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

Abstract

BackgroundBecause 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.MethodsThis 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 <7.0% in each hospital at the time of the baseline survey.ResultsOverall, 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.ConclusionsPhysician‐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.