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Impact of an intensive follow-up program on the postpartum glucose tolerance testing rate.
Mendez-Figueroa, Hector; Daley, Julie; Breault, Pauline; Lopes, Vrishali V; Paine, Virginia; Goldman, Dona; Francis, Mary Jean; Delgado, Blanca; Coustan, Donald R.
Afiliação
  • Mendez-Figueroa H; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, UT Health Science Center at Houston, 6431 Fannin MSB 3.286, Houston, TX, 77030, USA, Hector.R.Mendezfigueroa@uth.tmc.edu.
Arch Gynecol Obstet ; 289(6): 1177-83, 2014 Jun.
Article em En | MEDLINE | ID: mdl-24481876
ABSTRACT

OBJECTIVE:

Gestational diabetes mellitus (GDM) is a strong risk factor for the development of diabetes. We assessed the impact of a 1-year intensive follow-up demonstration program, using direct nurse and outreach worker case management, aimed at increasing compliance with postpartum oral glucose tolerance testing (OGTT). STUDY

DESIGN:

During the year of implementation, a nurse or bilingual outreach worker contacted patients to encourage attendance at their scheduled postpartum 2-h 75-g OGTT and assisted in overcoming obstacles to testing. All patients with GDM seen in our specialty clinic the previous year served as a control group for comparison.

RESULTS:

One hundred eighty-one patients treated during the year prior to implementation were compared to the 207 in the demonstration program. Baseline characteristics were similar in both groups. After the program's implementation, postpartum OGTT adherence increased from 43.1 to 59.4 % (p < 0.01, hazard ratio 1.59; 95 % confidence interval 1.20-2.12). Had the program been in place the previous year, we calculated that 12 additional cases of diabetes or prediabetes would have been detected, increasing the total number from 33 to 45 such cases.

CONCLUSION:

Implementation of direct nurse and outreach worker case management leads to a modest, but important increase in adherence to postpartum OGTT testing.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cooperação do Paciente / Diabetes Gestacional / Continuidade da Assistência ao Paciente / Teste de Tolerância a Glucose Tipo de estudo: Diagnostic_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: America do norte Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cooperação do Paciente / Diabetes Gestacional / Continuidade da Assistência ao Paciente / Teste de Tolerância a Glucose Tipo de estudo: Diagnostic_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: America do norte Idioma: En Ano de publicação: 2014 Tipo de documento: Article