A Cross-Sectional Study of the JOINT DQ Program Participants’ (Joslin Online Intensive Training Program in Diabetes and Quality Improvement for Primary Care Providers) Baseline Knowledge and Attitudes in the Field of Diabetes Care

Abstract

Background: Diabetes affects 3.85 million in the Kingdom of Saudi Arabia (KSA). Physicians providing care for diabetes patient in the primary care setting (PCPs) are at the forefront of the battle against diabetes at the Ministry of Health (MOH) of KSA, but their knowledge, attitudes, and beliefs towards their knowledge of diabetes and access to supportive educational and expert guidance have not been adequately studied. Objectives: Assess PCPs’ 1) knowledge of the various diabetes domains from diagnosis to management of complications; 2) self-efficacy; 3) sense of burden and anxiety when caring for patients with diabetes; 4) professional satisfaction; 5) professional isolation; 6) satisfaction with access to continuing medical education (CME) and expert opinion; 7) transfer of knowledge; and 8) perceived patient and clinic benefit/ referral to endocrine /diabetes clinics from current participation in CME. Design: An online self-administered open book case-based validated and timed multiple-choice exam and survey of PCPs. Participants: 249 PCPs currently employed and caring for diabetes patients at the MOH of KSA sampled from 19 primary locations and 11 diabetes units across KSA. Main measures: Descriptive analyses of exam results, survey questions on self-efficacy, sense of burden/anxiety when caring for diabetes patients, professional isolation, professional satisfaction, satisfaction with access to CME/expert opinion, transfer of knowledge, and perceived benefit to patients and reduction of referral to endocrine or diabetes clinics. Various tests of statistical association between the survey domains and knowledge scores were performed. Key results: Participants scored an average of 55% on the knowledge score exam and only 12% achieved a passing score of at least 70%. Around 50% reported a self-efficacy of competent, very competent, or expert in diabetes. More than 30% of participants reported moderate to severe levels of burden/stress when caring for patients with diabetes in all clinical domains of diabetes and more than 50% reported the same levels of burden in diabetes emergencies or inpatient diabetes care. Conclusions: These findings suggest that alignment between quality improvement initiatives and targeted CME activities is warranted. Furthermore, a wider needs assessment is required to explore the high levels of stress burden in this group.