnancy. Morgan, J., Bauer, S., Whitsel, A., et al.[2022]

Over half of the 25,692 women studied (50.5%) did not attend their postpartum care visit, indicating a significant gap in postpartum healthcare utilization.

Factors such as being a racial/ethnic minority and receiving care from specific healthcare facilities increased the likelihood of attending postpartum visits, while smoking and lack of prenatal care decreased attendance, highlighting the need for targeted interventions to improve access for high-risk groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Correlates of Postpartum Visits Among Medicaid Recipients: An Analysis Using Claims Data from a Managed Care Organization. Masho, SW., Cha, S., Karjane, N., et al.[2018]

The Postpartum Care Center, established in 1991, provides an innovative outpatient follow-up model that effectively addresses the needs of mothers and infants after shortened maternity stays.

This clinic model is cost-effective, allowing nurses to see two to three times more families in a day compared to home visits, while also benefiting from close access to essential support services like laboratory and pharmacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postpartum follow-up care in a hospital-based clinic: an update on an expanded program. Keppler, AB., Roudebush, JL.[2019]

Current postnatal care practices in hospitals often rely on rigid clinical pathways that do not accommodate individualized care for new mothers.

The paper advocates for the development of a new clinical pathway that incorporates best practices while being more woman-friendly and allowing for personalized care instead of following strict routines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postnatal care in hospitals: ritual, routine or individualized. Gilmour, C., Twining, S.[2019]

A novel intervention using a postpartum nurse navigator (PPNN) who provided daily text messaging support to 43 women after unplanned cesarean births showed high satisfaction, with 93% of participants rating their experience as outstanding or good.

The majority of participants (95%) expressed a strong interest in receiving similar daily text support for future pregnancies, highlighting the potential for this approach to improve postpartum care and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Nurse-Navigated, Postpartum Support Text Messaging Intervention: Satisfaction Among Primiparous Women. Morris, MH., Barton, M., Zane, M., et al.[2023]

A study involving 52 postpartum nurses from six hospitals revealed that while nurses do inform women about warning signs of postpartum complications, this education is often insufficient and primarily occurs on the day of discharge.

The findings suggest a need for improved educational strategies and consistency among nurses in teaching all women about postpartum warning signs, indicating that better resources and guidance are necessary for effective communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Discharge Education on Maternal Morbidity and Mortality Provided by Nurses to Women in the Postpartum Period. Suplee, PD., Kleppel, L., Bingham, D.[2018]

This study introduces a nurse practitioner-led postpartum intervention clinic aimed at women with severe pregnancy complications, providing comprehensive assessments and personalized care to address their increased cardiovascular risk.

The clinic will follow up with patients at 6 months, 18 months, and 5 years postpartum, collecting data to evaluate the effectiveness of the intervention in improving cardiovascular health in a socioeconomically disadvantaged population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Protocol for Nurse-Practitioner Led Cardiovascular Follow-Up After Pregnancy Complications in a Socioeconomically Disadvantaged Population. Aldridge, E., Verburg, PE., Sierp, S., et al.[2020]

Shorter hospital stays after childbirth have created a greater demand for postpartum home care services, highlighting the need for effective follow-up care.

The article discusses various postpartum home care options, such as telephone support, home visits, and lactation consultations, emphasizing the importance of integrating these services into maternity benefits in the U.S. healthcare system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postpartum home care in the United States. Evans, CJ.[2019]

The Postpartum Care Center, established in 1991, offers an innovative and cost-effective alternative to traditional home visits for postpartum care, providing early assessment and support for mothers and infants at one-third the cost.

The program demonstrates positive outcomes in postpartum support, addressing the need for effective follow-up care as maternity stays become shorter and healthcare costs rise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postpartum care center: follow-up care in a hospital-based clinic. Keppler, AB.[2019]

Citations

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

Development of a Clinical Risk Assessment Tool for 6-Week Postpartum Visit Nonadherence. [2019]

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

Society for Maternal-Fetal Medicine Special Statement: Postpartum visit checklists for normal pregnancy and complicated pregnancy. [2022]

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

Correlates of Postpartum Visits Among Medicaid Recipients: An Analysis Using Claims Data from a Managed Care Organization. [2018]

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

Postpartum follow-up care in a hospital-based clinic: an update on an expanded program. [2019]

5. Australia pubmed.ncbi.nlm.nih.gov

Postnatal care in hospitals: ritual, routine or individualized. [2019]

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

A Nurse-Navigated, Postpartum Support Text Messaging Intervention: Satisfaction Among Primiparous Women. [2023]

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

Discharge Education on Maternal Morbidity and Mortality Provided by Nurses to Women in the Postpartum Period. [2018]

8. Switzerland pubmed.ncbi.nlm.nih.gov

A Protocol for Nurse-Practitioner Led Cardiovascular Follow-Up After Pregnancy Complications in a Socioeconomically Disadvantaged Population. [2020]

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

Postpartum home care in the United States. [2019]

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

Postpartum care center: follow-up care in a hospital-based clinic. [2019]