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Universal access to screening and management of diabetes in pregnancy in Trinidad using an ICT solution
Lutchmansingh, F; Chamely, S; Mallalieu, K; Chow, H; Balkaran, R; Ramsewak, S; Teelucksingh, S.
Afiliação
  • Lutchmansingh, F; The University of the West Indies. Faculty of Medical Sciences. Department of Clinical Medical Sciences. St. Augustine. TT
  • Chamely, S; The Trinidad and Tobago Medical Association (T&TMA). Chaguanas. TT
  • Mallalieu, K; The University of the West Indies. Faculty of Engineering. Department of Electrical and Computer Engineering. St. Augustine. TT
  • Chow, H; The University of the West Indies. Faculty of Medical Sciences. St. Augustine. TT
  • Balkaran, R; The University of the West Indies. Faculty of Medical Sciences. School of Dentistry. St. Augustine. TT
  • Ramsewak, S; The University of the West Indies. Faculty of Medical Sciences. Department of Clinical Surgical Sciences. St. Augustine. TT
  • Teelucksingh, S; The University of the West Indies. Faculty of Medical Sciences. Department of Clinical Medical Sciences. St. Augustine. TT
In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1022720
Biblioteca responsável: TT5
ABSTRACT

Objective:

Undetected diabetes in pregnancy (DiP) can lead to deleterious consequences. Strengthening health systems and implementing national standardized protocols for screening and management can improve outcomes. This study aimed to achieve consensus on clinical guidelines and facilitate universal screening using standardized testing and an app. Design and

Methodology:

An integrated care model was developed and antenatal caregivers were trained on screening and management of DiP. A secure Information and Communication Technologies (ICT) solution for real-time communication of results was designed and piloted as the reporting system. The app provided automatic alerts to patients and doctors facilitating timely intervention and offered self-management tools. Pregnant women ≥ 18 years, n = 655 at two antenatal clinics in Trinidad (1 public and 1 private hospital) were screened using a standard 75g 2-hour oral glucose tolerance test (OGTT) after an overnight fast. Seven lab technologists and 24 doctors were trained to use the app. Cost-effectiveness was assessed.

Results:

National consensus was achieved with 197 antenatal caregivers, for universal screening for DiP. The app facilitated a reporting system of blood glucose results and delivered real-time SMS text and e-mail alerts to participants. 10.1% of participants had abnormal fasting glucose and 14.1% had at least one abnormal reading between 0hr to 2hrs. Universal screening for GDM was cost-effective in the local setting.

Results:

National consensus was achieved with 197 antenatal caregivers, for universal screening for DiP. The app facilitated a reporting system of blood glucose results and delivered real-time SMS text and e-mail alerts to participants. 10.1% of participants had abnormal fasting glucose and 14.1% had at least one abnormal reading between 0hr to 2hrs. Universal screening for GDM was cost-effective in the local setting.

Conclusions:

The high prevalence of DiP in T&T justifies the need for universal screening and related health systems change. Training healthcare teams in DiP screening and ICT-enabled management are essential elements of a standardized health system which features real-time reporting.
Assuntos
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Coleções: Bases de dados internacionais Base de dados: MedCarib Assunto principal: Diabetes Gestacional Tipo de estudo: Estudo diagnóstico / Guia de prática clínica / Estudo prognóstico / Fatores de risco / Estudo de rastreamento Limite: Adulto / Feminino / Humanos / Gravidez País/Região como assunto: Caribe Inglês / Trinidad e Tobago Idioma: Inglês Ano de publicação: 2019 Tipo de documento: Não convencional Instituição/País de afiliação: The Trinidad and Tobago Medical Association (T&TMA)/TT / The University of the West Indies/TT
Buscar no Google
Coleções: Bases de dados internacionais Base de dados: MedCarib Assunto principal: Diabetes Gestacional Tipo de estudo: Estudo diagnóstico / Guia de prática clínica / Estudo prognóstico / Fatores de risco / Estudo de rastreamento Limite: Adulto / Feminino / Humanos / Gravidez País/Região como assunto: Caribe Inglês / Trinidad e Tobago Idioma: Inglês Ano de publicação: 2019 Tipo de documento: Não convencional Instituição/País de afiliação: The Trinidad and Tobago Medical Association (T&TMA)/TT / The University of the West Indies/TT
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