1079-P: Assessing Clinical Inertia on Implementing Guideline Recommendations in Patients with Type 2 Diabetes—The ACTION Study

Current ADA standards of care (SOC) include recommendations for T2D patients with cardiorenal conditions. Research shows clinical inertia towards implementation of evidence-based guidelines. The study aimed to gain insight into clinician attitudes, knowledge and behavior related to the ADA SOC. Eligible clinicians (PCPs, Endos and PA/NPs) caring for T2D patients were identified from the Healthcare Integrated Research Database based on claims submitted for <u>></u>5 T2D patients during the study period, 11/30/2019 - 11/30/2021. A survey assessed clinician attitudes and knowledge. ADA SOC behavior was determined by 6 claims-based therapeutic management (TM) measures including A1c and eGFR/UACR testing; statin, GLP-1 and SGLT2 prescribing. High knowledge was defined as answering ≥80% of knowledge questions correctly; high TM metric attainment was defined as ≥75^th percentile attainment for each measure. Survey responses and claims-based TM metrics were linked for each respondent. Of 402 respondents, 260 (65%) were PCPs, 44 (11%) Endos and 98 (24%) PA/NPs. Clinician attitudes regarding cardiorenal aspects of the ADA SOC were positive and did not vary by clinician type. High knowledge scores were reported by 58% of PCPs, 77% of Endos and 60% of PA/NPs. Correlation coefficients between attitudes and TM metric attainment ranged from -0.04 - 0.15 and between knowledge and TM metric attainment ranged from -0.03 - 0.14. The most common pattern observed between knowledge and TM metric attainment was high knowledge/low TM measure attainment, followed closely by a low/low pattern. Clinician attitudes were positive and showed adequate knowledge of the cardiorenal ADA SOC. Correlation between ADA SOC attitudes and knowledge and claims-based TM metric attainment were low. Opportunities exist to provide guideline-focused medical education for PCPs and PA/NPs coupled with interventions at the point of care to translate guideline knowledge into improved evidence-based care.