Patient Engagement Strategies for Women with Gestational Diabetes Mellitus in Low-Resource Community Health Settings: A Narrative Review and Clinical Principles

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Background/Objectives: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and requires sustained patient engagement to achieve optimal maternal and neonatal outcomes. This narrative review synthesized current evidence on patient engagement strategies and developed clinical principles for implementing patient-centered care across the GDM care continuum. Methods: A domain-based narrative review was conducted using the Consensus literature search platform. A total of 5359 records were identified. After multi-phase screening for relevance and eligibility, 37 studies, including systematic reviews, randomized controlled trials, observational studies, and qualitative research, were included. Evidence was synthesized across four domains: universal screening and linkage to care, whole-person assessment, digital patient engagement, and postpartum transition. Results: Universal screening consistently detected more women with GDM than risk-based approaches, although greater detection alone did not consistently improve maternal or neonatal outcomes. Evidence supported structured patient education, culturally responsive communication, self-management support, and active clinician feedback as key components of effective engagement. Digital health interventions, including telehealth, mobile applications, and remote monitoring, improved adherence, self-management, patient satisfaction, and, in many studies, glycemic control when integrated with clinician oversight. Postpartum follow-up remained a persistent gap despite evidence supporting reminder systems and coordinated care transitions. These findings informed a stepped clinical care pathway tailored to low-resource community health settings. Conclusions: Current evidence supports several components of patient-centered GDM care that informed a proposed stepped clinical care pathway integrating early identification, whole-person assessment, structured education, self-management support, digital engagement, and coordinated postpartum care. Many recommended strategies can be implemented using existing personnel and low-cost digital technologies, although additional implementation research is needed to evaluate culturally tailored interventions and long-term effectiveness in underserved populations.