Clinical Decision Support for Women With a History of Gestational Diabetes

NCT01288144 | Completed

• 1 other identifier: 2007p000842
• Study Type: interventional
• Target: 1,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

The investigators hypothesize that computer-assisted decision support will increase the percentage of women with a history of gestational diabetes who receive appropriate follow-up screening. Specific Aim 1: Develop an algorithm to identify cases of gestational diabetes among patients in the Partners Health Care system using administrative and laboratory data. Specific Aim 2: Assess primary care provider knowledge, attitudes, beliefs, and barriers to compliance regarding screening guidelines for women with a history of gestational diabetes. Specific Aim 3: Test whether a computer-assisted decision support tool to identify patients with a GDM history and prompt screening will increase compliance with guidelines. The investigators hypothesize that decision support will significantly increase in the percentage of women screened.

Conditions

Gestational Diabetes Mellitus

Keywords

Screening; Gestational diabetes mellitus

Outcome Measures

Primary Outcomes (1)

• Rate of screening

  The American Diabetes Association recommends that women with a history of GDM undergo glucose screening at 6 weeks post partum. Women with normal postpartum glucose testing should receive follow-up testing every three years, and those with impaired glucose tolerance should receive annual follow-up screening. Our study will evaluate a quality improvement intervention to increase the number of women who are appropriately identified and undergo screening.

  1 year following implementation at all sites (Nov. 2011)

Study Arms (2)

Intervention

EXPERIMENTAL

Quality improvement initiative using computerized decision support

Other: Quality improvement initiative

Usual care

NO INTERVENTION

In control clinics, women will continue to receive usual care.

Interventions

Quality improvement initiative OTHER

In intervention clinics, the LMR will use the existing reminder function to alert providers that a patient has a probable history of gestational diabetes. The provider will then have the opportunity to clarify the subject's history and order appropriate screening testing. Providers will also have access to online reference material regarding GDM follow-up screening and lifestyle interventions.

Also known as: Quality improvement initiative using computerized decision support

Intervention

Eligibility Criteria

• Sex: female
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Primary care clinic (gynecology, internal medicine, community health center)
• Use longitudinal medical record (LMR) program for documentation
• Previously participated in rct of decision support intervention

You may not qualify if:

• None

Sponsors & Collaborators

• Brigham and Women's Hospital: lead

Related Publications (1)

• Zera CA, Bates DW, Stuebe AM, Ecker JL, Seely EW. Diabetes Screening Reminder for Women With Prior Gestational Diabetes: A Randomized Controlled Trial. Obstet Gynecol. 2015 Jul;126(1):109-14. doi: 10.1097/AOG.0000000000000883.

  PMID: 26241263 DERIVED

MeSH Terms

Conditions

Diabetes, Gestational

Condition Hierarchy (Ancestors)

Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: M.D.

Study Record Dates

• First Submitted: August 25, 2010
• First Posted: February 2, 2011
• Study Start: July 1, 2007
• Primary Completion: November 1, 2011
• Last Updated: February 6, 2012

Record last verified: 2012-02