(711) The Preeclampsia Education Postpartum Study (PrEPS): A randomized controlled trial

Preeclampsia is associated with short- and long-term maternal morbidity. Therefore, it is critical for providers to educate patients regarding the nature of the disease, ongoing health risks, and warning signs that indicate worsening of the disease. We aimed to identify the optimal educational tool for short- and long-term preeclampsia knowledge retention.

Study Design:
A pilot randomized controlled trial of postpartum patients with preeclampsia with or without severe features delivered at a single tertiary care center. Participants were randomized 1:1 to standard text-only education (TE) or a graphic version of the same information (GE) and completed a baseline preeclampsia knowledge assessment prior to receiving the educational intervention. All patients also enrolled in remote blood pressure monitoring (RBPM). The primary outcome was short-term difference in preeclampsia knowledge score (PKS) from baseline. Secondary outcomes included differences in long-term ( >4 week) PKS, engagement in RBPM, postpartum follow-up, and readmission. Anxiety was assessed as a balancing measure using GAD-7. To detect at 15% difference in short-term PKS with 80% power and assuming a baseline PKS of 50% and drop-out rate of 20%, the calculated sample size was 36 patients. Analyses were by intention-to-treat.

Results:

Of the 36 recruited patients, 17 were randomized to the TE and 19 were randomized to GE arms. Those who received GE had significantly higher change in short-term PKS (+3.7, 95% CI 1.45-5.97, p=0.003) and were more likely to engage in RBPM. Patients receiving TE had significantly higher change in long-term PKS (+1.8, 95% CI 0.12-3.47, p=0.03). There were no differences in short or long-term anxiety scores or readmission rates between groups.

Conclusion:

Those randomized to GE demonstrated improved short-term understanding about preeclampsia and were more engaged in RBPM compared to those receiving TE. However, this knowledge improvement was not sustained. Continued investigation is needed on educational strategies to maintain knowledge of the potential lifelong implications of preeclampsia.