Non-Compliance to Clinical Practice Guideline for Screening of Gestational Diabetes Mellitus in Siriraj Hospital
Irene Ruengkhachorn MD*, Prasert Sunsaneevithayakul MD*, Dittakarn Boriboonhirunsarn MD, MP H, PhD**
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University
Objective : To evaluate the rate of non-compliance to Clinical Practice Guideline (CPG) for screening of
Gestational Diabetes Mellitus (GDM) and related factors in Siriraj Hospital.
Study
Design : Descriptive cross-sectional study.
Setting : Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University.
Materials and Methods : One-hundred-and-fifty-nine pregnant women at risk for GDM and who delivered at
Siriraj Hospital were enrolled. Data were collected from history and medical records including base line
characteristics, clinical risk factors of GDM, and compliance to guideline. Rate of non-compliance and
related factors were evaluated.
Results : The rate of non-compliance to GPG for screening of GDM at Siriraj Hospital was 22% (95%CI
16.3%-29.1%). The rate was highest among women who had AnteNatal Care (ANC) at a private clinic
(82.1%), followed by the private cases in the hospital (40%).Those who received ANC at the hospital had the
lowest non-compliance rate of 6.6%.The most common neglected risk factor was maternal age > 30 years.
Significant higher compliance was found among women with 2 or more clinical risk factors compared to those
with only 1 risk factor (p = 0.028).
Conclusion : The rate of non-compliance to CPG for screening of GDM at Siriraj Hospital was 22%. Highest
non-compliance rate was found among the private cases. The most common neglected risk factor was maternal
age > 30 years.
Keywords : Clinical practice guideline, Gestational diabetes mellitus, Screening program, Non-compliance
