1119-P: Patient Directives to Improve Care for Gestational Diabetes Informed by Lived Experience—A Systematic Review of Qualitative Studies

Introduction & Objective: Gestational diabetes (GDM) can negatively impact the long-term metabolic health of patients and their infants, and mixed experiences with GDM care have been reported. The objective of this study was to identify themes and directives for improving quality of prenatal care from patients with lived experiences of GDM or their partners.

Methods: This study is a systematic review of qualitative studies and was registered on PROSPERO (CRD42023394014). A comprehensive search strategy was developed to identify qualitative studies including pregnant or postpartum patients with GDM, or their partners. A thematic synthesis approach, following meta-aggregation was applied to identify patient-directives for GDM care. The Critical Appraisal Skills Programme qualitative checklist was used to assess quality and risk of bias.

Results: Our search strategy was executed in six databases and a total of 80 studies were included. Patient-reported directives for improving care included: education on GDM and its management, personalized or tailored care, patient-centered care, digital or online adjuncts to care, and peer support. Additional directives for care arising from interpretation of patient-reported barriers and enablers of GDM management included providing support from healthcare professionals and facilitating support from partners and family, and acknowledging the stigma around GDM and patients’ motivations and concerns.

Conclusion: Many patient and environmental factors affect the experience of GDM. Our systematic review findings identify several patient-reported directives for care, and our interpretation of additional directions through barriers and enablers experienced by patients. These findings provide rich direction for improving antenatal GDM care from the patient perspective.