title: OS106. The postpartum preeclampsia clinic (PPPEC) - an interdisciplinary clinic for cardiovascular risk reduction for women with preeclampsia.
abstract: BACKGROUND
  Preeclampsia (PEC) is a well-established risk factor for the development of future premature cardiovascular disease (CVD). However, women with PEC are not routinely counselled about these longterm risks, nor are their risk factors regularly assessed or treated for prevention of CVD. An interdisciplinary PPPEC clinic was recently established at the University of Alberta in order to address patient education and CVD risk factor management.
  
  
  OBJECTIVE
  (1) To describe the implementation of a novel interdisciplinary clinic for postpartum women with PEC designed to both educate women of their CVD risk and manage their risk factors. (2) To describe our one-year experience with this clinic, identifying attendance issues common to postpartum clinics.
  
  
  METHODS
  We performed a retrospective chart review using data obtained from standardized clinic booking lists. From these records, we extracted the following information: number of referrals, attendance dates (including adherence to visit) and patient demographics. Descriptive statistics were used to summarize patient demographics and percentages of missed visits were calculated.
  
  
  RESULTS
  PPPEC Clinic Implemenation: All patients who attend this PPPEC clinic received education on PEC, its implications for future vascular health, and evidence-based strategies for CVD risk reduction through both a slide presentation, educational handouts as well as individualized CVD risk assessment by the interdisciplinary team (Obstetric Internist, nurse practitioner, pharmacist and dietician). Next, specific patient-directed lifestyle modification goals were developed in the form of an "Action Plan" for each CVD risk factor: blood pressure, cholesterol, glucose intolerance, physical activity level, weight, and smoking. These goals were reviewed at each follow-up visit. PPPEC Clinic Experience: From Sept 2010 to Feb 2012, there were 123 appointments in this bi-weekly clinic (63 new consults and 60 follow ups). The women's mean age was 29.4 years (range 17-43). Seventy-four percent of scheduled apointments were attended. Of those that were missed, half were initial consultations and halfwere follow-up appointments.
  
  
  CONCLUSIONS
  This interdisciplinary PPPEC addresses an important gap in clinical care for CVD prevention for these high-risk women. This study identified suboptimal attendance of scheduled postpartum visits. Future plans include: (1) identifying barriers to postpartum clinic attendance and strategies to overcome them, (2) examining the effectiveness of the educational and clinical intervention model in reducing cardiovascular risk factors in these women.
authors.affiliation: Medicine and Obstetrics & Gynecology, University of Alberta, Edmonton, Canada.
authors.forename: W W
authors.initials: WW
authors.lastname: Sia
authors.affiliation: Nutrition and Food Services, Edmonton, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Montgomery-Fajic
authors.affiliation: Obstetrics and Gynecology, Edmonton, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Germaine
authors.affiliation: Pharmacy Services, Alberta Health Services, Edmonton, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Wilkie
authors.affiliation: Medicine and Obstetrics & Gynecology, University of Alberta, Edmonton, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Khurana
authors.affiliation: Medicine and Obstetrics & Gynecology, University of Alberta, Edmonton, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Marnoch
authors.affiliation: Medicine and Obstetrics & Gynecology, University of Alberta, Edmonton, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Nerenberg