Knowledge of physicians regarding the management of Type two Diabetes in a primary care setting: the impact of online continuous medical education

Abstract

Background To explore the impact of an online continuing medical education (CME) program on physicians’ knowledge about the management of type two diabetes. Methods An online CME program was designed and uploaded in the CME platform, Department of Education, Ministry of health, Iran. A 28-item questionnaire was used for the assessment. In the beginning, a case scenario was introduced. Then, participants were asked to follow and answer to a pretest assessment. Details of the educational content were provided afterward. Finally, the participants took part in the same post-test exam 4 weeks later. The Wilcoxon matched-pairs signed-ranks test was used to compare the measurements. In addition, the Mann-Whitney test was applied to compare knowledge indices between the general practitioners (GPs) and internists. Results Five hundred twenty-six primary care physicians participated in this study. There was a significant positive effect regarding diagnosis confirmation (10.3% difference, P = 0.0001). Moreover, a smaller effect was observed in relation to the importance of glycosylated hemoglobin (HbA1c) at diagnosis (5.2% difference, P = 0.0006). The effect was positive in relation to the self-reported HbA1c testing frequency: more than 90% of the participants answered correctly in the post-test exam (7.6% difference, P = 0.0001). Considering improved knowledge in the treatment of diabetes, there was a very significant difference in response to questions targeting advice on a healthy diet, and physical activity; 27.7% (P = 0.000), and 18.7% (P = 0.000), respectively. In addition, the program had a positive impact on various aspects of treatment with oral glucose-lowering drugs (OGLDs). Moreover, the intervention difference was 25, and 34.4% for the questions targeting the appropriate type of insulin, and insulin initiation regimen after OGLD failure. Subgroup analyses revealed that the intervention increased the rate of correct responses among the GPs in various domains of knowledge in diagnosis and treatment. The initial differences between the GPs and internists no longer remained significant after the intervention. Conclusion Knowledge of Iranian primary health care professionals in diabetes management has significant shortcomings. This is concerning because they are at the front line of patient care. We demonstrate the effectiveness of online CME on improving GPs knowledge in the management of type 2 diabetes.

The role of primary physician training in improving regional standardized management of diabetes: a pre-post intervention study

“…After training, the knowledge scores of participants improved considerably. This suggested that training can effectively improve primary physicians’ knowledge about diabetes standardized management, which is consistent with the results of previous studies [ 18 – 20 ]. The survey of participants indicated that their understanding of all aspects of diabetes improved with training.…”

The Educational Impact of Web-Based, Faculty-Led Continuing Medical Education Programs in Type 2 Diabetes: A Survey Study to Analyze Changes in Knowledge, Competence, and Performance of Health Care Professionals

“…Many activities focusing on HCP education in the management of T2D have been developed. Although some peer-reviewed publications have described outcomes from educational activities in diabetes, these are highly heterogeneous, may include patients with type 1 diabetes, and may include a range of activities and a variety of end points [9,10,[14][15][16][17][18][19][20].…”

“…However, diabetes management has become increasingly complex for health care professionals (HCPs) owing to multiple medication classes and treatment combinations, the need to avoid hypoglycemia or hyperglycemia, multiple medical device options, and the need to facilitate patients’ lifestyles [ 8 ]. This multiplicity of treatment options, combined with the need to manage the risk of complications in patients with T2D, underscores the need for HCP education to ensure optimal patient management according to the most recent guidelines and evidence-based practice [ 9 , 10 ]. T2D management has also evolved from a glucocentric approach aimed at achieving glycemic control to a holistic approach aimed at preventing complications and improving quality of life, with a 2018 consensus report from the American Diabetes Association and European Association for the Study of Diabetes, highlighting the importance of person-centered care [ 5 , 11 ].…”

Continuity of care in patients with type 2 diabetes in Croatian primary care setting during COVID-19 pandemic: A retrospective observational study

“…Continuous medical education showed a significant improvement in diabetes management in Iranian FMP showing no difference between the effectiveness of FMP and internal medicine specialists [28] . We need to develop a better plan for achieving more successful continuity of care and prevention of diabetic complications in family practices with an emphasis on patient education, and at least once-a-year check-ups that include BMI, BP measurement, laboratory, ophthalmology, and neurology testing.…”