Clinical trial

Facilitated Transitions From Postpartum to Primary Care Coordination for People With Chronic Conditions

Recruiting now · Not applicable · 1 countries · Registry ID NCT06557005

Recruiting nowNot applicableInterventional

What this study is about

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.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age18 Years to Not listed

SexFemale

Healthy volunteersNot accepted

ConditionHypertension, Diabetes, Postpartum, Pregnancy, Anxiety, Depression, Obesity

Full registry criteria

Inclusion Criteria * Receiving obstetric care at an MGH-affiliated obstetrics practice (except for the MGH HOPE Clinic, which has a unique care model that provides prenatal and postnatal care for individuals with substance use disorder, including the provision of primary care through 2+ years postpartum) * Pregnant with a live fetus or delivered a live-born neonate ≥24 weeks of gestation, based on the clinical estimate of gestational age * If postpartum, has a neonate that is currently living at the time of enrollment * Has one or more of the following conditions listed in the "Problem List," "Medical History," or clinical notes during prenatal, intrapartum, or postpartum encounters in the EHR (or in the case of BMI, the patient's anthropometric measurements): * Chronic or essential hypertension * Hypertensive disorders related to pregnancy (e.g., pre-eclampsia) * Type 1 or 2 diabetes (i.e., pre-existing diabetes) * Gestational diabetes * Class II Obesity (pre-pregnancy body mass index ≥35 kg/m2; or if pre-pregnancy body mass index is not known, a first trimester BMI of ≥35 kg/m2) * Depression or anxiety disorder * Has a primary care clinician listed in the patient's medical record * Has access to or agrees to be enrolled in the electronic health record patient portal and consents to be contacted via these modalities * Able to read/speak English or Spanish language * Is age ≥18 years old Exclusion Criteria • Any individual not meeting all inclusion criteria

Treatments and study arms

Facilitated Transition to Primary Care

Other

The intervention includes 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.

Primary outcomes

Completion of a primary care visit155 days after date of delivery

Observation of a visit with a primary care practitioner (defined as physicians and advanced practice clinicians affiliated with the following medical specialties: internal medicine, family medicine, pediatrics and adolescent medicine, and gynecology).

Receipt of condition-specific recommended health screening and counseling by a primary care practitioner155 days after date of delivery

For individuals with gestational hypertensive disorders, appropriate management is defined as blood pressure screening by a primary care practitioner as documented in the electronic health record. For individuals with gestational diabetes, appropriate management is defined as observation of a postpartum glucose screening testing (e.g., GTT, HgbA1c) in the electronic health record. For individuals with chronic conditions, appropriate management is defined as receipt of both condition-specific screening (mood, weight, blood pressure and/or diabetes screening) and receipt of counseling, discussion of a management, and/or referral for or acknowledgment of subspecialist management for that condition by a primary care practitioner as documented in the electronic health record. "

Self-report of having a known, reliable primary care practitioner155 days after date of delivery

The outcome is the Self-report of having a known, reliable primary care practitioner (doctor, nurse practitioner, or physician's assistant).

Self-report of mental health155 days after date of delivery

Edinburgh Perinatal Depression Scale will be administered and the total EPDS score compared.

Study locations

1 locations were listed when this page was built. The first 40 are shown.

Massachusetts General Hospital🇺🇸 Boston, Massachusetts, United States

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