Abstract:
Aims:
To review/report the uptake of a district-wide Diabetes Contraception and Pre-pregnancy Program (DCAPP) for women with Type 1 and 2 diabetes by different healthcare provider groups.
Methods: DCAPP comprises of i) Development of pre-pregnancy care and contraception educational materials; ii) Implementation of pre-pregnancy clinics district-wide; iii) Mailing of letter packs to women regarding pre-pregnancy care and contraception advice from public clinics; iv) Distribution of educational material including posters, leaflets, enrolment forms and general pre-pregnancy care information across all participating pharmacies, general practices, private clinics and public clinics across South Western Sydney. Evaluation was by prospective monitoring of uptake and feedback.
Results: 187/194 (96.4%) pharmacies, 346/367 (94.3%) general practices, 35/35 (100%) private, 10/10 (100%) public clinics (p<0.01) were contacted. Of those contacted, expressions of interest were significantly different (p<0.001) between public clinic sites (100%), pharmacies (78.4%), general practices (71.1%) and private clinics (22.8%). After 6 months, posters were still up in 72/137 (52.6%) participating pharmacies, 159/190 (72.8%) general practices, 8/35 (100%) private clinics and 10/10 (100%) public clinics (p<0.001). Major barriers to the implementation and uptake of DCAPP were competing priorities of health care providers, barriers of access to health care providers and a lack of interest of pre-pregnancy care from women who are not actively planning a pregnancy.
Conclusions: In the uptake of DCAPP was high among public clinics and pharmacies indicating successful approach for pre-pregnancy care in Australian setting. However, it was poor among private clinics and further evaluation is needed to explore the gaps/barriers to enhance uptake among healthcare professionals in private clinics.