Evaluation of Implementation of an EHR-based Screening Tool for Initiation of Low-dose Aspirin in Pregnancy for Preeclampsia Prevention

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Publication Date

11-20-2025

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Presentation: 43:47

Abstract

Background: Preeclampsia is a common hypertensive disorder of pregnancy that affects up to 8% of pregnant patients and is a leading cause of morbidity and mortality in pregnant patients. Low-dose aspirin has been shown to decrease the risk of preeclampsia. The U.S. Preventive Services Task Force recommends every pregnant patient be screened and those who meet criteria based on moderate or high risk factors should be prescribed low-dose aspirin as a risk-reducing measure. A major barrier to initiation of therapy is patients not undergoing a history-based screen for risk factors.

Methods: In a large urban academic healthcare system, there was no standardized screening process for preeclampsia risk factors during prenatal appointments in the outpatient setting. Patients were not recommended for appropriate preventative management to decrease risk of preeclampsia development in pregnancy. The purpose of the initiative was to implement an EHR-based screening tool that would be incorporated into every new obstetric intake appointment. The implementation of this screening tool prompted all providers to identify patients who met the pre-specified/pre-studied risk criteria and recommend low-dose aspirin use during pregnancy to prevent preeclampsia for those at increased risk.

Results: A pilot project ascertained there was no standardized screening documented in charts. Data was collected for three months after implementation of the EHR screening tool. Data revealed that after implementation, 531 of 586 (90.6%) patients presenting for a new obstetric visit were screened for with the new tool.

Conclusion: The primary outcome was to determine if use of the tool led to improved documentation and screening rates by assessing the percentage of patients who underwent preeclampsia risk screening at the first prenatal visit versus total number of initial visits. The results revealed a significantly high screening rate for preeclampsia risk factors with the use of the EHR-based tool. Long term, reduction of preeclampsia will be measured going forward.

Language

English

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