Improving postpartum-to-primary care transitions for people with chronic conditions
Bridges to Primary Care: Transforming Postpartum Primary Care Coordination for People With Chronic Conditions
NA · Massachusetts General Hospital · NCT06557005
This study tests whether embedding default PCP appointments, tailored reminder messages, and care recommendations into routine inpatient postpartum care helps people with chronic conditions connect with primary care after delivery.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 1320 (estimated) |
| Ages | 18 Years and up |
| Sex | Female |
| Sponsor | Massachusetts General Hospital (other) |
| Locations | 1 site (Boston, Massachusetts) |
| Trial ID | NCT06557005 on ClinicalTrials.gov |
What this trial studies
This randomized controlled trial embeds a behavioral-economics-informed, multi-component intervention into usual inpatient postpartum care to strengthen handoffs from obstetrics to primary care. Key components include default primary care visit scheduling, tailored nudge messages to patients, and ongoing care recommendations sent to clinicians. Outcomes will be measured repeatedly using administrative data and patient surveys to capture primary care engagement, quality, and patient experience. The goal is to produce actionable evidence to make obstetric-to-primary care coordination a standard part of postpartum care.
Who should consider this trial
Good fit: People receiving obstetric care at an MGH-affiliated practice who are pregnant (with a viable fetus) or recently delivered (≥24 weeks gestation) and have one or more chronic or pregnancy-related conditions such as hypertension, diabetes, gestational diabetes, or class II obesity.
Not a fit: People whose prenatal and postpartum care is already delivered through integrated models that include primary care (for example the MGH HOPE Clinic), those who do not receive care at MGH-affiliated sites, or those unable or unwilling to attend follow-up primary care appointments may not benefit from this intervention.
Why it matters
Potential benefit: If successful, the intervention could increase timely postpartum primary care visits, improve management of chronic conditions, and reduce long-term health risks.
How similar studies have performed: Components like default scheduling and reminder nudges have improved appointment uptake in other settings, but applying this multi-component approach specifically to obstetric-to-primary care transitions is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria * Receiving obstetric care at an MGH-affiliated obstetrics practice (except for the MGH HOPE Clinic, which has a unique care model that provides prenatal and postnatal care for individuals with substance use disorder, including the provision of primary care through 2+ years postpartum) * Pregnant with a live fetus or delivered a live-born neonate ≥24 weeks of gestation, based on the clinical estimate of gestational age * If postpartum, has a neonate that is currently living at the time of enrollment * Has one or more of the following conditions listed in the "Problem List," "Medical History," or clinical notes during prenatal, intrapartum, or postpartum encounters in the EHR (or in the case of BMI, the patient's anthropometric measurements): * Chronic or essential hypertension * Hypertensive disorders related to pregnancy (e.g., pre-eclampsia) * Type 1 or 2 diabetes (i.e., pre-existing diabetes) * Gestational diabetes * Class II Obesity (pre-pregnancy body mass index ≥35 kg/m2; or if pre-pregnancy body mass index is not known, a first trimester BMI of ≥35 kg/m2) * Depression or anxiety disorder * Has a primary care clinician listed in the patient's medical record * Has access to or agrees to be enrolled in the electronic health record patient portal and consents to be contacted via these modalities * Able to read/speak English or Spanish language * Is age ≥18 years old Exclusion Criteria • Any individual not meeting all inclusion criteria
Where this trial is running
Boston, Massachusetts
- Massachusetts General Hospital — Boston, Massachusetts, United States (RECRUITING)
Study contacts
- Principal investigator: Mark A Clapp, MD, MPH — Massachusetts General Hospital
- Study coordinator: Mark A Clapp, MD, MPH
- Email: mark.clapp@mgh.harvard.edu
- Phone: 617-726-2000
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Hypertension, Diabetes, Postpartum, Pregnancy, Anxiety, Depression, Obesity, Postpartum Care