S L O'Reilly1, J A Dunbar2, J D Best3, V Versace4, D Ford5, D Young6, S Shih7, R Bills8, W Shepherdley9, E D Janus10. 1. Institute of Physical Activity and Nutrition, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. Electronic address: sharleen.oreilly@ucd.ie. 2. Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, VIC 3280, Australia. Electronic address: James.dunbar@deakin.edu.au. 3. Lee Kong Chian School of Medicine, Imperial College London and Nanyang Technological University, 11 Mandalay Road, 308232, Singapore. Electronic address: jamesbest@ntu.edu.sg. 4. Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, VIC 3280, Australia. Electronic address: vincent.versace@deakin.edu.au. 5. Improvement Foundation, 8/19 Grenfell St, Adelaide, SA 5000, Australia. Electronic address: Dale.Ford@improve.org.au. 6. Faculty of Medicine, Dentistry and Health Sciences, Building 181, University of Melbourne, Grattan Street, Melbourne, VIC 3010, Australia. Electronic address: D.young@unimelb.edu.au. 7. Centre for Population Health Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. Electronic address: sophy.shih@deakin.edu.au. 8. Brooke Street Medical Centre, 14 Brooke Street, Woodend, VIC 3422, Australia. Electronic address: RBills@bsmc.net.au. 9. Brooke Street Medical Centre, 14 Brooke Street, Woodend, VIC 3422, Australia. Electronic address: WShepherdley@bsmc.net.au. 10. General Internal Medicine Unit, Western Health, Sunshine Hospital, 176 Furlong Rd, St Albans, VIC 3021, Australia; Department of Medicine, Melbourne Medical School - Western Precinct, University of Melbourne, 176 Furlong Rd, St Albans, VIC 3021, Australia. Electronic address: edwarddj@unimelb.edu.au.
Abstract
AIMS: Gestational diabetes (GDM) and Type 2 diabetes pose tremendous health and economic burdens as worldwide incidence increases. Primary care-based systematic diabetes screening and prevention programs could be effective in women with previous GDM. GooD4Mum aimed to determine whether a Quality Improvement Collaborative (QIC) would improve postpartum diabetes screening and prevention planning in women with previous GDM in general practice. METHODS: Fifteen general practices within Victoria (Australia) participated in a 12-month QIC, consisting of baseline and four quarterly audits, guideline-led workshops and Plan-Do-Study-Act feedback cycles after each audit. The primary outcome measures were the proportion of women on local GDM registers completing a diabetes screening test and a diabetes prevention planning consultation within the previous 15 months. RESULTS: Diabetes screening increased with rates more than doubled from 26% to 61% and postpartum screening increased from 43%-60%. Diabetes prevention planning consultations did not show the same level of increase (0%-10%). The recording of body mass index improved overall (51%-69%) but the number of women with normal body mass index did not. CONCLUSIONS: GooD4Mum supported increased diabetes screening and the monitoring of high risk women with previous GDM in general practice.
AIMS: Gestational diabetes (GDM) and Type 2 diabetes pose tremendous health and economic burdens as worldwide incidence increases. Primary care-based systematic diabetes screening and prevention programs could be effective in women with previous GDM. GooD4Mum aimed to determine whether a Quality Improvement Collaborative (QIC) would improve postpartum diabetes screening and prevention planning in women with previous GDM in general practice. METHODS: Fifteen general practices within Victoria (Australia) participated in a 12-month QIC, consisting of baseline and four quarterly audits, guideline-led workshops and Plan-Do-Study-Act feedback cycles after each audit. The primary outcome measures were the proportion of women on local GDM registers completing a diabetes screening test and a diabetes prevention planning consultation within the previous 15 months. RESULTS:Diabetes screening increased with rates more than doubled from 26% to 61% and postpartum screening increased from 43%-60%. Diabetes prevention planning consultations did not show the same level of increase (0%-10%). The recording of body mass index improved overall (51%-69%) but the number of women with normal body mass index did not. CONCLUSIONS: GooD4Mum supported increased diabetes screening and the monitoring of high risk women with previous GDM in general practice.