Some health care professionals (HCPs) struggle to stay up to date with evolving technology and pharmacotherapy due to less exposure to people living with type 1 diabetes (PWT1D) compared to people living with type 2 diabetes (1). Codeveloped by HCPs and PWT1D, the online bilingual (English and French) Support platform aims to facilitate diabetes self-management through self-guided education with regular updates (2).
This patient-targeted platform was adapted into Support-Pro for HCPs, which covers multiple aspects of type 1 diabetes (T1D) management. This study aimed to determine if Support-Pro increases HCPs’ confidence and knowledge in treating PWT1D and their satisfaction with the platform.
A quasi–mixed-method, open-label, nonrandomized, 12-month prepost trial (NCT04859205) was performed. Throughout the intervention phase (months 0–3), participants were given access to Support-Pro with biweekly e-mail reminders to encourage engagement. During the sustainability period (months 3–12), access was maintained without reminders. Data collection included a baseline questionnaire, confidence assessments, knowledge evaluations, a satisfaction survey (closed and open-ended), and usage analytics, providing a comprehensive understanding of participants’ experiences with the platform. Platform design and features are described in Xie et al. (2).
Participants were recruited from May 2021 to June 2022. A total of 144 participants completed the baseline questionnaire, 69 completed the 3-month questionnaire, and 40 completed the 12-month questionnaire (13 ± 10, 14 ± 10, and 15 ± 10 years of practice, respectively; 85%, 91%, and 90% women, respectively; 73%, 73%, and 75% White, respectively; 28%, 45%, and 43% dietitians, respectively; 38%, 30%, and 35% nurses, respectively; 18%, 22%, and 23% pharmacists, respectively; and 9%, 3%, and 0% physicians or resident physicians, respectively).
Study findings revealed several significant outcomes:
- 1.
Increased confidence: HCPs’ mean (95% CI) confidence score significantly improved from baseline 53/95 (51, 56) to 65/95 (61, 69) after 3 months, which persisted after 12 months, i.e., 72/95 (67, 77) (Fig. 1A). This sustained enhancement in confidence suggests the platform’s influence in empowering HCPs to deliver optimized care to PWT1D.
- 2.
Increased knowledge: Participants reported a significant increase in knowledge from baseline to 3 months in 7 of 10 topics and 4 of 10 topics from 3 months to 12 months, indicating the platform’s effectiveness in enhancing HCPs’ understanding of recent best practices (Fig. 1B).
- 3.
Engagement: While participants exhibited high levels of engagement with the platform during the 3-month intervention phase (median [interquartile range] 63 [11; 215] page views/month), usage declined over time (e.g., 35 [8; 74] page views/month at 1 year). Despite this, HCPs who completed the 12-month questionnaire continued to use the platform. This underscores the importance of implementing strategies to sustain engagement and knowledge gain with digital health tools among HCPs.
- 4.
High user satisfaction: HCPs provided positive feedback regarding the platform’s usability, content relevance, and overall impact on clinical practice. Participants expressed high levels of satisfaction, highlighting the role of the platform as a valuable resource for continuous professional development in diabetes care. Features that support knowledge acquisition, such as case studies, videos, quizzes, and calculators, were identified as most preferred by 43%, 39%, 28%, and 25% of participants, respectively. Moreover, the qualitative analysis identified three main themes that emerged from participants’ feedback, namely, knowledge acquisition, increased confidence and motivation, and changes in patient care approach. These themes underscore the multifaceted benefits of Support-Pro, from enhanced clinical knowledge to improved counseling skills and more comprehensive patient care delivery.
Over 70% (n = 144) of participants lacked training specific to T1D before participating in the study. After having access to Support-Pro for 3 months, HCPs reported increased confidence and knowledge in treating and supporting PWT1D, which was sustained after 12 months. The most significant increase occurred at 12 months, which is likely attributed to participants gaining experience. Indeed, HCPs with more T1D patients stayed in the study longer. Additionally, the confidence increase for only the 12-month completers (n = 40) was comparable to the confidence increase of overall sample of HCPs.
These results parallel findings from the Support platform for PWT1D (3), which demonstrated high satisfaction and significant benefits for users. Despite a decline in engagement over time consistent with other studies (4,5), the initial positive effects on user confidence and knowledge demonstrate the platform’s role as a diabetes management resource. In a planned follow-up study, the efficacy of the training platforms will be evaluated by assessing changes in glycated hemoglobin and time in range.
The findings of this study emphasize the transformative potential of digital health tools like Support-Pro in enhancing diabetes care, benefiting clinical practice, and guiding future research. By equipping HCPs with the necessary knowledge, skills, and confidence to effectively manage T1D, these platforms play a pivotal role in improving patient outcomes and quality of care across diverse health care settings.
Clinical trial reg. no. NCT04859205, clinicaltrials.gov
Article Information
Acknowledgments. The authors thank the BETTER (Behaviors, Therapies, Technologies, and Hypoglycemic Risk in T1D) study group for guidance in establishing the research question and designing the platform.
Funding and Duality of Interest. The authors declare the following financial interests/personal relationships that may be considered potential competing interests: A.K. received a Diabetes Quebec summer bursary and a Canadian Graduate Scholarship-Master’s Program grant. S.H. is an Omnipod insulin pump trainer. R.R-L. has research grants from Diabetes Canada, AstraZeneca, Eli Lilly, Cystic Fibrosis Canada, Canadian Institutes of Health Research, Fondation Francophone pour la Recherche sur le Diabète, Janssen, JDRF, Merck, National Institutes of Health, Novo Nordisk, Société Francophone du Diabète, Sanofi, and Vertex Pharmaceuticals; is on a consulting or advisory panel for Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, HLS Therapeutics, Institut National d'Excellence en Santé et Services Sociaux, Insulet, Janssen, Medtronic, Merck, Novo Nordisk, Pfizer, and Sanofi; has received honoraria for conferences from Abbott, AstraZeneca, Boehringer Ingelheim, CPD Network, Dexcom, CMS Canadian Medical & Surgical Knowledge Translation Research Group, Eli Lilly, Janssen, Medtronic, Merck, Novo Nordisk, Sanofi, Tandem Diabetes Care, and Vertex Pharmaceuticals; has received consumable gifts (in kind) from Eli Lilly and Medtronic; has received unrestricted grants for clinical and educational activities from Abbott, Eli Lilly, Medtronic, Merck, Novo Nordisk, and Sanofi; has received patent support for type 2 diabetes risk biomarkers and catheter life; and has received purchase fees from Eli Lilly (artificial pancreas). A.-S.B. is a Fond de Recherche du Québec en Santé’s research scholar and holds grants from Canadian Institutes of Health Research, JDRF, and Diabetes Québec. She also has speaker’s fees from Dexcom. This study is part of the BETTER project, which is funded by the Canadian Institutes of Health Research and JDRF and through mandatory unrestricted research grants from Eli Lilly, Novo Nordisk, and Sanofi, representing 8% of the overall budget. No other potential conflicts of interest relevant to this article were reported.
Author Contributions. A.K. drafted the manuscript and contributed to writing the protocol, recruitment, data collection, and analysis. A.R.-F. coordinated platform development and the study and contributed to writing the protocol. A.H. aided with qualitative data coding and interpretation, and M.K.T. aided with quantitative analysis. S.H. contributed to designing the platform and updating its content. R.R.-L. and A.-S.B. designed the study and contributed to the writing of the protocol. All authors contributed to the interpretation of the data and reviewed the manuscript. A.-S.B. is the guarantor of this work and, as such, has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Prior Presentation. Parts of this study were presented in abstract form at the 83rd Scientific Sessions of the American Diabetes Association, San Diego, CA, 23–26 June 2023.
Handling Editors. The journal editors responsible for overseeing the review of the manuscript were John B. Buse and Jeremy Pettus.
