MON-025 - Online Medical Education Improves Primary Care Physician and Cardiologist Competence in Identifying Hypercortisolism in Difficult-to-Control Cardiometabolic Conditions

Background:
Hypercortisolism is an underdiagnosed underlying cause of resistant hypertension and difficult-to-control type 2 diabetes (T2D). When left untreated, it drives significant metabolic morbidity; however, clinicians often manage the underlying symptoms without knowing the cause. This study evaluates the impact of an online continuing medical education (CME) initiative designed to improve the ability of primary care physicians (PCPs) and cardiologists to recognize hypercortisolism and implement appropriate screening protocols in patients with resistant metabolic conditions.

Methods:
Educational design included a “test, then teach” approach, with evidence-based feedback provided following each learner response. Data were collected from an online CME activity launched in February 2025 to June 2025. The study used a methodology, pairing individual pre- and post-assessment responses to quantify specific cognitive shifts among participating learners (n=688). Statistical significance was determined using McNemar’s test (P < .05) and Cohen’s d for effect size.

Results:
574 PCPs & 114 cardiologists who answered all the assessment questions were included. Both groups were 8x and 7x more likely, respectively, to answer all assessment questions correctly post-education compared to baseline (P < .001). Additional insights include:
• Baseline data exposed a knowledge gap regarding disease burden; only 24% of PCPs & 30% of cardiologists correctly identified the prevalence of hypercortisolism in patients with difficult-to-control T2D and resistant hypertension. Education significantly improved this awareness to 67% and 78%, respectively, though continued reinforcement is warranted to ensure widespread recognition.
• Screening practices for these clinicians were suboptimal: ~50% of learners failed to select the appropriate diagnostic approach; however, education significantly corrected this, with correct identification of appropriate screening protocols rising to 85% for cardiologists and 78% for PCPs.
• While intent was high—with ~44% of both groups committing to actively screen patients—confidence gains were modest (mean shift from ~2.5 to ~2.9 on a 5-point scale), indicating that while learners intend to screen, they may still lack the practical strategies to execute these protocols routinely.

Conclusion
This online education was highly effective in closing knowledge gaps regarding screening protocols for hypercortisolism, effectively shifting the mindset of PCPs and Cardiologists from "refer immediately" to "screen first". However, the persistent need for confidence building suggests that future initiatives should focus on practical tools & strategies to support the routine implementation of hypercortisolism screening in practice.

Acknowledgements: This education was supported by an independent educational grant from Corcept Therapeutics.

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