title: A physician reminder to improve postpartum diabetes screening in women with gestational diabetes mellitus.
abstract: OBJECTIVE
  Women with gestational diabetes (GDM) have a 20% risk of developing diabetes in the 10 years following pregnancy, but the risk may be as high as 70% in higher risk populations. Guidelines recommend screening for diabetes postpartum, but screening rates are low. We evaluated the effect of a physician reminder on postpartum screening and in women with GDM.
  
  
  METHODS
  We conducted a retrospective chart review among women with GDM seen at our urban, academic endocrine clinic in Toronto, Canada between 2006 and 2010. Our primary outcome was to evaluate the effect of a reminder checklist on postpartum diabetes screening rates.
  
  
  RESULTS
  We included 314 women in our study, 173 had a checklist on their chart. Women had a mean age of 34.9 years, 45% were Caucasian and 23% had a previous GDM. The checklist was associated with a 3 fold increase in odds of being screened postpartum, and nearly 4 fold increase in postpartum follow up visits (OR 2.99, 95% CI 1.84-4.85 and OR 3.71, 95% CI 2.26-6.11).
  
  
  CONCLUSIONS
  A physician based reminder system is an effective way to improve postpartum screening rates. To further increase screening rates, a multilevel approach targeting both patients and physicians is required.
authors.affiliation: Women's College Hospital, Women's College Research Institute, Toronto, Ontario, Canada. iliana.lega@wchospital.ca
authors.forename: Iliana C
authors.initials: IC
authors.lastname: Lega
authors.forename: Heather
authors.initials: H
authors.lastname: McLaughlin
authors.forename: Marie
authors.initials: M
authors.lastname: Coroneos
authors.forename: Frances
authors.initials: F
authors.lastname: Handley-Derry
authors.forename: Nicola
authors.initials: N
authors.lastname: Donovan
authors.forename: Lorraine L
authors.initials: LL
authors.lastname: Lipscombe
mesh_terms: D000328:Adult; D002170:Canada; D003920:Diabetes Mellitus / Q000175:diagnosis*; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D008403:Mass Screening; D049590:Postpartum Period; D011247:Pregnancy; D017010:Reminder Systems; D012189:Retrospective Studies