Alice YY Cheng, MD, FRCPC (University of Toronto); Peter J. Lin, MD, CCFP (Canadian Heart Research Centre); Cynthia Lebovics, BSc. PDT, CDE (Sanofi Canada)
Purpose
Only 15% of people with type 2 diabetes in family practices use insulin, despite only 53% achieving glycemic targets. Lack of knowledge/confidence in starting and titrating insulin is a barrier and family practice training programs often have little or no coverage of the topic.
Methods
A collaborative team consisting of an endocrinologist, primary care physician and national education manager of a pharmaceutical company, developed a nationally accredited program (Insulin 101) which was delivered to family practice residents and physicians. The five modules included role play and hands-on experience. A pre-post evaluation assessed 7 barriers and comfort level with 7 skills using a 5-point scale.
Results
Insulin 101 has been delivered to 347 family practice residents, 113 family physicians and 50 nurse practitioners. Prior to the program, 86% of participants had “never” or only “sometimes” initiated insulin. After the program, a favourable change in the perceived barrier level was noted for (% with change): complexity of insulin (74%), worry about hypoglycemia (64%), not knowing how to start (77%), too many types of insulin (76%). The comfort level increased for the following: insulin type (72%), regimen (81%), identifying the patient (66%), selecting the regimen (85%), starting (81%) and titrating (80%) insulin.
Future Directions
This unique program demonstrates the success of a collaborative model between health care professionals and industry to address care gaps through development of a program to educate trainees and established physicians. An update of the current program and the development of “Insulin 201” are planned for the future.
Funding Sources
sanofi Canada provided an unrestricted educational grant for the development and delivery of Insulin 101.
Declaration
AYYC has received speaking honoraria from sanofi Canada, Novo Nordisk, Eli Lilly. PJL has received speaking honoraria from sanofi Canada. CL is an employee of sanofi Canada.
