Dr Judy Chen1, Dr Nisa Sheriff2, A/Prof Ajay Vatsayan3, Dr Divya Namboodiri2, Dr Jeremy Hoang2, Dr Sarina Lim2, George Barker2, Nicholas Grech2, Vanessa Waters2, Penelope Barker2, A/Prof Sarah Glastras4,5, Dr Natassia Rodrigo1,4,5
1Department of Diabetes and Endocrinology, Nepean Hospital, Sydney, Australia, 2Endocrinology Department, Hornsby-Ku-ring-gai Hospital, Sydney, Australia, 3Department of Obstetrics and Gynaecology, Hornsby-Ku-ring-gai Hospital, Sydney, Australia, 4Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney, Australia, 5Diabetes and Obesity Clinical Academic Group, Sydney Health Partners, ,
Biography:
Dr Judy Chen is an Endocrinology Registrar at Nepean Hospital and a General Medicine Advanced Trainee. Her primary research interests focus on the optimisation of healthcare systems to enhance the management and outcomes of patients with diabetes.
Abstract:
Background: Efforts to mitigate adverse maternal-foetal outcomes associated with gestational diabetes (GDM) can be enhanced through targeted interventions within dedicated antenatal services¹. Hornsby Ku-ring-gai Hospital, a major metropolitan hospital in Sydney, recently transitioned from a public/private care model, whereby endocrinologist review was provided by private consultation, to a public multidisciplinary antenatal service.
Aim: To evaluate patient satisfaction and maternal-foetal outcomes of women who received care from Maternity Endocrine Clinic (MEC), a recently established multidisciplinary antenatal service within an existing antenatal clinic.
Methods: Women with GDM who attended MEC ≥2 times participated in an online questionnaire assessing satisfaction in diabetes care, service model and barriers to attendance. Maternal-foetal outcomes of women who attended MEC will be compared with those managed through the public/private model 12 months prior.
Results: Preliminary results from 21 respondents revealed 52% felt primarily fear and anxiety at GDM diagnosis. Despite this, 71% felt supported throughout their pregnancy and >88% were satisfied with the multidisciplinary clinic structure. Following education sessions, 72% felt confident in administering insulin and diet management. Regarding service preferences, 55% were open to shared care, 48% preferred telehealth appointments, and 67% found the large volume of medical appointments a barrier to attendance. Appointment duration varied from <30 minutes to >2 hours, and 69% identified clinic wait-time as a key area for improvement.
Maternal and foetal outcomes for 175 women who attended MEC during the 12 months after the new model was instituted will be compared with 187 women who received antenatal care in the preceding 12 months.
Conclusion: Many women experience negative emotions at diagnosis of GDM. However, with multidisciplinary intervention, these feelings can be alleviated, empowering women to manage their GDM through education and support. We hypothesise maternal-foetal outcomes in women managed through MEC will be non-inferior to the older model of care.
Keywords
gestational diabetes, multidisciplinary antenatal service care model
References
1. Sina M, Cade TJ, Flack J, Nolan CJ, Rajagopal R, Wong V, et al. Antenatal models of care for women with gestational diabetes mellitus: Vignettes from an international meeting. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2020;60(5):720-8.