Papadakis Sophia, Anastasaki Marilena, Gergianaki Irini, Koek Ger, Mendive Juan, Anastasiou Foteini, Heyens Leen, Garcia-Retortillo Montserrat, Muris Jean, Lionis Christos
Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands.
Front Med (Lausanne). 2023 Mar 23;10:1034626. doi: 10.3389/fmed.2023.1034626. eCollection 2023.
Primary care has a crucial role to play in the prevention, early detection, referral, and risk factor management of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NAFLD/NASH). In 2021, a team of European collaborators developed a continuing medical education (CME) program on NAFLD/NASH that consolidates evidence and clinical best practices tailored to the primary care setting. This article reports on the methodology used to design and develop the CME and the results of a feasibility study.
An expert advisory group representing both European specialists and general practitioners supported the design of the CME to be implemented in three European settings (Greece, Spain, and Netherlands). The CME features four training modules and problem-based learning using clinical case studies. The CME was tested regarding feasibility and acceptability among a sample of primary care providers (PCPs) in Greece ( = 28) with measurements occurring before, immediately after, and 1 month following the training. Outcome measures included satisfaction with the CME, changes in PCPs' knowledge, attitudes, confidence, and self-reported clinical practices related to NAFLD/NASH.
The CME is available as an open-access e-learning course on the European Society for Primary Care Gastroenterology education platform in English, Greek, Spanish, and Dutch. The feasibility study documented high levels of satisfaction, with 96% of PCPs reporting they were extremely or very satisfied with the overall training. Statistically significant increases in PCPs' confidence in NAFLD/NASH-related clinical practices were documented between the pre- and post-assessments. At the follow-up, 62% of GPs reported that the CME had changed their clinical practices related to NAFLD/NASH to a great extent.
This CME intervention developed by experts and tailored to PCPs in European settings may serve as an asset for increasing knowledge, confidence, and practice behaviors related to NAFLD/NASH.
初级保健在非酒精性脂肪性肝病和非酒精性脂肪性肝炎（NAFLD/NASH）的预防、早期检测、转诊及危险因素管理中发挥着关键作用。2021年，一组欧洲合作者开发了一项关于NAFLD/NASH的继续医学教育（CME）项目，该项目整合了针对初级保健环境的证据和临床最佳实践。本文报告了用于设计和开发该CME的方法以及一项可行性研究的结果。
一个由欧洲专家和全科医生组成的专家咨询小组支持了将在三个欧洲地区（希腊、西班牙和荷兰）实施的CME的设计。该CME有四个培训模块，并采用基于临床案例研究的问题式学习。在希腊的28名初级保健提供者（PCP）样本中对该CME的可行性和可接受性进行了测试，在培训前、培训后立即以及培训后1个月进行测量。结果指标包括对CME的满意度、PCP在NAFLD/NASH相关知识、态度、信心以及自我报告的临床实践方面的变化。
该CME作为一门开放获取的电子学习课程，可在欧洲初级保健胃肠病学学会教育平台上以英语、希腊语、西班牙语和荷兰语获取。可行性研究记录了高水平的满意度，96%的PCP报告他们对整体培训极其或非常满意。在评估前和评估后之间，记录到PCP在NAFLD/NASH相关临床实践方面的信心有统计学意义的增加。在随访中，62%的全科医生报告该CME在很大程度上改变了他们与NAFLD/NASH相关的临床实践。
由专家开发并针对欧洲环境中的PCP量身定制的这种CME干预措施，可能有助于增加与NAFLD/NASH相关的知识、信心和实践行为。
