# Pilot Implementation of a Post–Hypertensive Disorders of Pregnancy Education and Follow-Up Package for Health Care Providers: Protocol for a Mixed Methods Pilot Study

## TL;DR

This study aims to develop and test an education and follow-up package for healthcare providers to improve long-term care for women with pregnancy-related high blood pressure.

## Contribution

A novel post-HDP care package is being piloted to address knowledge gaps and improve preventive health measures for affected women.

## Key findings

- HDP increases long-term risks for cardiovascular disease, diabetes, and kidney disease.
- Healthcare providers lack awareness and support for post-HDP follow-up care.
- The pilot will evaluate the package's effectiveness in improving provider knowledge and care delivery.

## Abstract

Medical complications of pregnancy provide a window into a woman’s future health risk. Hypertensive disorders of pregnancy (HDP) affect 1 in 10 pregnant women and elevate the risk for women of experiencing long-term health complications within 5 years of the affected pregnancy, continuing lifelong. These risks include a doubled to tripled risk of developing cardiovascular disease, a doubled risk of developing type 2 diabetes, and a 5- to 10-fold risk of developing chronic kidney disease. Early assessment and intervention following HDP are therefore crucial to improving women’s life-course health trajectory, as well as outcomes for any subsequent pregnancies. However, previous research has shown that Australian women and their primary health care providers are largely unaware of ongoing health risks and the necessary follow-up screening and assessments. Primary care providers also receive inadequate hospital-to-community handover and support to promote preventive health measures to women following pregnancy complications. Consequently, post-HDP care remains insufficient for optimizing long-term health.

This study aims to (1) explore whether a post-HDP education and follow-up service package can be designed, developed, and implemented among targeted general practitioners (GPs) and maternity hospitals across Sydney, Australia, and (2) evaluate whether the post-HDP education and follow-up package can address knowledge gaps among health care providers regarding the long-term health risks after HDP and build capacity among GPs to implement evidence-based care.

This pilot study will design, develop, and implement a post-HDP education and follow-up package (“the package”) adopting a collaborative and implementation methodological approach. The package, designed by expert health care providers and informed by prior evidence-based research, will include educational materials, improved hospital-to-community handover, and a funded 6-month postpartum visit.

Data collection occurred over an 18-month implementation and follow-up period between April 2024 and October 2025. Sixteen GPs across the Central and Eastern Primary Health Network (CESPHN) were recruited, along with their antenatal shared care (ANSC) affiliated tertiary referral hospitals in Sydney. Postimplementation data collection and analysis is planned for completion throughout 2026.

Mixed methods evaluation will assess the efficacy, acceptability, and utility of the post-HDP package among health care providers and inform its suitability for deployment at scale.