Background: Continuous glucose monitoring (CGM) is a powerful tool to help manage diabetes. Primary care providers (PCPs) have been slow to incorporate CGM into practice, representing a significant gap in healthcare delivery. We implemented a quality improvement intervention at our primary care clinic to increase utilization of CGM.
Methods: We conducted a pre-intervention survey with PCPs to assess baseline knowledge and comfort with CGM, followed by a 6 month post-intervention survey. Our interventions included the creation of a CGM toolkit, provider education, and implementation of an office workflow for prescribing CGM and educating patients. Our primary outcome measure was the number of CGM prescriptions written. Secondary outcome measures included change in provider knowledge and comfort with CGM use, and change in hemoglobin A1c after 3-6 months of CGM use.
Results: Our survey asked providers to rate their comfort and familiarity with CGM along with questions regarding barriers to CGM use. The baseline survey showed that provider familiarity and comfort explaining CGM to patients was poor, frequently rated as a 1 or 2 (1= not at all familiar, 5= very familiar) . Six months after implementation of our toolkit and education, 70% of providers responded with a 4 or 5. We identified 41 clinic patients who had CGM prescriptions in the six month time period prior to our study initiation. Six months after intervention, a total of 1patients had CGM prescriptions (146% increase) . Of the 60 patients newly prescribed CGM, we obtained retrospective data on patients. Mean hemoglobin A1c of was 9.96% at baseline and improved to 8.29% after 3-6 months of CGM use (change of 1.67%) .
Conclusion: Implementation of a toolkit focusing on provider education and an organized workflow for prescribing can increase the use of CGM in primary care practice, as well as positively affect provider knowledge and comfort with CGM use. Our preliminary data indicates that patients may also benefit from improved glycemic control.
R.Mamtani: None. T.Wolinsky: Other Relationship; Pfizer Inc. B.Simon: None.
American Diabetes Association