OR49-6 A PRESCRIBED LEARNING APPROACH TO IMPROVING MANAGEMENT OF TYPE 2 DIABETES

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR49-Insulin Therapy: Glycemic Control & Hypoglycemia
Clinical
Tuesday, June 18, 2013: 9:15 AM-10:45 AM
Presentation Start Time: 10:30 AM
Room 307 (Moscone Center)
Amy Larkin1, Anne Le*1, Catherine Capparelli1 and Luigi Meneghini2
1Medscape Education, 2Univ of Miami Schl of Medcn, Miami, FL
Introduction:Despite widespread dissemination of the evidence for better outcomes with improved glycemic control, a significant proportion of patients with type 2 diabetes (T2D) do not achieve A1c goals. The goal of this initiative was to educate physicians who care for patients with T2D on how to optimize A1c levels by targeting postprandial glucose (PPG) levels and improving patient self-management. We aim to determine the impact of the Personalized Learning Model (PLM), an innovative instructional design, on physician practice related to the management of T2D.

Methods: An internet-based, CME-certified self-assessment (SA) consisting of case-based questions evaluating knowledge, attitudes, practice patterns, and barriers to targeting PPG as a measure of glycemic control and improving patient self-management of T2D was developed. Each SA question maps to 1 or more of 6 CME activities. All activities were developed using proven education principles and have varied levels of content to allow appropriate targeting and matching of content to the learners' needs. Based on SA responses, learners in the intervention group are directed to relevant activities.  An independent, matched control group of learners also completed the SA to serve as a control arm in the evaluation. Each CME activity has an associated posttest that incorporates relevant questions from the SA. Posttest results are measured against both the individual leaners SA results and the control group to assess educational effectiveness.

Results: In total, 300 primary care physicians participated in this initiative. The analysis demonstrated improvement in several areas. Regarding PPG, participants were significantly more likely than nonparticipants to recognize that lowering HbA1c levels reduces the risk of microvascular complications. They also better understood the benefit of self-monitoring of blood glucose in differentiating between fasting and postprandial hyperglycemia. Finally, they were better educated on the use of a short-acting glucagon-like peptide (GLP-1) agonist rather than insulin or a long-acting GLP-1 for patients needing improved PPG while minimizing hypoglycemia concerns. With respect to encouraging patient self-management, participants were significantly more likely than nonparticipants to recognize the value of positive reinforcement in patients with low medication adherence and the use of nonaccusatory questioning to ascertain barriers to patient medication adherence. Overall, primary care physicians were 31% (actual effect size of 0.47) more likely to make evidence-based choices after participating in the prescribed educational program.

Conclusion: The PLM is an innovative educational model that may be used to positively impact physician practice. In this initiative, PLM was successful at improving knowledge and practice related to both PPG and patient self-management of T2D.

Disclosure: LM: Advisory Group Member, Novo Nordisk, Consultant, Sanofi, Principal Investigator, MannKind Corp., Principal Investigator, Pfizer, Inc., Principal Investigator, Boehringer Ingelheim Pharmaceuticals, Inc., , Dexcom. Nothing to Disclose: AL, AL, CC

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

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