Observational study evaluating the effectiveness of physician-targeted education for improving glycemic management of patients with type 2 diabetes (BEYOND II)

作者

Weng, JP; Zhao, JJ; Zhou, ZG; Guo, XH; Zou, DJ; Ji, QH; Tong, NW; Li, QF; Zhu, J; Li, Q; Qin, GJ; Feng, P; Yang, LY; Gao, ZN; Chen, LL; Li, H; Li, YM; Zeng, LY; Zhu, DL; Lu, JM; Luo, TH; Cui, N

作者单位

[Weng, Jianping] Univ Sci & Technol China, Div Life Sci & Med, Affiliated Hosp 1, Dept Endocrinol, 17 Lujiang Rd, Hefei, Anhui, Peoples R China; [Zhao, Jiajun] Shandong Univ, Dept Endocrinol, Shandong Prov Hosp, Jinan, Shandong, Peoples R China; [Zhou, Zhiguang] Cent South Univ, Natl Clin Res Ctr Metab Dis, Key Lab Diabet Immunol, Inst Metab & Endocrinol,Minist Educ,Xiangya Hosp, Changsha, Hunan, Peoples R China; [Guo, Xiaohui] Peking Univ, Hosp 1, Dept Endocrinol, Beijing, Peoples R China; [Zou, Dajin] Second Mil Med Univ, Changhai Hosp, Dept Endocrinol, Shanghai, Peoples R China; [Ji, Qiuhe] Fourth Mil Med Univ, Xijing Hosp, Dept Endocrinol, Xian, Shaanxi, Peoples R China; [Tong, Nanwei] Sichuan Univ, Div Endocrinol & Metab, West China Hosp, Chengdu, Sichuan, Peoples R China; [Li, Qifu] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China; [Zhu, Jun] Xinjiang Med Univ, Affiliated Hosp 1, Urumqi, Peoples R China; [Li, Qiang] Harbin Med Univ, Affiliated Hosp 2, Harbin, Heilongjiang, Peoples R China; [Qin, Guijun] Zhengzhou Univ, Affiliated Hosp 1, Dept Internal Med, Div Endocrinol, Zhengzhou, Henan, Peoples R China; [Feng, Ping] Tianjin Med Univ, Dept Endocrinol, Gen Hosp, Tianjin, Peoples R China; [Yang, Liyong] Fujian Med Univ, Affiliated Hosp 1, Dept Endocrinol, Fuzhou, Fujian, Peoples R China; [Gao, Zhengnan] Dalian Med Univ, Dalian Municipal Cent Hosp, Dept Endocrinol, Dalian, Peoples R China; [Chen, Lulu] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Endocrinol, Wuhan, Hubei, Peoples R China; [Li, Hong] Zhejiang Univ, Affiliated Sir Run Run Shaw Hosp, Sch Med, Dept Endocrinol & Metab, Hangzhou, Zhejiang, Peoples R China; [Li, Yiming] Fudan Univ, Huashan Hosp, Dept Endocrinol & Metab, Shanghai, Peoples R China; [Zeng, Longyi] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Endocrinol, Guangzhou, Guangdong, Peoples R China; [Zhu, Dalong] Nanjing Univ, Med Sch, Nanjing Drum Tower Hosp, Affiliated Hosp,Dept Endocrinol, Nanjing, Jiangsu, Peoples R China; [Lu, Juming] Gen Hosp Peoples Liberat Army, Dept Endocrinol, Beijing, Peoples R China; [Luo, Tianhong; Cui, Nan] Sanofi China Investment Co Ltd, Shanghai, Peoples R China; [Zhu, Jun] Shenzhen Baoan Peoples Hosp, Dept Endocrinol, Shenzhen, Guangdong, Peoples R China; [Li, Qiang] Shenzhen Univ, Gen Hosp, Dept Endocrinol & Metab, Shenzhen, Guangdong, Peoples R China

摘要

Background Because there has been no quality improvement initiatives targeting patients with type 2 diabetes (T2D) receiving basal insulin therapy, this study evaluated the effectiveness of physician-targeted education for optimizing glycemic management in these patients in China. Methods This multicenter open-label observational study conducted across China had a baseline sample survey, followed by a 6-month education program, and ended with a post-education sample survey. Education based on T2D treatment guidelines was given at Months 1 and 3, and was reinforced by self-audit every month. Each hospital enrolled 100 patients with T2D receiving basal insulin at both the baseline and post-education survey. The primary outcome was the proportion of hospitals meeting individual improvement goals. The goal setting was based on the proportion of patients achieving HbA1c Overall, the individual improvement goal was achieved by 35 centers (49%). Hospitals with poor glycemic management at the baseline survey had higher possibility to improve at post-education survey. Two large sample surveys at baseline and post-education showed improved glucose management among these hospitals. A higher proportion of patients achieved HbA1c <7.0% in the post-education survey (27.2% vs 36.5%; P < 0.001) with reduced HbA1c levels (8.10% vs 7.72%; P < 0.001). Questionnaires from 723 physicians showed that confidence and practice of basal insulin use were significantly improved. Conclusions Physician-targeted education improved glycemic management of patients with T2D in 71 hospitals in China, and was more effective at hospitals with poor glycemic management at the baseline survey.

关键词

QUALITY IMPROVEMENT STRATEGIES; BASAL INSULIN; CARE; ACHIEVEMENT; ASSOCIATION; OUTPATIENT; DRUGS; CHINA

基本信息

所属机构:

归属医师: 赵家军

PMID：31222955

UT：000479548800001

刊名:JOURNAL OF DIABETES

年，卷(期):2020年12卷1期

页码：66-76

DOI：10.1111/1753-0407.12963

附件： other

收录: SCIE