Understanding why some women with a history of gestational diabetes do not get tested for diabetes
| Autor: | Kathryn Paez, Matthew W. Gillman, Susan J. Griffey, Brandy Farrar, Jacquelyn Smith, Emma M. Eggleston, Jennifer Thompson |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Health (social science) Diabetes risk Context (language use) Interviews as Topic Appointments and Schedules Pregnancy Risk Factors Diabetes mellitus Maternity and Midwifery Health care medicine Humans Mass Screening Women Mass screening Gynecology Physician-Patient Relations Primary Health Care business.industry Data Collection Postpartum Period Public Health Environmental and Occupational Health Obstetrics and Gynecology Glucose Tolerance Test Patient Acceptance of Health Care medicine.disease Gestational diabetes Diabetes Gestational Logistic Models Diabetes Mellitus Type 2 Family medicine Female business Postpartum period |
| Zdroj: | Women's health issues : official publication of the Jacobs Institute of Women's Health. 24(4) |
| ISSN: | 1878-4321 |
| Popis: | Background The proportion of women with previous gestational diabetes mellitus (GDM) receiving postpartum diabetes testing is far less than desired. Even in health care systems with high testing rates, some women remain untested. We explored what helps and what hinders women to obtain recommended testing. Methods In this mixed methods study, we recruited 139 patients with a history of GDM in their most recent pregnancy (6 months to 4.5 years before study enrollment) from a delivery system that had instituted a quality improvement program to increase postpartum diabetes testing rates. We determined whether they had received a postpartum diabetes test according to American Diabetes Association guidelines. Using survey data, we ran logistic regression models to assess correlates of testing status, and we conducted in-depth interviews with 22 women to provide greater context to their survey responses. Results Of the 139 women, 21 women (15%) did not complete recommended diabetes testing. From the survey data, women who visited a primary care provider had 72% (95% CI, 0.09–0.83) lesser odds of not having been tested. From the qualitative interviews, difficulty fitting testing around work and caregiver demands were the most common reasons for not testing. Untested women interpreted providers' reassurances that diabetes would resolve after delivery and lack of reminders to reschedule missed appointments and to complete diabetes testing as indicators that their physicians were not concerned about their diabetes risk. Conclusions Among hard-to-reach women, multiple demands on their time were common explanations for not receiving a postpartum diabetes test. Consistent messages regarding long-term diabetes risk during pregnancy, access to postpartum primary care and convenient lab appointments, and systematic reminders to providers and patients are approaches that, in combination, may influence more resistant women to test. |
| Databáze: | OpenAIRE |
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