A pilot project put forward by the CHUM and the Pharmaprix chain will offer around a hundred women local care after their pregnancy, particularly with regard to their specific cardiovascular risks.
Complications such as gestational hypertension, gestational diabetes and preeclampsia should be monitored during pregnancy, but also after delivery because they can translate into a higher risk of cardiovascular disease.
But as women often give priority to the newborn at this time to the detriment of their own health, doctors Christine Pacheco and Jessica Forcillo decided to offer them follow-up better suited to their reality.
“The project consists of developing a new innovative care model to address the problem of assessing the cardiovascular risk of women who have a complication during their pregnancy,” summarized Dr. Pacheco.
Doctors Pacheco and Forcillo are the co-founders of the Cardio F Clinic at the CHUM, which specializes in cardiovascular diseases in women.
A collaboration with the Pharmaprix chain will offer the first participants in this study local care thanks to access to a pharmacist and a specialized nurse practitioner.
Up to 10% of women could be affected by a health problem during their pregnancy, recalled Dr. Pacheco, and those who are subsequently have a twice the risk of cardiovascular disease.
“We have several convincing data in the literature which tell us that women who have a problem with pressure or diabetes during pregnancy are more at risk of having a cardiovascular health problem later, a heart attack, a stroke, a heart failure heart,” she said.
It is therefore more than relevant, she continues, to take advantage of the fact that the patient is in contact with the health system to carry out prevention by acting early on several risk factors, especially since up to half medical appointments made by women after giving birth will be missed for reasons that are easy to imagine.
And although the new mother will often be too overwhelmed to go meet her doctor, she will still have no choice but to go to the pharmacy to obtain certain products she needs for her baby ― hence the idea of this pilot project.
“We really want to find ways to facilitate the monitoring of these patients,” explained Dr. Forcillo, who is a cardiac surgeon at the CHUM. It is also a way of raising awareness and educating them about risk factors (for cardiovascular disease) which are non-traditional. For example, you are four times more likely to have high blood pressure later if you had it during pregnancy. »
A collaboration was therefore established with the Aimez-vous program, from Pharmaprix, in order to reach women in their community. Visual material will be deployed in 15 participating pharmacies to inform women and their partners of the existence of this program, which represents a Canadian first.
The pilot project will initially allow participants to assess their attendance at their pharmacy appointments.
The involvement of specialized nurse practitioners and pharmacists in these “virtual clinics,” said Dr. Forcillo, will allow Cardio F to offer very close monitoring to these women.
“We want to reach women from diverse backgrounds,” said pharmacist-owner El-Shaimaa Saliem. Our role will really be to facilitate the recruitment and monitoring of community pharmacy patients. We want to remove one of the barriers to access to care that certain women face. »
The fact that customers are already going to pharmacies will facilitate their recruitment, she estimated. And as patients often consult their pharmacist in search of advice, it becomes easier to guide them regarding their lifestyle habits, adjust medication as needed or even initiate consultation requests, said Mme Saliem.
“As patients are already clients, the relationship of trust already exists and this facilitates open communication,” she added.
The recruitment of a first cohort of around a hundred patients will make it possible to verify whether the new proposed model promotes consistent follow-up, explained Dr. Pacheco, who is a cardiologist at Pierre-Boucher Hospital and an associate member at the CHUM.
“If we pick up women where they are, if we minimize travel and if we offer close follow-up in interprofessional collaboration, we really think that it will improve the frequency and attendance at follow-up,” she said. said.
The project could then be called upon to expand, which will make it possible to measure the impact of the initiative not only on attendance, but also on clinical outcomes, such as reducing the incidence of hypertension. poorly controlled or cardiovascular events.