The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis
BackgroundDespite guidelines recommending the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in certain patients with type 2 diabetes (T2D), they are not being prescribed for many of these patients. Web-based continuing medical education (CME) patient simulation...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-08-01
|
| Series: | JMIR Medical Education |
| Online Access: | https://mededu.jmir.org/2023/1/e48586 |
| _version_ | 1797733450134847488 |
|---|---|
| author | Katie Stringer Lucero Amy Larkin Stanislav Zakharkin Carol Wysham John Anderson |
| author_facet | Katie Stringer Lucero Amy Larkin Stanislav Zakharkin Carol Wysham John Anderson |
| author_sort | Katie Stringer Lucero |
| collection | DOAJ |
| description |
BackgroundDespite guidelines recommending the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in certain patients with type 2 diabetes (T2D), they are not being prescribed for many of these patients. Web-based continuing medical education (CME) patient simulations have been used to identify clinicians’ practice gaps and improve clinical decision-making as measured within a simulation, but the impact of this format on real-world treatment has not been researched.
ObjectiveThis study aimed to evaluate the effect of a simulation-based CME intervention on real-world use of GLP-1 RAs by endocrinologists and primary care physicians.
MethodsTwo evaluation phases of the CME simulation were conducted: phase I, the CME simulation phase, was a paired, pre-post study of 435 physician learners in the United States; and phase II, the real-world phase, was a retrospective, matched case-control study of 157 of the 435 physicians who had claims data available for the study period.
ResultsPhase I CME results showed a 29 percentage point increase in correct decisions from pre- to postfeedback (178/435, 40.9% to 304/435, 69.9%; P<.001) in selecting treatment that addresses both glycemic control and cardiovascular event protection. Phase II results showed that 39 of 157 (24.8%) physicians in the intervention group increased use of GLP-1 RAs, compared to 20 of 157 (12.7%) in the comparison group. Being in the intervention group predicted GLP-1 RA use after education (odds ratio 4.49; 95% CI 1.45-13.97; P=.001).
ConclusionsA web-based CME simulation focused on secondary prevention of cardiovascular events in a patient with T2D was associated with increased use of evidence-based treatment selection in the real world. |
| first_indexed | 2024-03-12T12:29:17Z |
| format | Article |
| id | doaj.art-070b062e9af4449f9d21226e85240a43 |
| institution | Directory Open Access Journal |
| issn | 2369-3762 |
| language | English |
| last_indexed | 2024-03-12T12:29:17Z |
| publishDate | 2023-08-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Medical Education |
| spelling | doaj.art-070b062e9af4449f9d21226e85240a432023-08-29T13:31:12ZengJMIR PublicationsJMIR Medical Education2369-37622023-08-019e4858610.2196/48586The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control AnalysisKatie Stringer Lucerohttps://orcid.org/0000-0002-3278-7878Amy Larkinhttps://orcid.org/0009-0001-3436-7869Stanislav Zakharkinhttps://orcid.org/0000-0001-9816-510XCarol Wyshamhttps://orcid.org/0000-0002-3056-0047John Andersonhttps://orcid.org/0000-0002-5699-7490 BackgroundDespite guidelines recommending the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in certain patients with type 2 diabetes (T2D), they are not being prescribed for many of these patients. Web-based continuing medical education (CME) patient simulations have been used to identify clinicians’ practice gaps and improve clinical decision-making as measured within a simulation, but the impact of this format on real-world treatment has not been researched. ObjectiveThis study aimed to evaluate the effect of a simulation-based CME intervention on real-world use of GLP-1 RAs by endocrinologists and primary care physicians. MethodsTwo evaluation phases of the CME simulation were conducted: phase I, the CME simulation phase, was a paired, pre-post study of 435 physician learners in the United States; and phase II, the real-world phase, was a retrospective, matched case-control study of 157 of the 435 physicians who had claims data available for the study period. ResultsPhase I CME results showed a 29 percentage point increase in correct decisions from pre- to postfeedback (178/435, 40.9% to 304/435, 69.9%; P<.001) in selecting treatment that addresses both glycemic control and cardiovascular event protection. Phase II results showed that 39 of 157 (24.8%) physicians in the intervention group increased use of GLP-1 RAs, compared to 20 of 157 (12.7%) in the comparison group. Being in the intervention group predicted GLP-1 RA use after education (odds ratio 4.49; 95% CI 1.45-13.97; P=.001). ConclusionsA web-based CME simulation focused on secondary prevention of cardiovascular events in a patient with T2D was associated with increased use of evidence-based treatment selection in the real world.https://mededu.jmir.org/2023/1/e48586 |
| spellingShingle | Katie Stringer Lucero Amy Larkin Stanislav Zakharkin Carol Wysham John Anderson The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis JMIR Medical Education |
| title | The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis |
| title_full | The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis |
| title_fullStr | The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis |
| title_full_unstemmed | The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis |
| title_short | The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: Retrospective Case-Control Analysis |
| title_sort | impact of web based continuing medical education using patient simulation on real world treatment selection in type 2 diabetes retrospective case control analysis |
| url | https://mededu.jmir.org/2023/1/e48586 |
| work_keys_str_mv | AT katiestringerlucero theimpactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT amylarkin theimpactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT stanislavzakharkin theimpactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT carolwysham theimpactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT johnanderson theimpactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT katiestringerlucero impactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT amylarkin impactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT stanislavzakharkin impactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT carolwysham impactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis AT johnanderson impactofwebbasedcontinuingmedicaleducationusingpatientsimulationonrealworldtreatmentselectionintype2diabetesretrospectivecasecontrolanalysis |