Improving follow-up care for women with a history of gestational diabetes: perspectives of GPs and patients
Andrew V. R. Pennington A D , Sharleen L. O’Reilly B , Doris Young A and James A. Dunbar C
+ Author Affiliations
- Author Affiliations
A Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia.
B Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia.
C Population Health Strategic Research Centre, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia.
D Corresponding author. Email: drandrewpennington@yahoo.com.au
Australian Journal of Primary Health 23(1) 66-74 https://doi.org/10.1071/PY15177
Submitted: 22 November 2015 Accepted: 10 February 2016 Published: 25 July 2016
Abstract
This paper investigates factors influencing women’s engagement with diabetes preventative care after a pregnancy with gestational diabetes (GDM) from the perspectives of GPs and women and explores the role of the GP in that care. Qualitative research using semi-structured interviews with women who had experienced GDM (n = 16) and GPs (n = 18) were conducted and a thematic content analysis conducted. Women’s interviews explored their experience of GDM, factors influencing, and engagement with, follow-up care for diabetes prevention and role of the GP in that care. GP interviews explored postnatal care provided to women with GDM, the role of the GP in that care and perceived factors influencing a mother’s engagement in her self-care. Three themes were identified: (1) advice and testing; (2) role of the GP; and (3) barriers and enablers to care. Significant consensus about the role of the GP and barriers and enablers to care existed. Both groups believed post GDM follow-up is best done by GPs and suggested recall and reminders would improve care. GPs gave consistent exercise advice, but lacked consensus on follow-up testing, dietary and weight-loss advice. Women’s health literacy influenced how they viewed their GPs role. Consensus guidelines on follow-up testing and diabetes prevention advice, tailored advice according to health literacy and addressing barriers to care would likely improve the capacity of GPs to prevent unnecessary conversion to type 2 diabetes in these at-risk women.
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