Understanding patient perspectives of specialized, longitudinal postpartum cardiovascular risk reduction clinics

BackgroundFemales who experience a hypertensive disorders of pregnancy (HDP) have an increased lifelong risk of cardiovascular diseases. Thus, Canadian clinical practice guidelines recommend cardiovascular risk reduction follow-up after HDP. This study examined the experiences of patients with HDP who attended a specialized, longitudinal General Internal Medicine (GIM) postpartum cardiovascular risk reduction clinic called PreVASC. PreVASC focuses on comprehensive cardiovascular risk reduction through cardiovascular risk factor screening and management tailored specifically for females after HDP.MethodsThis multi-method study examined the experiences of females with HDP through: 1) quantitative survey (summarized with descriptive statistics); 2) semi-structured qualitative patient phone interviews (results grouped thematically); and 3) triangulation of qualitative themes with quantitative survey results.ResultsOverall, 37% (42 of 115) of eligible clinic patients participated, 79% (n=33) of participants 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 behavior 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. telephone clinic visits was reported by participants.ConclusionAn in-person, GIM specialist-led, longitudinal model of CVD 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. Females who experience a hypertensive disorders of pregnancy (HDP) have an increased lifelong risk of cardiovascular diseases. Thus, Canadian clinical practice guidelines recommend cardiovascular risk reduction follow-up after HDP. This study examined the experiences of patients with HDP who attended a specialized, longitudinal General Internal Medicine (GIM) postpartum cardiovascular risk reduction clinic called PreVASC. PreVASC focuses on comprehensive cardiovascular risk reduction through cardiovascular risk factor screening and management tailored specifically for females after HDP. This multi-method study examined the experiences of females with HDP through: 1) quantitative survey (summarized with descriptive statistics); 2) semi-structured qualitative patient phone interviews (results grouped thematically); and 3) triangulation of qualitative themes with quantitative survey results. Overall, 37% (42 of 115) of eligible clinic patients participated, 79% (n=33) of participants 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 behavior 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. telephone clinic visits was reported by participants. An in-person, GIM specialist-led, longitudinal model of CVD 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.