Effect of implementation of a preconception counselling resource for women with diabetes: A population based study

Holmes, Valerie; Hamill, Louise; Alderdice, Fiona; Spence, Michelle; Harper, Roy; Patterson, Christopher; Loughridge, S; McKenna, Stacey; Gough, Aisling; McCance, David R.

doi:10.1016/j.pcd.2016.07.005

Cited by 12 publications

(29 citation statements)

References 23 publications

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“…To summarise each of the five studies show a mixed range of improvement in glycaemic control. However, only one study showed very little improvement [15]. Most of the studies showed at least some improvement.…”

Section: Glycaemic Controlmentioning

confidence: 91%

“…Holmes, Hamill, Alderdice, et al [15] showed a very little improvement rate (less than 5% difference in results of mean HbA1c between the intervention and control group) in glycaemic control. The overall difference in glycaemic control between the two groups was not as significant (a mean HbA1c of 7.4% in the intervention group vs 7.3% in the group with no intervention).…”

Section: Glycaemic Controlmentioning

confidence: 95%

“…Murphy, et al [19] found that 157/178 (88.2%) women attending preconception care took folic acid during the preconception period in comparison to 112/420 (26.7%) women who did not attend preconception care. However, Holmes, et al [15] found that 47/111 (42.3) women pre-intervention were taking 5mg folic acid preconception in comparison to 65/134 (48.5) women who were post intervention.…”

Section: Included Studiesmentioning

confidence: 98%

“…For women with type 1 diabetes their glycemic control was better in comparison to type 2 diabetes. A prospective population based study by Holmes, Hamill, Alderdice, et al [15] included 249 women of which 135 were post intervention and 114 pre-intervention. There were 183 women who had type1 diabetes and 66 with type 2 diabetes.…”

Section: Included Studiesmentioning

confidence: 99%

“…This number was more than double in women who did not receive in preconception care. Holmes, et al [15] decided to provide preconception care through an educational DVD via primary care and secondary care practitioners. The rate of congenital malformation and awareness of how to maintain a healthy pregnancy were higher in the post DVD group in comparison to pre DVD.…”

Section: Theme 3-attendance To Preconception Carementioning

confidence: 99%

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2023

DOIJ

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Introduction: The NICE guidelines provide extensive information on the importance of preconception care for women with type 1 and type 2 diabetes. However, there still remains dispute as to whether it is effective in improving maternal and foetal outcomes. This systematic review aims to establish the effectiveness of preconception care services for women with type 1 and/or type 2 diabetes and to evaluate the factors which prevent women from accessing these services by examining the current primary literature. Methods: This review involved conducting a thorough electronic search of studies using EMBASE, MEDLINE, CINAHL and grey literature. There was limited research in this area and as such, the main types of studies included were randomised controlled trials, population based studies and perspective cohort studies. The primary outcomes were to assess the level of glycaemic control, the uptake rate of women taking folic acid supplementation and the rate of attendance to preconception clinics. Results: In total, six studies with a total of two thousand, two hundred and thirty-four participants were included. The studies revealed varying results regarding the relationship between preconception care and overall pregnancy outcomes. Five out of the six included studies showed an overall improvement in glycaemic control. Only three of the studies showed an improved rate in women taking folic acid; whilst only one study stated the neural tube defect rate. The overall patient participation in preconception care services varied amongst studies due to the differences in social demographics of participants. Conclusions: Preconception care has been noted to improve maternal and foetal outcomes for women with diabetes. The NICE guidelines (2015) have set the standards at which care should be delivered. However the methods in Research Article Volume 2 Issue 3

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Section: Glycaemic Controlmentioning

confidence: 91%

Section: Glycaemic Controlmentioning

confidence: 95%

Section: Included Studiesmentioning

confidence: 98%

Section: Included Studiesmentioning

confidence: 99%

Section: Theme 3-attendance To Preconception Carementioning

confidence: 99%

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2023

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Preconception and Diabetes Information (PADI) App for Women with Pregestational Diabetes: a Feasibility and Acceptability Study

Nwolise

Carey

Shawe

2021

J Healthc Inform Res

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Diabetes mellitus increases the risk of adverse maternal and fetal outcomes. Preconception care is vital to minimise complications; however, preconception care service provision is hindered by inadequate knowledge, resources and care fragmentation. Mobile health technology, particularly smartphone apps, could improve preconception care and pregnancy outcomes for women with diabetes. The aim of this study is to co-create a preconception and diabetes information app with healthcare professionals and women with diabetes and explore the feasibility, acceptability and preliminary effects of the app. A mixed-methods study design employing questionnaires and semi-structured interviews was used to assess preliminary outcome estimates (preconception care knowledge, attitudes and behaviours), and user acceptability. Data analysis included thematic analysis, descriptive statistics and non-parametric tests. Improvements were recorded in knowledge and attitudes to preconception care and patient activation measure following the 3-month app usage. Participants found the app acceptable (satisfaction rating was 72%), useful and informative. The app’s usability and usefulness facilitated usage while manual data input and competing priorities were barriers which participants felt could be overcome via personalisation, automation and use of daily reminders. This is the first study to explore the acceptability and feasibility of a preconception and diabetes information app for women with diabetes. Triangulated data suggest that the app has potential to improve preconception care knowledge, attitudes and behaviours. However, in order for women with DM to realise the full potential of the app intervention, particularly improved maternal and fetal outcomes, further development and evaluation is required.

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