Adoption of the ADA/EASD guidelines in 10 Eastern and Southern European countries: Physician survey and good clinical practice recommendations from an international expert panel

Cardio-Metabolic Academy Europe East

doi:10.1016/j.diabres.2020.108535

Adoption of the ADA/EASD guidelines in 10 Eastern and Southern European countries: Physician survey and good clinical practice recommendations from an international expert panel

Diabetes Res Clin Pract. 2021 Feb:172:108535. doi: 10.1016/j.diabres.2020.108535. Epub 2020 Nov 13.

Author

Cardio-Metabolic Academy Europe East

Collaborators

Cardio-Metabolic Academy Europe East:
Maciej Banach¹, Dan Gaita², Martin Haluzik³, Andrej Janez⁴, Zdravko Kamenov⁵, Peter Kempler⁶, Nebojsa Lalic⁷, Ales Linhart⁸, Dimitri P Mikhailidis⁹, Aleksandra Nocoń¹⁰, Jose Silva Nunes¹¹, Nikolaos Papanas¹², Joao Filipe Raposo¹³, Manfredi Rizzo¹⁴, Anca Pantea Stoian¹⁵

Affiliations

¹ Department of Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute, Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
² Institute of Cardiovascular Diseases Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
³ Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
⁴ Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, Ljubljana, Slovenia.
⁵ Department of Internal Diseases, Medical Faculty, University of Sofia, Bulgaria; Center for Prevention of Diabetes and its Complications, Clinic of Endocrinology and Metabolic Diseases, Alexandrovska University Hospital, Sofia, Bulgaria.
⁶ Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.
⁷ Faculty of Medicine, University of Belgrade, Serbia; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia.
⁸ 2nd Department of Internal Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
⁹ Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK; Mohammed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, United Arab Emirates.
¹⁰ Novo Nordisk, Poland. Electronic address: avnc@novonordisk.com.
¹¹ Department of Endocrinology, Diabetes and Metabolism, Central Lisbon University Hospital Centre, Lisbon, Portugal; NOVA Medical School/ Medical Science College, New University of Lisbon, Lisbon, Portugal; Health and Technology Research Center, Lisbon Health Technology School, Lisbon, Portugal.
¹² Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
¹³ NOVA Medical School/ Medical Science College, New University of Lisbon, Lisbon, Portugal; APDP Diabetes Portugal, Lisbon, Portugal.
¹⁴ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Italy; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of South Carolina, Columbia, SC, USA.
¹⁵ Diabetes, Nutrition and Metabolic Diseases Department, "Carol Davila" University of Medicine, Bucharest, Romania.

PMID: 33189792
DOI: 10.1016/j.diabres.2020.108535

Abstract

Aims: Evidence from cardiovascular outcomes trials (CVOTs) of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors was reflected in the most recent guidelines from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). The aim of the present study was to assess the adoption of the ADA/EASD guidelines in a convenience sample of physicians from Eastern and Southern Europe, the barriers to the implementation of these guidelines and the measures needed to facilitate their implementation.

Methods: Attendees at two international diabetes conferences could volunteer to respond to a fully anonymous survey. Responses were analysed descriptively and a panel of experts from around the region was consulted to interpret the survey results.

Results: Responses (n = 96) from 10 countries were analysed. Most participants (63.4%) considered the ADA/EASD guidelines fundamental to their practice. All respondents saw the value of the CVOT-based ADA/EASD recommendations and 77-80% generally implemented them. Measures suggested to improve adherence to the ADA/EASD guidelines included aligning reimbursement policy with the guidelines (54.4%), publishing guidelines in a simple and concise form (42.4%) and translating guidelines into local languages (33.3%).

Conclusions: Aligning reimbursement with recent evidence and providing short summaries of the ADA/EASD guidelines in local languages could facilitate physician adherence.

Keywords: Adherence; Clinical guidelines; GLP-1RAs; SGLT2is; Type 2 diabetes.

Publication types

Multicenter Study

MeSH terms

Europe
Europe, Eastern
Female
Guidelines as Topic
Humans
Male
Physicians / standards*
Surveys and Questionnaires