Improving models of care for diabetes in pregnancy

Experience of current practice in Far North Queensland, Australia

Anna McLean, Renae Kirkham, Sandra Campbell, Cherie Whitbread, Jennifer Barrett, Christine Connors, Jacqueline Boyle, Alex Brown, Jacqueline Mein, Mark Wenitong, David McIntyre, Federica Barzi, Jeremy Oats, Ashim Sinha, Louise Maple-Brown

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    Abstract

    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.

    Original languageEnglish
    Article number192
    Pages (from-to)1-9
    Number of pages9
    JournalFrontiers in Public Health
    Volume7
    Issue numberJuly
    DOIs
    Publication statusPublished - 19 Jul 2019

    Fingerprint

    Pregnancy in Diabetics
    Queensland
    Health
    Focus Groups
    Information Systems
    Communication
    Technology
    Delivery of Health Care
    Education
    Professional Education
    Gestational Diabetes
    Electronic Health Records
    Glucose Tolerance Test
    Health Education
    Blood Glucose
    Life Style
    Cross-Sectional Studies
    Insulin
    Pregnancy

    Cite this

    McLean, Anna ; Kirkham, Renae ; Campbell, Sandra ; Whitbread, Cherie ; Barrett, Jennifer ; Connors, Christine ; Boyle, Jacqueline ; Brown, Alex ; Mein, Jacqueline ; Wenitong, Mark ; McIntyre, David ; Barzi, Federica ; Oats, Jeremy ; Sinha, Ashim ; Maple-Brown, Louise. / Improving models of care for diabetes in pregnancy : Experience of current practice in Far North Queensland, Australia. In: Frontiers in Public Health. 2019 ; Vol. 7, No. July. pp. 1-9.
    @article{4e4631aafca34dbfb5b0e5e84edacf6d,
    title = "Improving models of care for diabetes in pregnancy: Experience of current practice in Far North Queensland, Australia",
    abstract = "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.",
    keywords = "Access to health care, Care coordination, Diabetes in pregnancy, Diabetes management, Gestational diabetes - mellitus, Model of care, Screening practices",
    author = "Anna McLean and Renae Kirkham and Sandra Campbell and Cherie Whitbread and Jennifer Barrett and Christine Connors and Jacqueline Boyle and Alex Brown and Jacqueline Mein and Mark Wenitong and David McIntyre and Federica Barzi and Jeremy Oats and Ashim Sinha and Louise Maple-Brown",
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    McLean, A, Kirkham, R, Campbell, S, Whitbread, C, Barrett, J, Connors, C, Boyle, J, Brown, A, Mein, J, Wenitong, M, McIntyre, D, Barzi, F, Oats, J, Sinha, A & Maple-Brown, L 2019, 'Improving models of care for diabetes in pregnancy: Experience of current practice in Far North Queensland, Australia', Frontiers in Public Health, vol. 7, no. July, 192, pp. 1-9. https://doi.org/10.3389/fpubh.2019.00192

    Improving models of care for diabetes in pregnancy : Experience of current practice in Far North Queensland, Australia. / McLean, Anna; Kirkham, Renae; Campbell, Sandra; Whitbread, Cherie; Barrett, Jennifer; Connors, Christine; Boyle, Jacqueline; Brown, Alex; Mein, Jacqueline; Wenitong, Mark; McIntyre, David; Barzi, Federica; Oats, Jeremy; Sinha, Ashim; Maple-Brown, Louise.

    In: Frontiers in Public Health, Vol. 7, No. July, 192, 19.07.2019, p. 1-9.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Kirkham, Renae

    AU - Campbell, Sandra

    AU - Whitbread, Cherie

    AU - Barrett, Jennifer

    AU - Connors, Christine

    AU - Boyle, Jacqueline

    AU - Brown, Alex

    AU - Mein, Jacqueline

    AU - Wenitong, Mark

    AU - McIntyre, David

    AU - Barzi, Federica

    AU - Oats, Jeremy

    AU - Sinha, Ashim

    AU - Maple-Brown, Louise

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    N2 - 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.

    AB - 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.

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    KW - Diabetes management

    KW - Gestational diabetes - mellitus

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