Evaluating the Effectiveness of Education through online Media around Pregnancy planning and cOntraception for Women's EmpoweRment in Diabetes (EMPOWERED) in General Practice.
Why are we conducting this study?
Women with pre-existing diabetes have a high risk of adverse pregnancy outcomes. High glucose levels are teratogenic. The risk of congenital malformations increases exponentially the higher the HbA1c around the time of conception and 1st trimester. In Australia, women with pre-existing diabetes have a congenital malformation rate of 10%, over 3 times the rate for women without diabetes.
Unfortunately, approximately 50% of women with diabetes have unplanned pregnancies. This means that they miss out on the opportunity to optimise glycaemic control, start high dose folate and stop teratogenic medications.
What can we do to prevent this?
Effective contraception and education around pregnancy planning are essential in enabling women to plan their pregnancies and optimise their glycaemic management and other aspects of health before a pregnancy. Good preconception care has been shown to reduce the risk of congenital malformation by 71%, reduce the risk of perinatal mortality by 54%, lower neonatal intensive care admissions by 25% and lower 1st trimester HbA1c by a mean of 1.27%.
What are we asking you to do if you participate?
- Co-design a brief structured conversation around reproductive planning with us and with consumers already involved in our research team (i.e. women with lived experience of diabetes).
- Identify women of reproductive age with pre-existing diabetes in your practice.
- Invite women these women to be involved in the study eg. through a link to a study flyer texted through your practice.
- Initiate the brief reproductive planning conversation with participating women and refer them to 2 education videos on the National Diabetes Services Scheme website, one on contraception and the other on pregnancy planning for women with diabetes.
- Use a 1page decision tool to determine the next steps in investigation and management for the specific woman you see.
- Collect data on the reproductive planning conversation with participating women eg. date(s) and duration of the conversation and topics discussed, depending on a woman’s reproductive wishes.
- Collaborate with the research team in auditing your electronic medical records for contraceptive use and methods in women with diabetes before and after implementation of the reproductive planning conversation, as well as other markers of pregnancy planning, where relevant, and pregnancy outcomes. A medical student involved in the project can assist with this. This activity may be eligible for CPD points.
- Be involved in up to 2 further meetings of ≤1 hour over the first 6-9 months of the study, either as a focus group or a semi-structured interview with the research team to seek feedback on the feasibility and acceptability of implementing the interventions in your workflow and how this could be improved, including refining the reproductive planning conversation and the implementation process.
Will I be compensated for participating?
- Participating GPs will be compensated for their time in group meetings or interviews about the study and their practice will be compensated for administrative work associated with the study.
If you would like to find out more about this study please contact Associate Professor Emily Hibbert, Endocrinologist at Nepean Hospital and the University of Sydney:
Email: NBMLHD-EndoResearch@health.nsw.gov.au
Telephone: 02 4734 4754
Or click on the link below:
https://redcap.sydney.edu.au/surveys/?s=P3FW8AMP4MXFPH88
Ethics committee approval number: 2024/HE001564