scholarly journals Challenges in Treating Tardive Dyskinesia: Assessing the Impact of Virtual Medical Education

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 165-165
Author(s):  
Amanda Glazar ◽  
Cecilia Peterson ◽  
Michael Lemon ◽  
Chirag Shah ◽  
Prakash Masand
Keyword(s):  
Medical Education ◽  
Tardive Dyskinesia ◽  
Treatment Options ◽  
Respiratory Muscles ◽  
Educational Activity ◽  
Activity Participation ◽  
Chi Square ◽  
Practice Performance ◽  
New Treatments ◽  
The Impact

AbstractIntroductionTardive Dyskinesia (TD) refers to abnormal, involuntary, choreoathetoid movements of the tongue, lips, face, trunk, and extremities and is associated with long-term exposure to dopamine-blocking agents, such as antipsychotic medications. Once established, these movements usually persist. The movements are disfiguring and can bring unwanted attention to affected individuals. When severe, especially if the respiratory muscles are affected, the movements can be disabling, limit activity, and reduce quality of life. The prevalence is 7.2% in individuals on newer antipsychotics who have never been exposed to older neuroleptics. Until recently, there were no effective treatments for TD. In recent years, many new treatments have been investigated for the treatment of TD, including valbenazine, deutetrabenazine, and branched chain amino acids. Valbenazine first, followed by deutetrabenazine are FDA approved to treat TD. A virtual broadcast was developed to assess the ability of continuing medical education (CME) to improve awareness of the recognition and treatment of TD among psychiatrists.MethodsThe virtual broadcast (May 9, 2020) consisted of a two-hour, live-streamed discussion between two expert faculty. Impact of the educational activity was assessed by comparing psychiatrists’ responses to four identical questions presented before and directly after activity participation. A follow-up survey was sent to all participants six-weeks post-activity to measure performance in practice changes. A chi-square test was used to identify significant differences between pre- and post-assessment responses. Cohen’s d was used to calculate the effect size of the virtual broadcast.ResultsActivity participation resulted in a noticeable educational effect among psychiatrists (n=621; d=6.12, P<.001). The following areas showed significant (P<0.05) pre- vs post-educational improvements: recognition of movements in patients with TD, rate of TD in SGA exposed patients, treatment options for TD (on and off-label), and treatment of TD using VMAT inhibitors. Additionally, 54% of psychiatrists reported a change in practice performance as a result of the education received in the activity, including utilization of a standard scale to evaluate movement disorders and educate patients and family members about potential for TD, how to recognize symptoms, and when to treat.ConclusionsThe results indicated that a CME-certified two-hour virtual broadcast was effective at improving knowledge among psychiatrists for the recognition and treatment of TD. This knowledge also resulted in positive changes in practice performance post-activity. Future education should continue to address best practices in the diagnosis, treatment and management of patients with TD, as there remains an increased need for tailored CME among psychiatrists.FundingNeurocrine Biosciences, Inc.

scholarly journals Knowledge of The Recognition and Management of Tardive Dyskinesia Markedly Improved Among Psychiatrists: Assessing the Impact of Online Medical Education

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 153-154
Author(s):  
Thomas Finnegan ◽  
Anjali Mehra ◽  
Jovana Lubarda ◽  
Chirag Shah ◽  
Andrew J. Cutler
Keyword(s):  
Medical Education ◽  
Online Education ◽  
Tardive Dyskinesia ◽  
Prolonged Exposure ◽  
Activity Participation ◽  
Chi Square ◽  
Online Activity ◽  
Chi Square Test ◽  
Future Education ◽  
The Impact

AbstractIntroductionTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotic medications that jeopardizes adherence to treatment and reduces quality of life. The recognition and management of TD can be challenging in many instances. An online activity was developed to assess the ability of continuing medical education (CME) to improve awareness of the recognition and management of TD among psychiatrists.MethodsThe online CME activity consisted of a 30-minute video discussion between three expert faculty. Educational effect was assessed by comparing a matched sample of psychiatrists’ responses to four identical questions pre- and post-activity. A chi-square test identified significant differences between pre- and post-assessment responses. Cramer’s V was used to calculate the effect size of the online education (≥ 0.16 is considerable). Data were collected between June 26 and August 6, 2019.ResultsActivity participation resulted in a considerable educational effect among psychiatrists (n=739; V=0.25, P<0.001). The following areas showed significant (P <0.05) pre- vs post-educational improvements: recognition of incidence of TD associated with different antipsychotic therapies, differentiation of TD from parkinsonism, and the personalized selection of therapies for the management of TD. 37% of psychiatrists had a measurable increase in confidence in understanding the role of the interprofessional team in recognizing TD after activity participation.ConclusionsThe results indicated that a CME-certified 30-minute video activity was effective at improving knowledge among psychiatrists for the recognition and management of TD. Future education should continue to address best practices in the care of patients with TD.FundingNeurocrine Bioscience, Inc

scholarly journals 144 A Clinical Practice Assessment In Tardive Dyskinesia: Are Physicians Up-to-Date?

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 89-90
Author(s):  
Jovana Lubarda ◽  
Stacey Hughes ◽  
Christoph U. Correll
Keyword(s):  
Risk Factors ◽  
Medical Education ◽  
Clinical Practice ◽  
Tardive Dyskinesia ◽  
Continuing Medical Education ◽  
Educational Activity ◽  
List Type ◽  
Current Guideline ◽  
Emerging Treatments ◽  
Practice Assessment

AbstractStudy ObjectivesTo assess physicians’ current knowledge, skills, competence, and practice barriers regarding tardive dyskinesia (TD) and assess continuing medical education (CME) needs.Assessment MethodsA 29-question clinical practice assessment survey instrument consisting of multiple-choice knowledge and case-based questions was administered online to gather abaseline “snapshot” of knowledge, skills, attitudes, and competence on TD epidemiology, risk factors, diagnosis, current guideline-based management, and emerging management strategiesThe survey launched online on a website dedicated to continuous professional development on July 25, 2016, and was made available to healthcare providers without monetary compensation or charge. Data were collected through August 28, 2016Confidentiality was maintained and responses were de-identified and aggregated prior to analysesResultsData were collected for the 1157 psychiatrists and 177 neurologists who responded to all survey questions during the study period. The findings were:∙Epidemiology: 62% of psychiatrists and 68% of neurologists were aware that TD affects approximately 20% of patients treated with neuroleptic agents∙Risk factors: 63% of psychiatrists and 67% of neurologists were aware of risk factors for TD, such as older age∙Diagnosis: 93% of psychiatrists and 71% of neurologists were aware that Abnormal Involuntary Movement Scale (AIMS) can be used to support diagnosis of TD∙Guidelines: 21% of psychiatrists and 11% of neurologists were aware of the American Psychiatric Association guidelines for monitoring of TD, and 56% of psychiatrists and 42% of neurologists were aware of the American Academy of Neurology guidelines on treatment of TDNew/emerging treatments: 24% of psychiatrists and 34% of neurologists were aware of the mechanisms of action of new/emerging treatments for TD, and 54% and 44%, respectively, were aware of the clinical data for valbenazineConclusionsThis educational research yielded important insights into clinical practice gaps in TD, indicating that both psychiatrists and neurologists would benefit from continuing medical education on epidemiology, risk factors, diagnosis, guideline-based care, and information on how to incorporate new/emerging treatments for TD into practice.Funding AcknowledgementsThe educational activity and outcomes measurement were funded through an independent educational grant from Neurocrine Biosciences, Inc.

Pathways to faster access to medicines

2018 ◽  
Vol 56 (8) ◽  
pp. 93-96 ◽  
Keyword(s):  
Treatment Options ◽  
Clinical Trial Data ◽  
Access To Medicines ◽  
Trial Data ◽  
European Medicines Agency ◽  
The European Union ◽  
Life Threatening ◽  
The Uk ◽  
New Treatments ◽  
The Impact

Before a medicine can be marketed in the UK, marketing authorisation approval is needed from the European Medicines Agency (EMA) or the Medicines and Healthcare products Regulatory Agency (MHRA). However, the time it takes to appraise a medicine is considered by some to delay access to new treatments for people with serious or life-threatening conditions who have no other treatment options. Also, the standard regulatory process may be less suitable for medicines for rare conditions in which it is difficult to gather a large amount of clinical trial data. Here we look at a range of new regulatory and access pathways that have been developed to respond to these challenges and consider some of their potential pitfalls. In a future article we will review the impact that the UK’s departure from the European Union (EU) will have on licensing processes.

scholarly journals Using the CTC tool in establishing Mid-Levels of Expanded Outcomes Framework - A CME Provider Perspective

2015 ◽  
Author(s):  
Farhan Vakani, MCPS-HPE, MSc, BDS ◽  
W. Daniel Cogan, EdD, FAODME
Keyword(s):  
Medical Education ◽  
Continuing Medical Education ◽  
Quality Of Healthcare ◽  
Practice Change ◽  
Educational Activity ◽  
Physician Competence ◽  
Provider Perspective ◽  
And Performance ◽  
The Impact

Existing gaps in the quality of healthcare have led to calls for change by Continuing Medical Education (CME) providers around the world to plan and implement continuing medical education activities based on improving physician competence and performance. This article offers the use of the commitment to practice change (CTC) tool at mid-levels of the expanded outcomes framework using post-only design, for inquiring and promoting physicians’ commitment to practice change, and for assessing the impact of the educational activity.

Optimizing management of glioblastoma: Educational impact on clinicians.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11026-11026
Author(s):  
Michelle Arielle Worst ◽  
Ann Carothers ◽  
Kinjal Parikh ◽  
Lisa Brauer ◽  
Giuseppe Lombardi ◽  
...  
Keyword(s):  
Clinical Care ◽  
Statistical Significance ◽  
Treatment Options ◽  
Educational Activity ◽  
Molecular Testing ◽  
Chi Square ◽  
Assessment Scores ◽  
Confidence Assessment ◽  
Investigational Agents ◽  
Post Assessment

11026 Background: Glioblastoma multiforme (GBM) is a rare, malignant tumor of the central nervous system (CNS) with poor prognosis. Nearly all patients experience recurrence due to GBM’s heterogeneity and there is currently no standard approach to treatment. Despite having few targeted agents with demonstrated efficacy, molecular testing is utilized due to its value in improving diagnostic accuracy and prognostic stratification. Moreover, recent data has shown an increase in promising data with regards to treating GBM using various mechanisms. Because of the clinical conundrum GBM poses and the lack of available treatment options, clinicians are challenged to stay current with new data and how best to integrate new agents into treatment paradigms. The objective of this study was to assess the changes in oncologists’ and pathologists’ knowledge through participation in education regarding optimal GBM treatment. Methods: The educational activity was a 30-minute online, video discussion segmented into 3 parts with synchronized slides and 2 faculty. Educational effect was assessed with a repeated pairs pre-/post-assessment study with a 3-item, multiple choice, knowledge questionnaire and one confidence assessment question. For all questions, each participant served as his/her own control. Pre- and post-assessment scores were compared to determine the relative changes in the proportion of correct responses. A chi-square test assessed statistical significance at the P < 0.05 level. The activity launched 26th June 2019; data were collected until 19th August 2019. Results: Overall significant improvements were seen after education for oncologists (N = 62, P < .001) and pathologists (N = 67, P < .01). The relative improvement was 67% for oncologists and 45% for pathologists (pre-/post-assessment average correct response rates were 30%/50% and 29%/42%, respectively). Following the activity, 55% of oncologists and 51% of pathologists had a measurable improvement in confidence in their ability to differentiate among late-stage investigational agents for GBM based on mechanism of action. Conclusions: Participation in an online, CME intervention consisting of a series of video discussions, totaling 30-minutes, resulted in statistically significant improvements in knowledge and confidence of oncologists and pathologists, that may lead to improvements in clinical care. As new data and agents emerge, new educational activities are necessary to reinforce knowledge, close persistent gaps, and increase oncologists’ and pathologists’ confidence in this clinical setting.

scholarly journals 1165 Online CME-Certified Case Challenges Improve Competence for the Diagnosis and Management of Pediatric Narcolepsy Among Pediatricians

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A445-A445
Author(s):  
T Finnegan ◽  
C F Murray ◽  
S Hughes ◽  
K Maski
Keyword(s):  
Educational Intervention ◽  
Treatment Options ◽  
Educational Activity ◽  
Multiple Choice Questions ◽  
Chi Square ◽  
Diagnosis And Management ◽  
Continued Education ◽  
Chi Square Test ◽  
Case Based

Abstract Introduction Narcolepsy is a chronic neurologic sleep disorder that typically starts in childhood. Symptoms of narcolepsy in pediatric patients can differ from adult onset narcolepsy and few treatment options are approved for pediatric narcolepsy. Given the challenges of recognizing the condition in children and selecting an appropriate therapeutic intervention, we investigated whether a case-based educational activity was able to improve the competence of pediatricians to accurately diagnose and manage narcolepsy. Methods An online, text-based educational intervention comprised of 2 patient case scenarios was developed. Using a “test and teach” approach, clinicians were presented with multiple-choice questions to evaluate their application of evidence-based recommendations. Each response was followed by detailed, referenced, feedback to teach. Educational effect was evaluated with a repeated-pairs pre- to post-assessment study design in which each individual learner acts as his/her own control. A chi-square test was utilized to identify whether proportions of correct answers at pre and post were significantly different. Cramer’s V was used to calculate the effect size of the intervention. Data were collected between April 20, 2019 and September 17, 2019. Results The education resulted in an extensive educational effect for pediatricians (n=125; V =.424). Significant improvements were observed in several topics (P &lt;.05 for all comparisons) including: the use of hypocretin cerebrospinal fluid testing as a diagnostic tool for patients with symptoms suggestive of type 1 narcolepsy; appropriate guidance to transition patients with type 1 narcolepsy from one therapeutic regimen to another; and therapeutic selection for a patient with type 2 narcolepsy. Overall, participation in the education resulted in 34% of pediatricians reporting increased confidence in diagnosing and managing sleep disorders in children. Conclusion This study demonstrated the success of a targeted, online, interactive, case-based educational intervention on improving awareness among pediatricians regarding the diagnosis and management of narcolepsy. The results indicated that pediatricians would benefit from continued education on the care of patients with narcolepsy. Support Support for this program came from an unrestricted educational grant from Jazz Pharmaceuticals, Inc.

scholarly journals Caregiver-Reported Burden in RE-KINECT: Data From a Prospective Real-World Tardive Dyskinesia Screening Study

2021 ◽  
pp. 107839032110235
Author(s):  
Andrew J. Cutler ◽  
Stanley N. Caroff ◽  
Caroline M. Tanner ◽  
Huda Shalhoub ◽  
William R. Lenderking ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Real World ◽  
Treatment Options ◽  
Body Region ◽  
Full Time ◽  
Abnormal Involuntary Movements ◽  
Involuntary Movements ◽  
Screening Study ◽  
Part Time ◽  
The Impact

Background: RE-KINECT (NCT03062033), a real-world study of possible tardive dyskinesia (TD) in antipsychotic-treated patients, included a questionnaire to assess the effects of patients’ abnormal involuntary movements on caregivers. Objective: To capture the experiences of caregivers who assisted individuals with abnormal involuntary movements that were confirmed by clinicians as being consistent with TD. Methods: Qualified (nonpaid) caregivers were invited to complete a questionnaire that included the following: caregivers’ sociodemographic characteristics, their perceptions about the impact of abnormal involuntary movements on patients, and the impact of these movements on themselves (caregivers). Results: Of the 41 participating caregivers, 25 (61.0%) were women, 20 (48.8%) were employed full time or part time, and 35 (85.4%) were family members or friends. Based on responses from caregivers who noticed patients’ abnormal involuntary movements and were caring for individuals who also noticed those movements, 48.0% of patients had “a lot” of severity in ≥1 body region and 76.0% had abnormal involuntary movements in ≥2 regions. Caregiver ratings were significantly correlated with patient ratings (but not with clinician ratings) for maximum severity of abnormal involuntary movements and the number of affected regions (both p <.05). Based on their own judgments and perceptions, caregivers reported that the patient’s movements had “some” or “a lot” of impact on their (caregiver’s) ability to continue usual activities (50.0%), be productive (58.3%), socialize (55.6%), or take care of self (50.0%). Conclusion: Caregivers as well as patients are negatively affected by TD, and the impact of TD on caregivers’ lives should be considered when determining treatment options.

scholarly journals FORMATION OF EDUCATIONAL AND COGNITIVE COMPETENCY OF JUNIOR SPECIALISTS IN THE PROCESS OF SELF-EDUCATIONAL ACTIVITY: EXPERIENCIAL ASPECT

2020 ◽  
Vol 73 (12) ◽  
pp. 2657-2663
Author(s):  
Svitlana P. Palamar ◽  
Liudmyla A. Nazarenko ◽  
Halyna O. Vaskivska ◽  
Liudmyla L. Nezhyva ◽  
Nataliya N. Golota ◽  
...  
Keyword(s):  
Medical Education ◽  
Goal Setting ◽  
Educational Process ◽  
Educational Activity ◽  
Cognitive Tasks ◽  
Cognitive Competence ◽  
Cognitive Principles ◽  
Main Component ◽  
The Impact ◽  
Cognitive Competency

The aim: The purpose is to elucidate the methodical system of formation of educational and cognitive competence of students of medical education institutions, the results of the research. Materials and methods: The approbation of the proposed methodology is analyzed, the results of the experiment were clarified. Using the methods of Student’s mathematical statistics, the effectiveness of the methodical system of formation of educational and cognitive competence of students of medical education institutions was determined, the results are reflected in tables and calculations. Results: With the purpose of solving educational and practical, scientific, educational and cognitive tasks, the types of activity of future junior specialists, which differ in the degree of obligatory fulfillment, are distinguished. It is shown that the realization of the cognitive principles of self-educational activity, which students perceive as their own internal need, is of great importance. Conclusions: After investigation of the impact of students’ self-educational activities on the formation of their educational and cognitive competence, we argue that it is the main component of the educational process, which requires a willful effort to overcome difficulties and is implemented through goal-setting, planning and staged implementation.

scholarly journals The Impact of Selected Bacterial Sexually Transmitted Diseases on Pregnancy and Female Fertility

2021 ◽  
Vol 22 (4) ◽  
pp. 2170
Author(s):  
Katarzyna Smolarczyk ◽  
Beata Mlynarczyk-Bonikowska ◽  
Ewa Rudnicka ◽  
Dariusz Szukiewicz ◽  
Blazej Meczekalski ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Treatment Options ◽  
Mycoplasma Genitalium ◽  
Current Treatment ◽  
Female Fertility ◽  
Sexually Transmitted ◽  
Tubal Factor ◽  
Adverse Pregnancy ◽  
New Treatments ◽  
The Impact

Sexually transmitted infections (STIs) caused by Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium are a common cause of pelvic inflammatory disease (PID) which can lead to tubal factor infertility (TFI). TFI is one of the most common causes of infertility, accounting for 30% of female fertility problems. STIs can also have an impact on pregnancy, leading to adverse pregnancy outcomes. Escalating antibiotic resistance in Neisseria gonorrhoeae and Mycoplasma genitalium represents a significant problem and can be therapeutically challenging. We present a comprehensive review of the current treatment options, as well as the molecular approach to this subject. We have given special attention to molecular epidemiology, molecular diagnostics, current and new treatments, and drug resistance.

scholarly journals Rare Lymphoma Cases: Online Education Significantly Improves Hematologist/Oncologist Ability to Personalize Treatment

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 11-12
Author(s):  
Lauren Willis ◽  
Tristin Abair ◽  
Sara R. Fagerlie
Keyword(s):  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Educational Activity ◽  
Activity Participation ◽  
Educational Impact ◽  
Imaging Results ◽  
Mantle Cell ◽  
The Impact ◽  
Post Assessment ◽  
Case Based

Background: Mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL) are rare types of non-Hodgkin lymphoma (NHL). While MZL is generally indolent, MCL often has a more aggressive clinical course and many patients progress after initial treatment. This study was conducted to determine if an online, case-based continuing medical education (CME) intervention could improve skills of hematologists/oncologists (hem/oncs) to personalize treatment for patients with relapsed/refractory (R/R) MCL or R/R MZL. Methods: The format was an online CME-certified text-based activity composed of 2 patient cases with interactive questions on the diagnosis and treatment of rare types of NHL. Evidence-based educational feedback was provided following each response. Three case-based questions were repeated immediately after activity participation and learners had to select treatment for patients based on prior treatment history, imaging results, and lab values. Question 1, 2, and 3 tested hem/oncs ability to select treatment for a patient with R/R MZL, R/R MCL, and R/R MCL, respectively. Additionally, 1 self-efficacy question was also repeated immediately after activity participation. These questions assessed the impact of the education in the form of a repeated pairs pre-assessment/post-assessment study design in which each participant served as his/her own control. Using data from the assessment completers, percentages of correct responses to pre- and post-assessment questions were compared. A chi-square test was used to assess statistical significance of the educational impact, where P &lt; .05 was considered statistically significant. Cramer's V was used to estimate the magnitude of change in the total number of correct responses between the compared test scores, where V &gt;0.26 indicates an extensive educational impact. The activity launched online on January 9, 2020 and data reported were collected through July 9, 2020. Results: At the time of data collection 203 hem/oncs had completed the activity. Of these 104 (57%) were community-based practitioners. Education had an extensive impact (V =.424) and significantly improved hem/oncs competence to select personalized treatment for patients with these rare types of NHL (Figure 1). Table 1 shows the case summary, questions, and answer choices. Conclusions: This online, interactive, case-based CME-certified educational activity led to statistically significant improvements in the clinical competence of hematologists/oncologists regarding personalizing treatment selection for patients with R/R mantle cell or marginal zone lymphoma. The results indicate that unique educational methodologies and platforms, which are available on-demand, can be effective tools for advancing clinical decision making. Additional studies are needed to assess whether improved aptitude translates to improved performance during clinical practice. Acknowledgements: This CME activity was supported by an independent educational grant from Celgene Corporation and Pharmacyclics, Inc. Reference: https://www.medscape.org/viewarticle/923424 Figure 1 Disclosures No relevant conflicts of interest to declare.

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