How Patient Education, Preventive Care Mitigate Preeclampsia
CVS Health deployed a patient education campaign aimed at delivering preventive care to pregnant people at risk for preeclampsia.
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By Sara Heath
- Preeclampsia is a seriously dangerous condition that affects pregnant people which can result in stroke, cardiovascular disease, and harm to the baby. It’s also a key driver behind black maternal health disparities.
But the good news is, through strong patient education and preventive care, preeclampsia can be somewhat preventable, according to Joanne Armstrong, MD, MPH, the executive medical director and chief medical officer for Women’s Health and Genomics at CVS Health.
“Preeclampsia is this weird form of high blood pressure that really happens in pregnancy, but we don't have an analogous example when women are not pregnant,” Armstrong said in the season three premiere of Healthcare Strategies, an Xtelligent Healthcare Media podcast.
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In recent years, medical researchers have determined a fairly simple and low-cost preventive strategy for the illness: baby aspirin. The only trouble is preeclampsia can be pretty hard to detect, whether it be in a risk assessment or when managing a pregnant person with no preeclampsia risk factors.
“About half the women with preeclampsia have some underlying risk factors,” Armstrong explained. “If you know the underlying risk factors it offers the possibility that you might be able to prevent it.”
Armstrong and her team at CVS Health recently introduced an intervention focusing on pregnant people with preeclampsia risk factors, providing them with patient education and a small sample bottle of that baby aspirin ideally to spark patient-provider communication. Armstrong said the intervention aimed to support shared decision-making about preeclampsia.
But that’s only half the story, she noted.
“Then the other half or so of women don't have any risk factors, and in that group, early recognition of symptoms so that you can get to a hospital and intervene, make sure that you're delivering in a safe place, being taken care of by people who know how to handle this, is really important,” Armstrong stated.
“The tricky thing about the symptoms and recognition is that many of the symptoms are bread and butter things that happen in pregnancy—mild headache, feet get swollen—but preeclampsia is really more than that,” she added.
Armstrong advocated strong patient education about preeclampsia symptoms. Pregnant people might be experiencing preeclampsia if they have a persistent headache that doesn’t go away, or extremely rapid weight gain and significant swelling in the feet. Some pregnant people with preeclampsia also have some sort of vision problems, like seeing dots, which is called scotoma in your eyes.
Making these connections does not just constitute good preventive care, but is a key step forward in health equity, Armstrong added. Part of CVS Health’s initiative zeroed in on Black women because of pronounced risk in that population.
“It's important for all pregnant women, but why are we sensitive to this in black women? And the answer for that is that black women are about 60 percent more likely to have preeclampsia and to have more severe forms of preeclampsia,” Armstrong concluded. “So recognition of symptoms and prevention strategies are important for everybody, but particularly in that group of women.”
