Skip to main content

Table 1 Included intervention and observational studies for postpartum follow-up after gestational diabetes. (N = 6)

From: The forgotten risk? A systematic review of the effect of reminder systems for postpartum screening for type 2 diabetes in women with previous gestational diabetes

Author (year) country Design Setting Reminder targeted participants and study location Outcome and Follow-up Description of intervention Results
Chittleborough et al. (2010) Australia Intervention using letter Secondary
The Diabetes Center at The Queen Elizabeth Hospital
Intervention target group: Patient and physicians
429 Postpartum women and their GPs in the GDM Recall Register receiving reminders for postpartum OGTT testing
Outcomes
1. Rate of returned update forms that was included in the reminder letter
2. The range of women reporting they had attended an OGTT test the previous year
Two times reminder letter to both patients and GPs.
First time 15 months after delivery
Second time every 12 months thereafter
Of the 429 women receiving a reminder letter 46 % returned an update form and 56 % had an OGTT in the previous 12 months
Second reminder letter resulted in 45 % return of which 75 % had OGTT the previous 12 months
Clark et al. (2009) Canada Intervention using letters Secondary
Ottawa Hospital, Ontario
Intervention target group: Patient and physicians
256 Patients and their physicians assigned randomly to 4 groups according to reminder intervention
Outcomes
1. Percentage of women who underwent OGTT
2. Performance of postpartum screening test
Patients assigned randomly to 4 groups:
1. Reminders both to physicians and patient
2. Reminders to patients only
3. Reminders to physician only
4 No reminders sent
OGTT rates
1. Both patient and physician reminders: 60.5 %
2. Patient only: 55.3 %
Physician only: 51.6 %
No reminders: 14.3 %
Korpo-Hyövälti et al. (2012) Finland Intervention using telephone calls Primary
South Ostrobothnia, Finland
Intervention target group: Patient and physicians
Counselling during pregnancy and lifestyle intervention for GDM patients. From this population a postpartum intervention was carried out among 266 high-risk-for-GDM women and their physicians in four municipalities
Outcome: the prevalence of high-risk-for-GDM women who underwent an OGTT in the postpartum period Postpartum intervention was offered to the high-risk-for-GDM women who were included in lifestyle interventions
Nurses received a list of patients and were advices to call the women for reminding them of glucose test. Reminder was sent out to the patients from the central hospital nurses or from the central hospital to the health care provider of the patient
A telephone reminder from the central hospital to the women or to their health care provider vs. no reminder: OR: 13.4, 95 % CI (2.1; 12.2), p < 0.0001
Lega et al. (2011) Canada Register-based observational study Secondary
Toronto, Canada
Intervention target group: Patients Retrospective study of 314 women from an endocrine clinic, 173 had a checklist for the physician at their record which resulted in a reminder follow-up visit Outcomes: OGTT Follow-up visit: The effect of a reminder system in the database on screening rates on outpatient postpartum women No direct intervention
Retrospective recording of checklist on patients in database
Intervention-group: OR (95 % CI) 2.99 (1.84; 4.85) for completion of OGTT.
Intervention-group OR (95 % CI) 3.71 (2.26; 6.11) for follow-up visit
Shea et al. (2011) Canada Intervention using mailed reminders Secondary
Ontario, Canada
Intervention group: Patients in screening sites. Three clinical sites providing screening tests with 262 patients in total: two sites received reminder (A and B), one did not (C) Outcome: Percentage of women who received an OGTT test within 6 months after delivery Intervention targeted patients
Clinical site A received mailed reminders with a laboratory requisition for OGTT
Clinical site B were sent a laboratory requisition for OGTT, phoned for appointment, or both
Clinical site C: no reminders
Prediction of postpartum glucose screening:
reminder site A vs site C: OR (95 % CI): 1.57 (0.66; 3.70)
reminder site B vs. site C: OR (95 % CI): 3.10 (1.35; 7.14)
Vesco et al. (2012) US Intervention using combined telephone calls/emails and staff education Secondary
Oregon and Washington
Intervention target group: Patients
200 Women for the pre-implementation (no intervention group)
179 Women for the post-implementation (intervention group)
Two-fold outcome
1. Outcome among providers was the rates of women for whom a screening test was ordered
2. Patient outcome measured by postpartum screening rates among previous GDM patients
Implementation of a process improvement program consisting of
1. Staff education sessions
2. Revised GDM protocols
3. Implementation of system-based reminders to call in women for glucose screening send out within 3 months of delivery and after 3 months of delivery
With implementation of program the rate of women receiving order for OGTT increased from 77.5 to 88.8 %
Final screening rate with completion of OGTT increased from 59.5 to 71.5 % (p = 0.004), (HR (95 % CI) 1.37 (1.07; 1.75)