PMID- 33947667
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20240210
IS  - 1478-5242 (Electronic)
IS  - 0960-1643 (Print)
IS  - 0960-1643 (Linking)
VI  - 71
IP  - 707
DP  - 2021 Jun
TI  - Barriers to postpartum diabetes screening: a qualitative synthesis of clinicians' 
      views.
PG  - e473-e482
LID - 10.3399/BJGP.2020.0928 [doi]
AB  - BACKGROUND: Gestational diabetes mellitus (GDM) is an important risk factor for 
      developing type 2 diabetes mellitus (T2DM) later in life. Postpartum screening 
      provides an opportunity for early detection and management of T2DM, but uptake is 
      poor. AIM: To explore barriers to screening from clinicians' perspectives to 
      guide future interventions to increase uptake of postpartum screening. DESIGN AND 
      SETTING: Systematic review and qualitative synthesis. METHOD: Qualitative studies 
      included in a previous review were assessed, and then five electronic databases 
      were searched from January 2013 to May 2019 for qualitative studies reporting 
      clinicians' perspectives on postpartum glucose screening after GDM. Study quality 
      was assessed against the Critical Appraisal Skills Programmes checklist. 
      Qualitative data from the studies were analysed using thematic synthesis. 
      RESULTS: Nine studies were included, containing views from 187 clinicians from 
      both community and hospital care. Three main themes were identified: difficulties 
      in handover between primary and secondary care (ambiguous roles and communication 
      difficulties); short-term focus in clinical consultations (underplaying risk so 
      as not to overwhelm patients and competing priorities); and patient-centric 
      barriers such as time pressures. CONCLUSION: Barriers to diabetes screening were 
      identified at both system and individual levels. At the system level, 
      clarification of responsibility for testing among healthcare professionals and 
      better systems for recall are needed. These could be achieved through registers, 
      improved clinical protocols, and automatic flagging and prompts within electronic 
      medical records. At the individual level, clinicians should be supported to 
      prioritise the importance of screening within consultations and better 
      educational resources made available for women. Making it more convenient for 
      women to attend may also facilitate screening.
CI  - (c) The Authors.
FAU - Lithgow, Georgina E
AU  - Lithgow GE
AD  - School of Clinical Medicine, University of Cambridge, Cambridge.
FAU - Rossi, Jasper
AU  - Rossi J
AD  - School of Clinical Medicine, University of Cambridge, Cambridge.
FAU - Griffin, Simon J
AU  - Griffin SJ
AD  - MRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical 
      Medicine, University of Cambridge, Cambridge.
FAU - Usher-Smith, Juliet A
AU  - Usher-Smith JA
AD  - Primary Care Unit, Department of Public Health and Primary Care, School of 
      Clinical Medicine, University of Cambridge, Cambridge.
FAU - Dennison, Rebecca A
AU  - Dennison RA
AD  - Primary Care Unit, Department of Public Health and Primary Care, School of 
      Clinical Medicine, University of Cambridge, Cambridge.
LA  - eng
GR  - 21464/CRUK_/Cancer Research UK/United Kingdom
GR  - MC_UU_00006/6/MRC_/Medical Research Council/United Kingdom
GR  - MC_UU_12015/4/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Systematic Review
DEP - 20210527
PL  - England
TA  - Br J Gen Pract
JT  - The British journal of general practice : the journal of the Royal College of 
      General Practitioners
JID - 9005323
SB  - IM
MH  - *Diabetes Mellitus, Type 2/diagnosis
MH  - *Diabetes, Gestational/diagnosis
MH  - Female
MH  - Humans
MH  - Mass Screening
MH  - Postpartum Period
MH  - Pregnancy
MH  - Qualitative Research
PMC - PMC8103924
OTO - NOTNLM
OT  - diabetes mellitus, type 2
OT  - diabetes, gestational
OT  - postnatal care
OT  - postpartum period
OT  - qualitative research
OT  - systematic review
EDAT- 2021/05/06 06:00
MHDA- 2021/07/02 06:00
PMCR- 2021/05/05
CRDT- 2021/05/05 05:52
PHST- 2020/10/14 00:00 [received]
PHST- 2020/12/11 00:00 [accepted]
PHST- 2021/05/06 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2021/05/05 05:52 [entrez]
PHST- 2021/05/05 00:00 [pmc-release]
AID - BJGP.2020.0928 [pii]
AID - 10.3399/BJGP.2020.0928 [doi]
PST - epublish
SO  - Br J Gen Pract. 2021 May 27;71(707):e473-e482. doi: 10.3399/BJGP.2020.0928. Print 
      2021 Jun.