Perspectives on the provision of GDM screening in general practice versus the hospital setting: a qualitative study of providers and patients

Marie Tierney, Angela O'Dea, Andrii Danyliv, Louise Carmody, Brian E McGuire, Liam G Glynn, Fidelma Dunne

A novel gestational diabetes mellitus (GDM) screening programme which involved offering screening at the patient's general practitioner (GP) compared with the traditional hospital setting was trialled. This study investigates perspectives of involved stakeholders on the provision of GDM screening at both settings. Thematic analysis of the perspectives of stakeholders involved in the receiving and provision of GDM screening in both the GP and hospital settings drawn from focus groups and interviews. 3 groups of participants are included in this research-patient participants, GP screening providers and hospital screening providers. All were recruited from a larger sample who participated in a randomised controlled screening trial. Purposeful sampling was utilised to select participants with a wide variety of perspectives on the provision of GDM screening. Participants were recruited from a geographical area covered by 3 hospitals in Ireland. 4 themes emerged from thematic analysis-namely (1) travel distance, (2) best care provision, (3) sense of ease created and (4) optimal screening. The influence of travel distance from the screening site is the most important factor influencing willingness to attend for GDM screening among women who live a considerable distance from the hospital setting. For patients who live equidistance from both settings, other factors are important; namely the waiting facilities including parking, perceived expertise of screening provider personnel, access to emergency treatment if necessary, accuracy of tests and access to timely results and treatment. Optimal screening for GDM should be specialist led, incorporate expert advice of GDM screening, treatment and management, should be provided locally, offer adequate parking and comfort levels, provide accurate tests, and timely access to results and treatment. Such a service should result in improved rates of GDM screening uptake. ISRCTN41202110.