Author of

• 20171

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  P2.07 - Immunology and Immunotherapy (ID 708)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Immunology and Immunotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23411

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    P2.07-036 - Appropriate Use of Immune Checkpoint Inhibitors in Advanced NSCLC: Effectiveness of Unique Case-Based Education on Clinical Decision-Making (ID 9441)

    09:30 - 09:30  |  Author(s): E. Hamarstrom
    • Abstract

    Background:
    The past several years have witnessed unparalleled changes in treatment for patients with advanced NSCLC. Although these changes present significant hope, it remains unclear if oncologists have been able to stay current on the breadth of practice changes, and effectively incorporate evidence-base into practice. The objective of this study was to evaluate oncologists’ competence regarding the use of immune checkpoint inhibitors (ICI) in the management of advanced NSCLC and the impact of education on narrowing gaps in clinical practices.
    
    Method:
    An online education environment that employed video vignettes to simulate practice, presented 3 CME-certified case activities, each illustrating a clinical challenge. Questions regarding point-of-care decisions were posed as a means of testing the oncologist’s ability to make treatment decisions and to communicate effectively with patients who have NSCLC. These case activities included patients with non-squamous and squamous NSCLC and who exhibited adverse events. For each activity, an assessment instrument using case-based, multiple-choice questions was administered to compare each oncologist’a responses to questions posed before and after the education was presented. Confidentiality of respondents was maintained, responses were de-identified, and aggregated prior to analyses. McNemar's χ[2] test compared learners' responses from pre- to post-assessment. The activities were launched between October 21, 2016, and December 6, 2016, and data were collected through April 26, 2017.
    
    Result:
    2,399 oncologists participated in at least one of the 3 activities. Responses of 325 participants who answered all questions during the study period were included. Upon completion of the activities, an improvement was observed in oncologists’ ability to: Identify the correct evidence-based regimen including when to use ICIs for a patient that has progressed on first line therapy (76% vs 98%, P <0.001) Counsel patients on the expected effectiveness of ICI in patients (69% vs 89%, P <0.001) Select the most appropriate monitoring strategy to detect immune-related adverse events in patients receiving an ICI (52% vs 78%, P <0.001) Order appropriate tests to identify the etiology of symptoms that appear during treatment (60% vs 92%, P <0.001) Properly manage immune-related adverse events due to treatment with ICI (67% at baseline to 88% post education, P =0.001) In addition, comfort with prescribing ICIs also increased.
    
    Conclusion:
    Use of online, case-based CME utilizing video vignettes to simulate practice improved competence among participating oncologists, demonstrating that online CME can be an effective tool to improve clinical decision-making in the rapidly changing environment of advanced NSCLC disease management.