Equity and Effectiveness of Remote Patient Blood Pressure Monitoring in Postpartum Care: A Systematic Review

Abstract

Introduction: The postpartum period is a clinically vulnerable stage for women with Hypertensive Disorders of Pregnancy (HDP), yet blood pressure surveillance commonly declines after discharge. Postpartum blood pressure monitoring is often not performed as recommended, resulting in an important monitoring gap. Methodology: In this systematic review, results from 22 studies were synthesized to assess the effectiveness and equity of Remote Blood Pressure Monitoring (RPM) in postpartum care. Results: The results indicate that effective integration of RPM into care pathways can enhance early blood pressure monitoring, facilitate faster up-triage to initiate treatment and optimize continuity of care. For example, blood pressure was recorded within 10 days postpartum for 94.4% of women with RPM vs 60.3% with standard monitoring, and hypertension-related readmissions were significantly reduced (0.5% vs 3.7%). However, there were variations in effectiveness due to the design of the programmes implemented, enrolment processes, clinical responsiveness and the level of integration within routine services. Findings on equity were more ambivalent, with digital literacy, socioeconomic disadvantage, insurance status, language, and internet access affecting participation and benefit. Conclusion: RPM in postpartum care is an effective strategy to enhance monitoring and to prevent unnecessary deterioration after childbirth; however, the impact of RPM benefits are more likely to be achieved when RPM structures and digital tools are designed to fill digital and structural inequalities.