SUN-531 - Implementing Continuous Glucose Monitors in Primary Care - A Teaching Module for Internal Medicine Residents

Introduction
The American Diabetes Association recommends routine use of continuous glucose monitors (CGM) for all adults with diabetes on insulin therapy or glucose lowering agents. As CGM use increases, primary care providers will likely play a larger role in CGM management. The objective of this quality improvement project is to determine if a CGM-focused teaching module administered to internal medicine residents addresses knowledge gaps in prescribing and managing CGMs.

Methods
Internal medicine residents within one institution at four primary care clinic sites completed an approximately 20-minute teaching module on CGMs, including basics on how CGMs work, indications for prescription, insurance coverage, and how to access and interpret CGM reports. This module was integrated into an existing resident-led and attending-supervised pre-clinic teaching structure. Prior to the module, participants completed a survey assessing barriers to CGM prescription, along with a baseline knowledge assessment. Post-intervention, a follow-up survey assessed post-module knowledge and satisfaction. A Wilcoxon signed-rank test (one-sided, post > pre) was used to compare pre- and post-intervention survey results.

Results
There were 17 participants who completed the teaching module with 15 completing both the pre- and post-intervention survey. Of the 15, 7 (46.7%) reported never previously prescribing a CGM. The most selected barriers to prescribing CGMs were lack of knowledge on how to prescribe (11/15; 73.3%), lack of knowledge on indications to prescribe (8/15; 53.3%), and insurance concerns (8/15; 53.3%). Post-module, 33.3% (5/15) of participants somewhat agreed and 66.7% (10/15) strongly agreed that they felt more comfortable prescribing and managing CGMs, with the same percentages reporting intention to apply the knowledge in their future practice. Participants demonstrated significant improvements in understanding across all surveyed areas following completion of the module, including knowledge of how CGMs work (p = .003, r = .89), the various types of CGMs and their features (p < .001, r = .88), indications for CGM use and basic insurance principles (p < .001, r = .88), how to access CGM reports (p = < .001, r = .88), and how to interpret CGM reports (p = .002, r = .88).

Discussion
This teaching module significantly increased internal medicine residents’ reported knowledge and confidence in prescribing and managing CGMs, with most participants reporting plans to use this information in their primary care practice. These findings highlight the impact that targeted teaching modules can have on residents’ clinical knowledge and potential for improved patient care. Additionally, by integrating the module into a pre-existing teaching structure which rotates through topics annually, this project is sustainable for future resident cohorts.

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