The Impact of Web-Based Continuing Medical Education Using Patient Simulation on Real-World Treatment Selection in...

Area of Science:

• Endocrinology
• Medical Education
• Cardiovascular Disease Prevention

Background:

• Guidelines recommend glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for type 2 diabetes (T2D), but uptake is suboptimal.
• Web-based continuing medical education (CME) patient simulations can identify practice gaps but their real-world impact is unstudied.

Purpose of the Study:

• To evaluate the impact of a simulation-based CME intervention on the real-world prescription patterns of GLP-1 RAs.
• To assess if CME simulations improve the selection of evidence-based treatments for T2D patients, focusing on glycemic control and cardiovascular protection.

Main Methods:

• A two-phase study involving 435 physicians in the US.
• Phase I: Paired pre-post CME simulation to assess decision-making improvements.
• Phase II: Retrospective, matched case-control study of 157 physicians using claims data to evaluate real-world treatment changes.

Main Results:

• CME simulation significantly improved correct treatment decisions by 29 percentage points (40.9% to 69.9%, P<.001).
• Physicians in the intervention group were more likely to increase GLP-1 RA use (24.8% vs 12.7%, P=.001).
• Intervention group participation predicted increased GLP-1 RA use (OR 4.49, 95% CI 1.45-13.97).

Conclusions:

• A web-based CME simulation targeting secondary cardiovascular prevention in T2D is associated with improved real-world, evidence-based treatment selection.
• Simulation-based CME can be an effective tool to bridge the gap between guideline recommendations and clinical practice for GLP-1 RA utilization.