Women’s Health program leaders at ChristianaCare endeavored to improve postpartum screening rates for type 2 diabetes among women with gestational diabetes.
Poor compliance with the two-hour oral glucose tolerance testing (2hr OGTT) at 6-12 weeks postpartum is attributed to the stress of caring for a new child and challenges with appointment logistics exacerbated by demanding work schedules, wait times, childcare, and transportation. Barriers to screening are higher among women of low income and racial minority communities.
“The text-based messaging program increased screening compliance by 92%, which improved our disease detection rates and alleviated racial disparities in healthcare.“– Helen Gomez, MD, ChristianaCare
ChristianaCare investigated the effectiveness of text-based mobile messaging and in-home fasting blood sugar (FBS) in the detection of type 2 diabetes compared to traditional 2hr OGTT.
ChristianaCare partnered with Twistle by Health Catalyst® to provide smartphone-based patient engagement; patients used glucometers and lancets that they were also using during pregnancy. Preconfigured communication pathways delivered time-based, HIPAA-compliant education and reminders, and captured FBS data using easy-to-complete forms.
Patients received appropriate automated text replies and if warranted, data was escalated to clinical staff for additional intervention. Participants could also engage with clinical staff asynchronously to address questions or issues.
“We found many more women who are diabetic with the Twistle by Health Catalyst platform. Why? Radical convenience!“– Matthew Hoffman, MD, Christianacare
ChristianaCare conducted a prospective cohort study1 of postpartum women with gestational diabetes.
The study assessed agreement with 2hr OGTT using sensitivity, specificity, positive and negative predictive value with exact binomial 95% confidence intervals.
* Compliance was measured by the percentage of women who submitted all three fasting values.