Improving models of care for diabetes in pregnancy: Experience of current practice in Far North Queensland, Australia
journal contributionposted on 02.06.2021, 00:02 by A McLean, R Kirkham, Sandra Campbell, C Whitbread, J Barrett, C Connors, J Boyle, A Brown, J Mein, M Wenitong, D McIntyre, F Barzi, J Oats, A Sinha, L Maple-Brown
Aims: To map health practitioners' experiences and describe knowledge regarding screening and management of Diabetes in Pregnancy (DIP) in Far North Queensland, Australia. Methods: Mixed methods including a cross-sectional survey (101 respondents) and 8 focus groups with 61 health practitioners. All participants provided clinical care for women with DIP. Results: A wide range of healthcare professionals participated; 96% worked with Indigenous women, and 63% were from regional or remote work settings. Universal screening for gestational diabetes at 24-28 weeks gestation was reported as routine with 87% using a 75g Oral Glucose Tolerance Test. Early screening for DIP was reported by 61% although there was large variation in screening methods and who should be screened < 24 weeks. Health practitioners were confident providing lifestyle advice (88%), dietary and blood glucose monitoring education (67%, 81%) but only 50% were confident giving insulin education. Electronic medical records were used by 80% but 55% also used paper records. Dissatisfaction with information from hospitals was reported by 40%. In the focus groups improving communication and information technology systems were identified as key areas. Other barriers described were difficulties in care coordination and access for remote women. Conclusion: Communication, information technology systems, coordination of care and education for health professionals are key areas that will be addressed by a complex health systems intervention being undertaken by the DIP Partnership in North Queensland.
The NT and FNQ DIP Partnership was funded by NHMRC (National Health and Medical Research Council of Australia) Global Alliance Chronic Disease Grant #1092968. LM-B was supported by NHMRC Practitioner Fellowship #1078477; JBo was supported by NHMRC Career Development Fellowship; AB was supported by a Sylvia and Charles Viertel Senior Medical Research Fellowship. The views expressed in this publication are those of the authors and do not reflect the views of the NHMRC. The funders had no role in study design, data collection, and analysis, decision to publish or preparation of the manuscript.
JournalFrontiers in Public Health
PublisherFrontiers Media S.A.
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Science & TechnologyLife Sciences & BiomedicinePublic, Environmental & Occupational Healthgestational diabetes-mellitusdiabetes in pregnancymodel of carescreening practicesdiabetes managementcare coordinationaccess to health careSTRAIT ISLANDER WOMENINTERNATIONAL ASSOCIATIONNEONATAL OUTCOMESINDIGENOUS WOMENMELLITUSINCREASEPATIENTHYPERGLYCEMIAPREVALENCEgestational diabetes–mellitus