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The effectiveness of implementing a reminder system into routine clinical practice: does it increase postpartum screening in women with gestational diabetes?


Introduction — During regular care, women with previous gestational diabetes mellitus (GDM) rarely receive the recommended screening test for type 2 diabetes, a 2-hour oral glucose tolerance test (OGTT), in the postpartum period. The current study examined whether the implementation of a reminder system improved screening rates.

Methods — Based on their previous randomized control trial, the researchers implemented a postpartum reminder (letter or phone call) protocol into routine care at two of three clinical sites. They verified postpartum testing by searching hospital laboratory databases and by linking to the provincial physician service claims database. The primary outcome was the proportion of patients who underwent an OGTT within 6 months of delivery.

Results — Women who received care in a setting using a reminder system were more likely to receive an OGTT within 6 months postpartum (28%) compared with usual care (14%). The OGTT rates for both reminder groups were lower than that found in our randomized control trial (28% vs. 60%).

Conclusion — Although the screening rates remain low, postpartum reminders doubled screening rates using the recommended test, the OGTT.



Shea AK, Shah BR, Clark HD, Malcolm J, Walker M, Karovitch A, Keely EJ. Chronic Dis Can. 2011; 31(2):58-64.

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