Diabetes in pregnancy: are we providing the best care ... - HQIP

Social and lifestyle issues
7.4.2 Panel comments on suboptimal approach of the woman to managing her diabetes
Panels made 283 comments for 222 women before pregnancy and 199 comments for 174 women during
pregnancy (table 7.3). The main issues were non-adherence to medical advice, non-attendance at planned
appointments, and social factors including unplanned pregnancy, poor motivation and poor understanding
of diabetes.
Table 7.3
Panel comments on suboptimal approach of the woman to managing her diabetes (table contains information
following categorisation of free text)
Women assessed to have suboptimal
approach to diabetes management before
pregnancy
Good pregnancy
outcome
(N=88)
No. of
comments
% of
women
Poor pregnancy
outcome
(N=134)
No. of
comments
% of
women
Women assessed to have suboptimal
approach to diabetes management during
pregnancy
Good pregnancy
outcome
(N=56)
No. of
comments
% of
women
Poor pregnancy
outcome
(N=118)
No. of
comments
% of
women
Total comments* 110 167 65 106
Medical,
lifestyle, social 42 - 65 - 16 - 38 -
factors †
Unplanned
pregnancy or no 14 16 22 16 1 2 2 2
contraception
Poorly motivated 8 9 8 6 4 7 2 2
Poor education or
understanding of 3 3 6 4 3 5 4 3
diabetes
Other social or
lifestyle factors 15 17 29 22 4 7 16 14
Medical factors 2 2 0 - 4 7 14 12
Non-adherence to
medical advice 32 36 45 34 27 48 38 32
Woman did
not attend
25 28 46 34 13 23 18 15
appointments
Woman actively
chose not to
follow medical
advice
8 9 7 5 7 13 9 8
Duration or
severity of
diabetes
3 3 4 3 2 4 3 3
* There were 6 comments on clinical care before pregnancy and 28 comments on clinical care during pregnancy; these comments are
not included in the table.
†
A single woman could have more than one comment in the medical, social and lifestyle category, therefore % of women calculated
only for individual factors.
36