Accepted for/Published in: JMIR Medical Education
Date Submitted: Apr 28, 2023
Date Accepted: Aug 3, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Impact of Continuing Medical Education Using Virtual Patient Simulation on Real-World Treatment Selection in Type 2 Diabetes: A Retrospective Matched Case-Control Analysis
ABSTRACT
Background:
There is a clear need for education on cardiovascular complications of diabetes and the use of new guideline-based treatment approaches to prevent adverse cardiovascular outcomes in patients with diabetes type 2 diabetes (T2D). Virtual patient simulation (VPS) has been used to identify clinicians’ practice gaps and improve clinical decision-making, but the impact of online, VPS-based continuing medical education (CME) on real-world (RW) treatment selection among clinicians who treat patients with T2D has not been researched
Objective:
This retrospective matched case-control study was conducted to evaluate the effect of continuing medical education using online, cased-based virtual patient simulation on real-world utilization of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) by diabetologists/endocrinologists (D/Es) and primary care physicians (PCPs) for their patients with T2D.
Methods:
Two study phases were conducted; a paired, pre-post study of 435 US physicians participating in a CME VPS activity who made at least 1 clinical decision in the simulation, and a retrospective matched case-control study of 157 US physicians for whom 3 months of pre-intervention data and 3 months of post-intervention RW data were available on prescription claims for patients who were on oral treatment for T2D.
Results:
In the VPS phase, across physicians, there was a 29 percentage point increase in correct responses from pre- to post-feedback (41% to 70%, P < .001) for selecting treatment that addresses both glycemic control and cardiovascular (CV) event protection. Overall, in the RW treatment selection phase, 24.84% of the intervention group clinicians increased their use of GLP-1 RAs for their patients with T2D compared with 12.74% of the comparison group clinicians. Logistic regression results showed that being in the intervention group predicts GLP-1 RA use (odds ratio [OR] = 4.492, P = .001, confidence interval [CI, 1.445 to 13.969]).
Conclusions:
A case-based VPS CME intervention focused on secondary prevention of CV events in a patient with T2D increased the selection of cardioprotective antihyperglycemic treatments in RW clinical practice among both D/Es and PCPs. Clinical Trial: NA
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