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An Enhanced Postpartum Transition Program to Primary Care.
Cameron, Natalie A; Birdsell, Heather; Niznik, Charlotte M; Michon, Ruth; Donelan, Emily; Yee, Lynn M; Dolan, Brigid M.
Afiliação
  • Cameron NA; Department of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Birdsell H; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Niznik CM; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Michon R; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Donelan E; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Yee LM; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Dolan BM; Department of Obstetrics and Gynecology, Dartmouth University, Geisel School of Medicine, Hanover, New Hampshire, USA.
Article em En | MEDLINE | ID: mdl-38634543
ABSTRACT

Background:

Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are risk factors for future cardiovascular disease, yet few individuals receive postpartum care with primary care clinicians (PCP). To facilitate transitions of care to PCPs and improve cardiovascular health monitoring within the first 13 months postpartum, we developed and piloted an enhanced postpartum referral pathway for patients with GDM or HDP.

Methods:

Eligible patients included those who received perinatal care at a large, urban, academic medical center, experienced GDM or HDP during their most recent pregnancy, and lacked an existing PCP. Resident, faculty, and advanced practitioners referred patients during antenatal, delivery-related, or postpartum visits. A dedicated scheduler contacted patients to schedule an appointment with a women's health-focused resident or faculty PCP. The percent of patients who attended a postpartum PCP visit, who had an HbA1c and cholesterol panel checked within the first 13 months postpartum, were compared between patients referred and not referred to the program using adjusted odds ratios (aOR).

Results:

Of 129 individuals referred, 48.1% attended a PCP visit, 31.8% completed cholesterol screening, and 41.9% completed HbA1c screening within 13 months postpartum. After adjusting for age, parity, insurance, and referral indication, referred individuals had greater odds for each outcome (PCP visit aOR = 6.0, 95% CI 4.0-9.0; cholesterol aOR = 2.4, 95% 1.6-3.9; HbA1c aOR = 2.5, 95% CI 1.7-3.7) compared with nonreferred individuals in the same time period.

Discussion:

A enhanced postpartum PCP referral pathway pilot for birthing individuals was associated with improved follow-up in the first year postpartum.
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Texto completo: 1 Bases de dados: MEDLINE Idioma: En Revista: J Womens Health (Larchmt) Assunto da revista: GINECOLOGIA / SAUDE DA MULHER Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Bases de dados: MEDLINE Idioma: En Revista: J Womens Health (Larchmt) Assunto da revista: GINECOLOGIA / SAUDE DA MULHER Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos