pt331 evaluation of certificate course in evidence based diabetes management: a pan india capacity...

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Conclusion: We found gender differences in HRQoL and conrm the negative impact of chronic conditions on HRQoL. Our data in a large urban sample from India and Pakistan are consistent with results from EQ5D population studies in other countries. Disclosure of Interest: None Declared PT330 Monitoring and Evaluation Mechanism of one of the PAN India NCDs program with specic focus on Gestational Diabetes Mellitus Management Manoj Joshi* 1 , Sandeep Bhalla 1 , Kolli S. Reddy 2 , Viswanathan Mohan 3 , Ranjit Unnikrishnan 4 , Pratibha Karnad 5 , Dorairaj Prabhakaran 6 1 Training, 2 President, Public Health Foundation of India (PHFI), New Delhi, 3 Dr. Mohans Diabetes Specialities Centre, 4 Dr. Mohans Diabetes Specialities Centre, Chennai, 5 Johnson & Johnson Medical India, Mumbai, 6 Centre for Chronic Disease Control- CCDC, Public Health Foundation of India (PHFI), New Delhi, India Introduction: Given the current scenario of high incidence (15% of pregnant women) of Gestational Diabetes Mellitus (GDM) worldwide and an estimated 4 million women affected in India; there is a huge shortage of trained cadre of Obstetricians and Gynaecologists (OG specialists), Primary Care Physicians (PCPs) to combat this burden. To address this need, a comprehensive Certicate Course in GDM (CCGDM) was launched on 25 th August, 2013 to train 1460 OG specialists and PCPs in 55 Regional Centers covering 16 States, 1 Union Territory and 39 cities across India. The training would be provided by 110 Regional Faculty under the guidance of 15 Na- tional Experts. Objectives: To ensure quality and standardized delivery of training program, a robust and innovative Monitoring and Evaluation (M & E) mechanism has been devised which comprises of onsite and offsite monitoring. Methods: CCGDM aims to follow a vigorous Monitoring Mechanism during the entire tenure of program as it will synthesize evidence regarding the challenges faced by stake- holders, help in collation of feedback on course modalities and timely solutions for chal- lenges which are crucial to maintain interest and reduce attrition of participants. A cadre of 25 Observers who are eminent Public Health Professionals and Hospital Administrators are the backbone of M & E Mechanism. A detailed onsite and offsite Monitoring Plan has been developed on the basis of standardized indicators and parameters to provide clear and uniform format where data would be collected and stored for greater efciency, trans- parency and ease of access for all stakeholders. M & E for this program comprises of indicators that measure inputs, process, outputs, and outcomes. For effective M and E of CCGDM a list of indicators/ parameters have been nalized. These include baseline survey to assess Knowledge, Attitude and Practices (KAP) of GDM among participants, Short Message services (SMS) Real Time E- Monitoring System and an End Line Evaluation. Routine data collection and compilation will be done and compiled into a meaningful process document so that appropriate programmatic in- terventions can be identied. Results: The preliminary results will be presented at the meeting. Conclusion: The launch of this program to tackle the shortage of trained manpower in GDM management in India is just the beginning but the nal success of program will depend on how effectively we monitor and evaluate it. Disclosure of Interest: None Declared PT331 Evaluation of certicate course in evidence based diabetes management: A pan India capacity building program for primary care physicians Rakesh Mehra* 1 , Shivangi Vats 1 1 Training, Public Health Foundation of India, New Delhi, India Introduction: Diabetes is considered as one of the major contributors to global burden of disease. In India, health system is constraint in term of trained manpower and limited institutional capacities for diabetes management. So keeping this fact in mind, Public health foundation of India in collaboration with Dr Mohan Diabetes Education Academy devel- oped an evidence based diabetes management course in 2010 for primary care physicians to build their capacity and improve their skill in diabetes management. Objectives: The aim of this study is to evaluate the short term impact of PAN India Certicate Course in Evidence Based Diabetes Management (CCEBDM). Methods: We used mixed method design for data collection incorporation on site pre and post evaluation of all the primary care physicians and off site follow ups from n ¼ 225 participants who attended the course from 2010 to 2012. Impact of on site pre and post evaluation was assessed used the signicance level and off site evaluation was assessed by using 5-point Likert Scale and observational technique was used to evaluate the impact of course on their clinical practices and infrastructure. Results: 2776 primary care physicians were assessed for knowledge improvement and it was found that there is signicant improvement (P value < 0.001) in knowledge regarding basics of diabetes, pharmacological treatment, acute and chronic complica- tions with management. Off site evaluation showed that frequency of treating diabetic patient/physician/month increased (38% 501 to 1,500 patients per month and 44% stated that they treated about 101 to 500 patients per month), condence level of physician increased. 90% were condent about managing patients on insulin independently. Assessment of clinic structure showed that 66% physicians had provision for laboratory facilities routine blood screenings, 53% had on-site dieticians to help diabetic patients, 35% had counsellors to guide patients, 49% were using DBMS, 79% had full time nurses on duty, 76% used various forms of Patient Education Resources to elicit awareness about diabetes. Conclusion: CCEBDM found to be effective in knowledge improvement of physicians and ultimately improving clinical practice in diabetes management. Also by building capacity of primary care physicians in diabetes management, there seems to be a solution to control the increasing burden of diabetes and to improve productivity of people who are living with diabetes. Disclosure of Interest: None Declared PT332 An Integrated Potential Monitoring System for the Pan-India Capacity Building Initiative for Primary Care Physicians in Non-Communicable Diseases- Evidence Based Diabetes Management Rakesh Mehra 1 , Shivangi Vats 1 , Shreyas Sharma* 2 1 Training, Public Health Foundation of India, New Delhi, 2 Training, Public Health Foundation of India, Gurgaon, India Introduction: Non-Communicable diseases are embracing India like a plague and the huge burden is faced from Diabetes. Medical and Health fraternity is alarmed due to early onset of Type-2 diabetes among young Indians as compared to their western counter- parts. There is a contiguous need of building a national capacity of primary care physicians through evidence based knowledge on diabetes management. Primary care physicians are the rst person to diagnose the disease in the initial stage. Based on this, a year-long once- in-a- month Pan-India certicate course is launched to train physicians in the eld of evidence based diabetes management. 2776 doctors are already benetted from the course in past 2 years and 2306 are currently getting trained. With 134 centers and 164 trainers spread across India, an unparalleled and rigorous monitoring plan needed to be formu- lated with a practical and robust approach to ensure quality and effectiveness of the program. Objectives: Monitoring component was designed and executed to ensure quality and effectiveness of the sessions conducted as per the standardised protocols of the program, to determine the difculties faced by trainers and participants in smooth session conduction and take remedial actions to resolve the concerned issues to facilitate smooth conduction of the program. Methods: Monitoring component was divided into two sections, rst in On-site moni- toring component and second in Off-site monitoring component. For On-site monitoring observers from all across India were identied and trained for monitoring visits. Tools were developed for On-site and Off-site monitoring. Every month 13% of total centers were monitored on-site and 10% of remaining centers were monitored off-site by collecting feedback from the enrolled doctors. Results: Regular and consecrated monitoring continuously for 3 years throughout the program cycles, show 93% average satisfaction level among Observers in conduction of sessions and adherence to protocols. Trainers average satisfaction level with the quality management of the program is 78%. Participants reect 84% average satisfaction level pertaining to program management and quality of the course delivery. Conclusion: Program specic designing and implementation of a well planned, stringent and veritable monitoring model is important to ensure quality conduction of such Pan- India programs to achieve satisfaction levels of the stakeholders. Disclosure of Interest: None Declared GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters e231 POSTER ABSTRACTS

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Conclusion: We found gender differences in HRQoL and confirm the negative impact ofchronic conditions on HRQoL. Our data in a large urban sample from India and Pakistanare consistent with results from EQ5D population studies in other countries.Disclosure of Interest: None Declared

PT330

Monitoring and Evaluation Mechanism of one of the PAN India NCDs program withspecific focus on Gestational Diabetes Mellitus Management

Manoj Joshi*1, Sandeep Bhalla1, Kolli S. Reddy2, Viswanathan Mohan3, Ranjit Unnikrishnan4,Pratibha Karnad5, Dorairaj Prabhakaran61Training, 2President, Public Health Foundation of India (PHFI), New Delhi, 3Dr. Mohan’sDiabetes Specialities Centre, 4Dr. Mohan’s Diabetes Specialities Centre, Chennai, 5Johnson &Johnson Medical India, Mumbai, 6Centre for Chronic Disease Control- CCDC, Public HealthFoundation of India (PHFI), New Delhi, India

Introduction: Given the current scenario of high incidence (15% of pregnant women)of Gestational Diabetes Mellitus (GDM) worldwide and an estimated 4 million womenaffected in India; there is a huge shortage of trained cadre of Obstetricians andGynaecologists (OG specialists), Primary Care Physicians (PCPs) to combat thisburden. To address this need, a comprehensive Certificate Course in GDM (CCGDM)was launched on 25th August, 2013 to train 1460 OG specialists and PCPs in 55Regional Centers covering 16 States, 1 Union Territory and 39 cities across India. Thetraining would be provided by 110 Regional Faculty under the guidance of 15 Na-tional Experts.Objectives: To ensure quality and standardized delivery of training program, a robust andinnovative Monitoring and Evaluation (M & E) mechanism has been devised whichcomprises of onsite and offsite monitoring.Methods: CCGDM aims to follow a vigorous Monitoring Mechanism during the entiretenure of program as it will synthesize evidence regarding the challenges faced by stake-holders, help in collation of feedback on course modalities and timely solutions for chal-lenges which are crucial to maintain interest and reduce attrition of participants. A cadre of25 Observers who are eminent Public Health Professionals and Hospital Administrators arethe backbone of M & E Mechanism. A detailed onsite and offsite Monitoring Plan has beendeveloped on the basis of standardized indicators and parameters to provide clear anduniform format where data would be collected and stored for greater efficiency, trans-parency and ease of access for all stakeholders.M & E for this program comprises of indicators that measure inputs, process, outputs,

and outcomes. For effective M and E of CCGDM a list of indicators/ parameters have beenfinalized. These include baseline survey to assess Knowledge, Attitude and Practices (KAP)of GDM among participants, Short Message services (SMS) Real Time E- MonitoringSystem and an End Line Evaluation. Routine data collection and compilation will be doneand compiled into a meaningful process document so that appropriate programmatic in-terventions can be identified.Results: The preliminary results will be presented at the meeting.Conclusion: The launch of this program to tackle the shortage of trained manpower inGDM management in India is just the beginning but the final success of program willdepend on how effectively we monitor and evaluate it.Disclosure of Interest: None Declared

GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters

PT331

Evaluation of certificate course in evidence based diabetes management: A pan Indiacapacity building program for primary care physicians

Rakesh Mehra*1, Shivangi Vats11Training, Public Health Foundation of India, New Delhi, India

Introduction: Diabetes is considered as one of the major contributors to global burden ofdisease. In India, health system is constraint in term of trained manpower and limitedinstitutional capacities for diabetes management. So keeping this fact in mind, Public healthfoundation of India in collaboration with Dr Mohan Diabetes Education Academy devel-oped an evidence based diabetes management course in 2010 for primary care physiciansto build their capacity and improve their skill in diabetes management.Objectives: The aim of this study is to evaluate the short term impact of PAN IndiaCertificate Course in Evidence Based Diabetes Management (CCEBDM).Methods: We used mixed method design for data collection incorporation on site pre andpost evaluation of all the primary care physicians and off site follow ups from n ¼ 225participants who attended the course from 2010 to 2012. Impact of on site pre and postevaluation was assessed used the significance level and off site evaluation was assessed byusing 5-point Likert Scale and observational technique was used to evaluate the impact ofcourse on their clinical practices and infrastructure.Results: 2776 primary care physicians were assessed for knowledge improvement and itwas found that there is significant improvement (P value < 0.001) in knowledgeregarding basics of diabetes, pharmacological treatment, acute and chronic complica-tions with management. Off site evaluation showed that frequency of treating diabeticpatient/physician/month increased (38% 501 to 1,500 patients per month and 44%stated that they treated about 101 to 500 patients per month), confidence level ofphysician increased. 90% were confident about managing patients on insulinindependently.Assessment of clinic structure showed that 66% physicians had provision for laboratory

facilities routine blood screenings, 53% had on-site dieticians to help diabetic patients, 35%had counsellors to guide patients, 49% were using DBMS, 79% had full time nurses onduty, 76% used various forms of Patient Education Resources to elicit awareness aboutdiabetes.Conclusion: CCEBDM found to be effective in knowledge improvement of physicians andultimately improving clinical practice in diabetes management. Also by building capacity ofprimary care physicians in diabetes management, there seems to be a solution to control theincreasing burden of diabetes and to improve productivity of people who are living withdiabetes.Disclosure of Interest: None Declared

PT332

An Integrated Potential Monitoring System for the Pan-India Capacity BuildingInitiative for Primary Care Physicians in Non-Communicable Diseases- EvidenceBased Diabetes Management

Rakesh Mehra1, Shivangi Vats1, Shreyas Sharma*21Training, Public Health Foundation of India, New Delhi, 2Training, Public Health Foundation ofIndia, Gurgaon, India

Introduction: Non-Communicable diseases are embracing India like a plague and thehuge burden is faced from Diabetes. Medical and Health fraternity is alarmed due to earlyonset of Type-2 diabetes among young Indians as compared to their western counter-parts. There is a contiguous need of building a national capacity of primary care physiciansthrough evidence based knowledge on diabetes management. Primary care physicians arethe first person to diagnose the disease in the initial stage. Based on this, a year-long once-in-a- month Pan-India certificate course is launched to train physicians in the field ofevidence based diabetes management. 2776 doctors are already benefitted from the coursein past 2 years and 2306 are currently getting trained. With 134 centers and 164 trainersspread across India, an unparalleled and rigorous monitoring plan needed to be formu-lated with a practical and robust approach to ensure quality and effectiveness of theprogram.Objectives: Monitoring component was designed and executed to ensure quality andeffectiveness of the sessions conducted as per the standardised protocols of the program, todetermine the difficulties faced by trainers and participants in smooth session conductionand take remedial actions to resolve the concerned issues to facilitate smooth conduction ofthe program.Methods: Monitoring component was divided into two sections, first in On-site moni-toring component and second in Off-site monitoring component. For On-site monitoringobservers from all across India were identified and trained for monitoring visits. Tools weredeveloped for On-site and Off-site monitoring. Every month 13% of total centers weremonitored on-site and 10% of remaining centers were monitored off-site by collectingfeedback from the enrolled doctors.Results: Regular and consecrated monitoring continuously for 3 years throughout theprogram cycles, show 93% average satisfaction level among Observers in conduction ofsessions and adherence to protocols. Trainers average satisfaction level with the qualitymanagement of the program is 78%. Participants reflect 84% average satisfaction levelpertaining to program management and quality of the course delivery.Conclusion: Program specific designing and implementation of a well planned, stringentand veritable monitoring model is important to ensure quality conduction of such Pan-India programs to achieve satisfaction levels of the stakeholders.Disclosure of Interest: None Declared

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