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- How Well Do U.S. Primary Care and Obstetrics and Gynecology Clinicians Screen for Pregnancy Complications at Well Woman Visits? A Retrospective Cohort Study
- Eli D. Medvescek, Sorana Raiciulescu, Andrew S. Thagard, Katerina Shvartsman
- J Prev Med Public Health. 2023;56(2):190-195. Published online March 15, 2023
- DOI: https://doi.org/10.3961/jpmph.22.492
- 1,382 View
- 58 Download
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Abstract
PDF - Objectives
Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology.
Methods
We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate.
Results
In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively).
Conclusions
Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions. -
SummaryOriginal Article
- Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes
- Narges Malih, Mohammad-Reza Sohrabi, Alireza Abadi, Shahnam Arshi
- J Prev Med Public Health. 2021;54(3):190-198. Published online April 7, 2021
- DOI: https://doi.org/10.3961/jpmph.20.496
- 3,142 View
- 163 Download
- 2 Web of Science
- 4 Crossref
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Abstract
PDF
Supplementary Material - Objectives
Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes.
Methods
This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study.
Results
Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55).
Conclusions
Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence. -
Summary
Citations
Citations to this article as recorded by
- Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis
Nahid Shahabi, Yadolah Fakhri, Teamur Aghamolaei, Zahra Hosseini, Atefeh Homayuni
Primary Care Diabetes.2023; 17(3): 205. CrossRef - Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity:
an analysis of data from the community-based KoGES cohort study
Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park
Epidemiology and Health.2023; 45: e2023029. CrossRef - BİR ÜNİVERSİTE AKADEMİSYENLERİNİN SAĞLIK DAVRANIŞLARINA VE TARAMA PROGRAMLARINA UYUMU: KESİTSEL BİR ÇALIŞMA
Hatice İKİIŞIK, Sibel SAKARYA
ESTÜDAM Halk Sağlığı Dergisi.2022; 7(1): 98. CrossRef - Association between a family history of diabetes and carotid artery atherosclerosis in Korean adults
Sun Young Shim, Ga Bin Lee, Jee-Seon Shim, Sun Jae Jung, Hyeon Chang Kim
Epidemiology and Health.2021; 43: e2021049. CrossRef
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