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M.N. Becker
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-035 - Treatment of NSCLC Patients by Community Health Practitioners: Practice Pattern and Competence Assessments (ID 1593)
09:30 - 09:30 | Author(s): M.N. Becker
- Abstract
Background:
The complexity of current treatment and management for patients with metastatic non-small cell lung cancer (NSCLC) continues to rise. The volume and pace of scientific advances make it challenging for the community practitioner to stay abreast of optimal patient care. Education is vital in disseminating critical information to practitioners and allows professional reflection of appropriate therapeutic decision making and peer discussion. Understanding the base knowledge, competence, and current practice patterns of practitioners is essential to identifying community needs and implementation of education that impacts patient care.
Methods:
From May through December 2014, educational outcomes assessments were gathered from 42 live independent continuing medical education (CME) activities held within community practices across the United States. Participants were asked a series of case-based questions via an audience response system to assess baseline knowledge, competence, and identify practice patterns. Assessments were repeated following the 1-hour CME certified activity. Long-term assessment was conducted electronically 6-weeks following the educational initiative.
Results:
The overall program educated 847 practitioners, including 477 physicians. Three patient scenarios were profiled during the activity: 1) non-squamous NSCLC, non-smoker, no targetable mutation, 2) non-squamous NSCLC, EGFR del19 mutation, and 3) non-squamous NSCLC, ALK rearranged. Participant responses at baseline indicated a need for further education about molecular testing, maintenance therapies, and front-line therapies. All three cases also addressed treatment options at disease progression following initial treatment. For all cases, education resulted in responses better aligned to current practice guidelines and clinical data. With respect to molecular testing there was a 28% increase in the number of participants who would recommend testing and a 17% increase in participants who would recommend sufficient biopsy specimen for testing prior to treatment. There was a large gap in knowledge about the need for a repeat biopsy after progression on EGFR TKI therapy to confirm the nature of the lesion and select the optimal targeted therapy. Education closed this gap with a 53% increase in respondents understanding this need. With respect to maintenance therapies in the different scenarios, there was 22% change in the use of pemetrexed for non-targeted NSCLC and 21% for radiotherapy after progression on crizotinib. Self-reported levels of competence to integrate biomarkers, clinical characteristics and tumor histology to provide an individualized treatment for patients increased after education. At 6-week follow-up the majority of participants reported that they were more likely to order molecular testing (80%), and were better able to select first-line (93%) and second-line therapies (93%). Participants also report increased familiarity with therapeutic options after education. Barriers to implementation included the newness of treatment data and lack of reimbursement.
Conclusion:
The results highlight baseline gaps in clinical practice. Several gaps are closed both in the short-term and the long-term through continuing education. Educational benefits appear to endure to the 6-week time point. Longer term follow-up would benefit CME educational providers and in turn drive more relevant activities that would benefit clinicians and ultimately, their patients.
