title: The effectiveness of implementing a reminder system into routine clinical practice: does it increase postpartum screening in women with gestational diabetes?
abstract: BACKGROUND
  During regular care, women with previous gestational diabetes mellitus (GDM) rarely receive the recommended screening test for type 2 diabetes, a 2-hour oral glucose tolerance test (OGTT), in the postpartum period. The current study examined whether the implementation of a reminder system improved screening rates.
  
  
  METHODS
  Based on our previous randomized control trial, we implemented a postpartum reminder (letter or phone call) protocol into routine care at two of three clinical sites. We verified postpartum testing by searching hospital laboratory databases and by linking to the provincial physician service claims database. The primary outcome was the proportion of patients who underwent an OGTT within 6 months of delivery.
  
  
  RESULTS
  Women who received care in a setting using a reminder system were more likely to receive an OGTT within 6 months postpartum (28%) compared with usual care (14%). The OGTT rates for both reminder groups were lower than that found in our randomized control trial (28% vs. 60%).
  
  
  CONCLUSIONS
  Although the screening rates remain low, postpartum reminders doubled screening rates using the recommended test, the OGTT.
authors.affiliation: Faculty of Medicine, University of Ottawa, Ontario, Canada.
authors.forename: A K
authors.initials: AK
authors.lastname: Shea
authors.forename: B R
authors.initials: BR
authors.lastname: Shah
authors.forename: H D
authors.initials: HD
authors.lastname: Clark
authors.forename: J
authors.initials: J
authors.lastname: Malcolm
authors.forename: M
authors.initials: M
authors.lastname: Walker
authors.forename: A
authors.initials: A
authors.lastname: Karovitch
authors.forename: E J
authors.initials: EJ
authors.lastname: Keely
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009313:National Health Programs; D009864:Ontario / Q000453:epidemiology; D011181:Postnatal Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D017010:Reminder Systems / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D001786:Blood Glucose