Gestational diabetes mellitus care re-imagined: women's experiences of a major model of care change at a large metropolitan hospital

Abstract

Background: A gestational diabetes mellitus (GDM) pregnancy has significant psychological, time and resource impacts. In 2020–21, a digitally-supported radical GDM service redesign was undertaken at a Brisbane tertiary centre, producing substantial cost savings without compromising clinical outcomes. Aims: To describe women's experiences within this new model of care (MOC), specifically the app user experience (MOC) (post), compared with a traditional MOC (pre). Methods: The new MOC was evaluated using a pre–post study design. This MOC included a smartphone app-to-clinician blood glucose communication platform. A convenience sample of women were surveyed about care experiences and app use pre- and post-implementation. An additional survey queried user app experience at four weeks’ postpartum. Results: Within the service, 34% (n=24) and 22% (n=48) of women were surveyed pre and post MOC introduction, respectively. Pre-implementation, 50% (n=12) of women missed work to attend appointments and 75% spent 30–120 minutes at the hospital. Questions regarding understanding GDM, initial dietary changes and glucometer use received similar or slightly lower ratings, pre- to post-implementation. Nearly a quarter of women in the app-experiences survey (24.2%; n=177) showed high levels of satisfaction with care received (91.5%) and with the app for managing GDM (87.1%). Two experience themes that emerged were Enhanced GDM management and Usability issues. Conclusions: The new MOC reduced time impositions associated with attending appointments. Despite the removal of face-to-face visits in the new MOC, women still established a connection with their treating team and maintained their understanding of their GDM management. Copyright © 2024 John Wiley & Sons.