Aghili Rokhsareh, Malek Mojtaba, Baradaran Hamid-Reza, Peyvandi Ali Asghar, Ebrahim Valojerdi Ameneh, Khamseh Mohammad Ebrahim
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
Arch Iran Med. 2015 Sep;18(9):582-5.
To obtain information related to the knowledge and clinical practice of general practitioners (GPs) in management of people with type 2 diabetes, and to explore the impact of formal continuous medical education (CME) programs.
A total of 1104 GPs participated in a cross sectional survey related to diabetes management considering ADA/EASD consensus 2011 focused on demographic and background characteristics, diabetes related knowledge, and patient care. Fisher's Exact and Chi-square tests were used in the analysis of contingency tables.
The majority of the participants (83.9%) worked in large cities and 39.8% had taken part in CME programs in diabetes management. Overall, 52% of the GPs knew the treatment goal for HbA1c. The rate was slightly higher for those taken part in CME (P = 0.003). Considering patient care, slightly more than half of the participants answered correctly to the questions on duration and distribution of physical activity, with no difference by taking part in CME programs. On average, 41.5% of the physicians selected metformin as the first OGLD for treatment of type 2 diabetes, and only 27.9% stated that they add basal insulin to OGLD if treatment failed.
The results of this study provide the evidence that the knowledge and clinical practice of Iranian GPs in management of type 2 diabetes were not satisfactory. Furthermore, traditional CME programs in diabetes management were not effective in changing the GPs' clinical practice. Consequently, designing and implementing more effective strategies are necessary for improving patient health related outcomes.
获取有关全科医生（GP）在2型糖尿病患者管理方面的知识和临床实践的信息，并探讨正规继续医学教育（CME）项目的影响。
共有1104名全科医生参与了一项与糖尿病管理相关的横断面调查，该调查考虑了2011年ADA/EASD共识，重点关注人口统计学和背景特征、糖尿病相关知识以及患者护理。在列联表分析中使用了Fisher精确检验和卡方检验。
大多数参与者（83.9%）在大城市工作，39.8%参加过糖尿病管理方面的继续医学教育项目。总体而言，52%的全科医生知道糖化血红蛋白（HbA1c）的治疗目标。参加继续医学教育的医生这一比例略高（P = 0.003）。考虑患者护理方面，略超过一半的参与者正确回答了关于体育活动时长和分布的问题，参加继续医学教育项目与否并无差异。平均而言，41.5%的医生选择二甲双胍作为治疗2型糖尿病的首选口服降糖药（OGLD），只有27.9%的医生表示如果治疗失败会在口服降糖药基础上加用基础胰岛素。
本研究结果表明，伊朗全科医生在2型糖尿病管理方面的知识和临床实践并不令人满意。此外，传统的糖尿病管理继续医学教育项目在改变全科医生的临床实践方面并不有效。因此，有必要设计和实施更有效的策略来改善与患者健康相关的结果。
