Epidemiology: Open Access
Open Access

Abstract

Introduction: Diabetes is considered as one of the major contributors to global burden of disease; it exemplifies management challenge because of long latency, chronicity, multi-organ involvement and long term care. In India, health system is constraint in term of trained manpower and limited institutional capacities for diabetes management. So keeping this fact in mind, Public health foundation of India in collaboration with Dr. Mohan Diabetes Education Academy developed an evidence based diabetes management course in 2010 for primary care physicians to build their capacity and improve their skill in diabetes management. With this study we aimed to evaluate the short term impact of PAN India Certificate Course in Evidence Based Diabetes Management (CCEBDM). Methods: We used mixed method design for data collection incorporation on site pre and post evaluation of all the primary care physicians and off site follow ups from n=225 participants who attended the course from 2010 to 2012. Impact of onsite pre and post evaluation was assessed used the significance level and off site evaluation was assessed by using 5-point Likert Scale and observational technique was used to evaluate the impact of course on their clinical practices and infrastructure. Results: 2776 primary care physicians were assessed for knowledge improvement and it was found that there is significant improvement ( P value<0.001 ) in knowledge regarding basics of diabetes, pharmacological treatment, acute and chronic complications with management. Offsite evaluation showed that frequency of treating diabetic patient/physician/month increased (38% 501 to 1,500 patients per month and 44% stated that they treated about 101 to 500 patients per month), confidence level of physician increased in field of diabetes diagnoses and management, confident to manage diabetic complication like hypoglycaemia, peripheral neuropathy, skin complication, sexual dysfunction, diabetic foot and nephropathy increased. 90% were confident about managing patients on insulin independently. Assessment of clinic structure showed that 66% physicians had provision for laboratory facilities routine blood screenings, 53% had on-site dieticians to help diabetic patients, 35% had counsellors to guidepatients, 49% were using DBMS, 79% had full time nurses on duty, 76% used various forms of Patient Education Resources to elicit awareness about diabetes. Majority of physicians agreed that course contributed significantly to their knowledge of diabetes management, added value to their treatment skills and curriculum was up-to-date with latest advances and guidelines and faculty?s personal clinical experience were very useful and now they can consult diabetic experts anytime for references. Conclusion: CCEBDM was found to be effective in knowledge improvement of physicians and ultimately improving clinical practice in diabetes management. Also by building capacity of primary care physicians in diabetes management, there seems to be a solution to control the increasing burden of diabetes and to improve productivity of people who are living with diabetes.

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