基于网络的持续医学教育使用患者模拟对2型糖尿病的现实世界治疗选择的影响:回顾性病例对照分析
Katie Stringer Lucero1, Amy Larkin1, Stanislav Zakharkin1
1Medscape, LLC, New York, NY, United States.
JMIR medical education
|August 29, 2023
概括
基于网络的持续医学教育 (CME) 模拟改进了对2型糖尿病患者的葡萄糖类-1受体激动剂 (GLP-1RA) 的现实处方. 这种干预措施增加了基于证据的治疗方法的使用,以减少心血管风险.
科学领域:
- 内分泌学 在内分泌学.
- 医学教育 医学教育
- 预防心血管疾病 预防心血管疾病
背景情况:
- 指导方针建议用于2型糖尿病 (T2D) 的葡萄糖类-1受体激活剂 (GLP-1RA),但吸收率低于最佳水平.
- 基于网络的持续医学教育 (CME) 患者模拟可以识别实践差距,但它们在现实世界的影响尚未研究.
研究的目的:
- 评估基于模拟的CME干预对GLP-1RA的现实处方模式的影响.
- 评估CME模拟是否可以改善对T2D患者基于证据的治疗选择,重点关注血糖控制和心血管保护.
主要方法:
- 这是一项两阶段的研究,涉及美国435名医生.
- 第一阶段:对联前后CME模拟以评估决策改进.
- 第二阶段:对157名医生进行了回顾性,匹配的病例控制研究,使用索赔数据来评估现实世界治疗变化.
主要成果:
- CME模拟显著提高了正确治疗决策的29个百分点 (40.9%至69.9%,P<.001).
- 干预组的医生更有可能增加GLP-1RA的使用 (24.8%对12.7%,P=.001).
- 干预组参与预测GLP-1RA使用量增加 (OR 4.49,95% CI 1.45-13.97).
结论:
- 针对T2D中二次心血管预防的基于网络的CME模拟与改善现实世界,基于证据的治疗选择有关.
- 基于模拟的CME可以成为弥合GLP-1RA利用指南建议和临床实践之间的差距的有效工具.
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