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PA clinic for gestational diabetes: An observational study
Nikki Semaniuk1, Abigail Meadows, Pam Katz
1At the University of Manitoba in Winnipeg, Manitoba, Canada, Nikki Semaniuk is a clinical instructor for the Master of Physician Assistant Studies program; Abigail Meadows is a first-year medical resident; Pam Katz is an assistant professor in the Department of Internal Medicine and section head for the Section of Endocrinology; Sora Ludwig is a professor; Bruce Roe is an assistant professor of endocrinology and metabolism; Elizabeth Salamon is an assistant professor; Sarah M. Sigurdson is a first-year medical student; Katherine J. Bernier is a first-year medical student; Christy Pylypjuk is an associate professor and associate head of research in the Department of Obstetrics, Gynecology and Reproductive Sciences, as well as the assistant director of the Manitoba Obstetrical Outreach Program; and Jennifer M. Yamamoto is an assistant professor in the Department of Internal Medicine. Outside of the University of Manitoba, N. Semaniuk is an endocrinology PA at St. Boniface Hospital in Winnipeg; P. Katz is medical director of the Manitoba Adult Insulin Pump Program at Health Sciences Centre Winnipeg in Winnipeg; and J.M. Yamamoto is an adjunct assistant professor in the Department of Medicine at the University of Calgary in Calgary, Alberta, Canada. E. Salamon discloses receipt of monetary compensation from Novo Nordisk for educational sessions. C. Pylypjuk discloses receipt of grants to University of Manitoba and Health Sciences Centre Foundation for unrelated work. J.M. Yamamoto discloses receipt of devices for no or reduced cost from Abbott and Medtronic for investigator-initiated and publicly funded studies. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
Physician associate-led clinics effectively manage gestational diabetes, showing comparable maternal and neonatal outcomes to physician-led care. This model offers a safe and efficient approach to managing this common pregnancy complication.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Healthcare Management
Background:
- Gestational diabetes mellitus (GDM) is a frequent pregnancy complication.
- Managing GDM necessitates specialized expertise and frequent patient monitoring.
- Existing specialty clinics face significant strain due to high GDM referral rates.
Purpose of the Study:
- To evaluate the safety and effectiveness of a gestational diabetes clinic led by physician associates (PAs).
- To compare outcomes between PA-led and physician-led interdisciplinary GDM clinics.
Main Methods:
- A retrospective cohort study design was employed.
- Outcomes were compared between a PA-led interdisciplinary team clinic and a physician-led interdisciplinary team clinic.
- Statistical adjustments were made for patient characteristic differences.
Main Results:
- Maternal and neonatal outcomes were comparable across both clinic models after adjustments.
- Pharmacotherapy initiation was significantly lower in the PA-led clinic (aOR 0.19; 95% CI, 0.11-0.31).
- Differences in referral triage processes may explain the reduced pharmacotherapy initiation.
Conclusions:
- Physician associates can effectively manage a substantial proportion of gestational diabetes referrals.
- The PA-led model demonstrated comparable care quality to physician-led management.
- This approach offers a safe and effective alternative for GDM care delivery.
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