Antenatal care traditionally requires regular hospital appointments. For low-risk women, this equates to monthly appointments, increasing in frequency towards pregnancy’s end. However, for women with increased needs, appointment frequency can become burdensome, with women with GDM attending fortnightly to weekly to see multiple clinicians. In addition to personal costs, there are issues of service capacity to accommodate the increasing prevalence of GDM while maintaining an evidence-based level of care.

Women who receive medical nutrition therapy according to a schedule of visits have reduced insulin requirements and improved BGL control. Further, timely and targeted counselling following GDM diagnosis can reduce the incidence of macrosomia and slow excessive gestational weight gain. However, there is limited research evaluating and informing the ideal model of care for initial ‘information sharing’ in GDM.

At ADIPS 2018 a panel discussion revealed this to include a range of class lengths, content, with minimal evaluation of effectiveness widely acknowledged not to be conducive to information retention or delivered to facilitated behaviour change.   

Novel strategies are required to ensure evidence-based care in GDM; ideally involving systematic delivery of standardised information to women in an accessible and easy to comprehend format, with follow up and tailoring of advice in a timely and useful method. It would ensure optimal use of service resources, potentially re-orienting time to purposeful contact with women and their clinical information. All women, regardless of language would receive equivalent, optimal care.

mHealth is a relatively new concept, with a focus on technology-supported self-monitoring and self-empowerment. A large proportion of patients in both low and high resource countries use technology for self-management. This provides the potential of broad reach/low intensity methods of timely and responsive information. 

Digitally-supported programs embedded in a service, with functionality for tailoring messages that facilitate knowledge acquisition AND behaviour change may help to overcome the complexity resulting from ‘noise’ of social media. It can also increase a service’s capacity to accommodate women needing greater assistance and contact, as well as allow information provision back to clinicians, facilitating effective and targeted ongoing support.

This body of work had two aims:

1. produce a multilingual GDM education video and
2. implement and evaluate a digital solution interface for the remote collection and action of patient’s clinical data.

This presentation will outline the steps undertaken to meet these aims as well as showcase the clinical, economic and experiential data from women who engaged in the new model of care.