Peer-to-Peer, Interactive GP Education can Reduce Barriers to Best Practice in Diabetes Management

Abstract

IntroductionPerceived difficulties in initiating insulin in patients with type 2 diabetes (T2D) may prevent many general practitioners (GPs) from using insulin even when recommended in guidelines. This paper describes a Royal Australian College of General Practitioners accredited education program on starting insulin in T2D, and its impact on GPs’ attitudes and behavior.MethodsA faculty comprising GPs with diabetes expertise, Credentialed Diabetes Nurse Educators, and endocrinologist developed and implemented the education program. The program content was highly procedure focussed, emphasizing simple, best-practice processes for starting insulin therapy and focussing on multidisciplinary models of care. The highly interactive format of the workshops included peer-to-peer learning, in which education was led by diabetes-experienced GP educators, as well as case study-based approaches and small group discussions. GP attendees were asked to rate their individual confidence and attitudes at the beginning and end of the meeting. In addition, participants (n = 220) from two workshops in 2013 were sent a survey 3 months after the meeting to gauge the longer-term impact on their clinical practice.ResultsSince 2008, more than 2500 GPs have attended the workshops, and report substantial improvements in confidence; after attending, more GPs were willing to start insulin within their practice. Evaluations at 3 months post-meeting indicate that the increased confidence was associated with behavioral changes in the subgroup evaluated at this time (n = 48). Success of this program was attributed to peer-to-peer education, multidisciplinary input, easily implemented best practice procedures and checklists for starting insulin, and constant adjustment of meeting process and content based on feedback and guideline changes.ConclusionA peer-to-peer, interactive GP education program reduced GPs’ perceptions of the difficulties of starting insulin in T2D and achieved changes in attendees’ clinical practice. This education program offers an effective approach to overcome the therapeutic inertia that is too common in diabetes management.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-016-0156-0) contains supplementary material, which is available to authorized users.

Barriers and Facilitators to Nurse Management of Hypertension: A Qualitative Analysis from Western Kenya

“…33 Evidence has shown that appropriate training of community health workers and nurses can effec-Nurse Management of Hypertension in Kenya -Vedanthan et al tively increase hypertension knowledge and clinical skills. By empowering these health care professionals through appropriate hypertension training, it is possible to increase confidence, 34 consequently creating an improved patient experience and possibly improved clinical outcomes.…”

Contemporary Educational Interventions for General Practitioners (GPs) in Primary Care Settings in Australia: A Systematic Literature Review

“…After reading the full text, 13 articles were selected for the final systematic review. Eleven were quantitative [six randomized controlled studies (9–14), one non–randomized community intervention (15), three pre- and post-intervention analysis (16–18), one cross-sectional (19)], one was a qualitative study (20), and one used mixed methods (21). The main characteristics of the studies are summarized in Table 1.…”

“…Three pre- and post-intervention studies focused on the management of chronic hepatitis B (17), diabetes (16), and radiation oncology (18) (Table 1). Educational interventions included workshops with interactive peer-to-peer group learning (16) or interactive sessions with case discussions (18) and the distribution of treatment guidelines delivered by nurses (17).…”

“…The recruitment methods varied across the studies and often combined strategies to improve the response rate (Table 1). Recruitment methods varied from a single one-time invitation letter (9, 10, 16, 19, 21), or gratification points for professional development (CPD) (10, 16) and a combination of invitation letter, followed by a phone call and a visit by a research team member to clarify the study (14). An invitation letter followed by a phone call and a $250 retail voucher was used by another study (20).…”

“…One of these studies (9) had obtained contact details of GPs from the data base of a medical publishing company, while the actual numbers of practicing GPs may be different, this may have led to inaccurate assessment of the response rate. In 4 studies (10, 15, 16, 20) the setting was not stated.…”