Pilot project hopes to take care of women's health after giving birth

A newborn and their mother. (Credit: kenan zhang/pexels.com)

A pilot project by the CHUM and Pharmaprix is hoping to offer some 100 women greater care post-birth, particularly when it comes to cardiovascular risks.

Complications such as gestational hypertension, gestational diabetes and pre-eclampsia are followed during pregnancy, but can also translate into a higher risk of cardiovascular disease if not monitored after birth.

However, as women often put their newborns first -- sometimes to the detriment of their own health, doctors Christine Pacheco and Jessica Forcillo say they want to offer mothers a service that is better adapted to their realities.

"The project develops a new, innovative care model to address the problem of cardiovascular risk assessment for women who have  complications during pregnancy," said Pacheco.

She, along with Forcillo, are the co-founders of the CHUM's Clinique Cardio F, which specializes in cardiovascular disease in women.

They are collaborating with Pharmaprix to provide participants in the study with local care through access to a pharmacist and a specialized nurse practitioner.

Up to 10 per cent of women face some sort of health problem during pregnancy, Pacheco states, adding their risk then doubles for cardiovascular disease.

"We have several convincing data in the literature that tell us women who have a pressure or diabetes problem during pregnancy are at greater risk of having a cardiovascular health problem later on, a heart attack, a stroke, heart failure," she said.

Pacheco adds it's important to take advantage of the fact that while a patient is in contact with the health care system, preventive action must be taken -- especially since women often miss up to half their medical appointments after giving birth.

The doctors explain that though a mother may be too overwhelmed to visit a medical professional, she will have to go to the pharmacy for her baby -- hence the idea behind the pilot project.

"We really want to find ways to facilitate follow-up care for these patients," explains Forcillo, a cardiac surgeon at the CHUM. "It's also a way of raising awareness and educating them about non-traditional risk factors (for cardiovascular disease). For example, you're four times more likely to develop hypertension later on if you developed it during pregnancy."

The collaboration with Pharmaprix's Aimez-vous program includes visual advertising in 15 participating pharmacies to inform women and their spouses of the program -- a Canadian first.

As a first step, the pilot project will assess how many participants attend their pharmacy appointments.

"We want to reach women from a variety of backgrounds," said pharmacist-owner El-Shaimaa Saliem. "Our role will really be to facilitate the recruitment and follow-up. We want to remove one of the barriers to access to care that some women face."

She says she believes the fact that customers already go to pharmacies will make recruitment easier.

Since patients often consult their pharmacist in search of advice, it becomes easier to orient them about lifestyle habits, adjust medication and initiate requests for consultation, Saliem said.

"Since the patients are already clients, the relationship of trust already exists and this facilitates open communication," she added.

The recruitment of an initial cohort of 100 patients will enable doctors to see if the model needs regular follow-up, explained Pacheco, a cardiologist at Pierre-Boucher Hospital and associate member of the CHUM.

"If we go and find women where they are, if we minimize travel and if we offer close contact, we really think it will improve frequency and attendance at follow-ups," she said.

If it does well, the project could be expanded to measure clinical outcomes, such as fewer instances of poorly controlled hypertension or cardiovascular complications.

-- This report by The Canadian Press was first published in French on Feb. 13, 2024.