Referral to telephonic nurse management improves outcomes in women with gestational diabetes - 24/05/12
, Monique M. Hedderson, PhD a, Jenny Ching, RN b, Catherine Kim, MD, MPH c, Tiffany Peng, MA a, Yvonne M. Crites, MD b
Reprints: Assiamira Ferrara, MD, PhD, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612Résumé |
Objective |
We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing.
Study Design |
There was medical center–level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes.
Results |
Compared with women from centers where the annual proportion of referral nurse management was <30%, women who delivered from centers with an annual referral proportion >70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57–0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56–3.42, respectively).
Conclusion |
Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.
Le texte complet de cet article est disponible en PDF.Key words : gestational diabetes, macrosomia, nurse management, postpartum glucose screening
Plan
| Cite this article as: Ferrara A, Hedderson MM, Ching J, et al. Referral to telephonic nurse management improves outcomes in women with gestational diabetes. Am J Obstet Gynecol 2012;206:491.e1-5. |
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| This study was supported in part by funds from the Translating Research into Action for Diabetes study, which was supported by the Centers for Disease Control and Prevention, grant number U58/CCU523525-03, and by grants number R18DK067334 and K23DK071552 from the National Institute of Diabetes and Digestive and Kidney Diseases. |
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| The authors report no conflict of interest. |
Vol 206 - N° 6
P. 491.e1-491.e5 - juin 2012 Retour au numéro
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