Physician care patterns and adherence to postpartum glucose testing after gestational diabetes mellitus in Oregon.
OBJECTIVE
This study examines obstetrician/gynecologists and family medicine physicians' reported care patterns, attitudes and beliefs and predictors of adherence to postpartum testing in women with a history of gestational diabetes mellitus.


METHODS
In November-December 2005, a mailed survey went to a random, cross-sectional sample of 683 Oregon licensed physicians in obstetrician/gynecologists and family medicine from a population of 2171.


RESULTS
Routine postpartum glucose tolerance testing by both family physicians (19.3%) and obstetrician/gynecologists physicians (35.3%) was reportedly low among the 285 respondents (42% response rate). Factors associated with high adherence to postpartum testing included physician stated priority (OR 4.39, 95% CI: 1.69-7.94) and physician beliefs about norms or typical testing practices (OR 3.66, 95% CI: 1.65-11.69). Specialty, sex of physician, years of practice, location, type of practice, other attitudes and beliefs were not associated with postpartum glucose tolerance testing.


CONCLUSIONS
Postpartum glucose tolerance testing following a gestational diabetes mellitus pregnancy was not routinely practiced by responders to this survey. Our findings indicate that physician knowledge, attitudes and beliefs may in part explain suboptimal postpartum testing. Although guidelines for postpartum care are established, some physicians do not prioritize these guidelines in practice and do not believe postpartum testing is the norm among their peers.
University of Gothenburg, Public Health Epidemiology and Community Medicine, Gothenburg, Sweden. monica.hunsberger@gu.se
Monica L
ML
Hunsberger
Rebecca J
RJ
Donatelle
Karen
K
Lindsay
Kenneth D
KD
Rosenberg
D003430:Cross-Sectional Studies; D003625:Data Collection; D016640:Diabetes, Gestational; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009922:Oregon; D010820:Physicians / Q000706:statistics & numerical data; D049590:Postpartum Period; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011247:Pregnancy; D011897:Random Allocation