AUTHOR=McLean Anna , Kirkham Renae , Campbell Sandra , Whitbread Cherie , Barrett Jennifer , Connors Christine , Boyle Jacqueline , Brown Alex , Mein Jacqueline , Wenitong Mark , McIntyre H. David , Barzi Federica , Oats Jeremy , Sinha Ashim , Maple-Brown Louise
TITLE=Improving Models of Care for Diabetes in Pregnancy: Experience of Current Practice in Far North Queensland, Australia
JOURNAL=Frontiers in Public Health
VOLUME=7
YEAR=2019
URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00192
DOI=10.3389/fpubh.2019.00192
ISSN=2296-2565
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 75 g 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.
Conclusions: 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.