Quebec Pilot Project on Women's Postpartum Health

The CHUM and Pharmaprix pilot project will provide local post-pregnancy care to around 100 women, especially women with cardiovascular disease.

Complications such as gestational hypertension, gestational diabetes, and preeclampsia need to be monitored during pregnancy, as well as after delivery, as they can lead to an increased risk of cardiovascular disease.

Women often put their newborns first at the expense of their own health, so Dr. Christine Pacheco and Dr. Jessica Forcillo decided to offer them a form of reality check.

Dr. Pacheco is a cardiologist at Pierre Boucher Hospital and Dr. Forcillo is a cardiac surgeon at CHUM.

“The project involves the development of a new, innovative model of care to address the challenge of assessing cardiovascular risk in women with complications during pregnancy,” explains Dr. Pacheco.

Both are the founders of CHUM Clinique Cardio F, which specializes in women's cardiovascular diseases.

The collaboration with Pharmaprix will provide local care with access to a pharmacist and specialist nurse for the first participants in this study.

“Up to 10 percent of women may be affected during pregnancy and are at risk for cardiovascular disease,” Dr. Pacheco said. “We have a number of robust data in the literature that show that women with high blood pressure or diabetes during pregnancy are at increased risk of developing cardiovascular disease, such as heart attack, stroke or heart failure, later in life. »

He continued by explaining that a patient's contact with the health care system should be taken advantage of to take preventive measures by early action on several risk factors.

Pacheco says about half of women's postpartum medical appointments are missed for simple reasons.

“Even though a new mother often misses a doctor's appointment, she has no choice but to go to the pharmacy to pick up some of the products her baby needs, which sparked the idea for this pilot project.”

Dr. Forcillo wants to find ways to make monitoring these patients easier.

“It's also a way to raise awareness and educate them about non-traditional risk factors (for cardiovascular disease). For example, if you have high blood pressure during pregnancy, you are four times more likely to develop it later in life.”

A collaboration was established with Pharmaprix's Aimez-vous program to reach women in their communities.

Visual material will be placed in 15 participating pharmacies to inform women and their spouses about this program.

The first phase of the pilot project will be to evaluate participants' participation in pharmacy practice.

“Having dedicated nurses and pharmacists in these 'virtual clinics' allows Cardio F to monitor these women very closely,” said Dr. Forcillo.

Pharmacist/owner El-Shaimaa Saleem said she wants to reach women from all walks of life.

“Our role will really be to facilitate recruitment and follow-up of community pharmacy patients. We want to remove one of the barriers to access care for some women.”

He believes that having customers visit the pharmacy makes it easier to recruit them.

“And since patients often consult a pharmacist for advice, it becomes easier to guide them in their lifestyle, adjust their medication if necessary, or even initiate a consultation request,” Saliem explained. “Because patients are already clients, a relationship of trust already exists, and that facilitates open communication.”

Dr. Pachecho says recruiting an initial cohort of about 100 patients will allow testing whether the new model promotes consistent follow-up.

“We think that if we keep women where they go, reduce travel, and offer more careful monitoring in interprofessional collaboration, it will improve the frequency and consistency of monitoring,” she said. “The project can then be scaled up, allowing us to measure the impact of the initiative not only on attendance but also on clinical outcomes such as a reduction in the incidence of poorly controlled hypertension or cardiovascular events.”

This report from La Presse Canadienne was translated by CityNews.