Screening for type 2 diabetes following gestational diabetes: family physician and patient perspectives.
OBJECTIVE
To explore primary care provider (PCP) and patient perspectives on postpartum screening for type 2 diabetes (T2DM), including reasons for not completing oral glucose tolerance tests (OGTTs) specifically, preferred provider for organizing screening, and value of reminder letters for facilitating screening.


METHODS
A follow-up survey, administered by fax or telephone, to PCPs and patients who participated in a randomized controlled trial assessing effectiveness of postpartum postal reminders to enhance screening for T2DM in women with gestational diabetes mellitus (GDM).


METHODS
The Ottawa Hospital, a university-affiliated tertiary centre in Ottawa, Ont.


METHODS
A total of 223 female patients with previously identified GDM and their respective PCPs were surveyed; 173 PCPs and 140 patients participated.


METHODS
Whether or not the patient was screened for T2DM post partum, the test used for screening, the factors contributing to the patient not being screened, perspectives on the importance of screening post partum, and opinions about which care provider should be responsible for screening in the postpartum period.


RESULTS
Response rates were 78% (173 of 223) for PCPs and 63% (140 of 223) for patients. Only 37% of the PCP responders had their patients complete OGTTs, while 85% of patient responders reported that they had completed OGTTs. The most common reason PCPs gave for not screening was no postpartum visit from the patient for any reason. Time pressures were the most common reason provided by patients for not being screened. More than 95% of patients and providers agreed that screening for T2DM was important. Patients and PCPs agreed that PCPs should be responsible for screening. Reminder letters were perceived as helpful by more than 85% of patients and PCPs.


CONCLUSIONS
This follow-up survey demonstrates that PCPs and patients value the importance of screening for diabetes, identify the PCP as pivotal to screening, and appreciate a reminder strategy. There continue to be barriers that affect screening rates, despite the perceived importance of screening by PCPs and patients.
Keely
Erin
E
Department of Medicine, University of Ottawa in Ontario, Canada. ekeely@ottawahospital.on.ca
Clark
Heather
H
Karovitch
Alan
A
Graham
Ian
I
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002170:Canada; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000523:psychology; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000523:psychology; D004522:Educational Status; D005194:Family Practice; D005260:Female; D005951:Glucose Tolerance Test / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D049590:Postpartum Period; D011247:Pregnancy; D017010:Reminder Systems / Q000706:statistics & numerical data; D012737:Sex Factors