633 Incorporating checkpoint inhibitors into cancer care: a study of the impact of digital education on clinical competence and practice patterns

BackgroundImmune checkpoint inhibitors have transformed the treatment landscape for a variety of tumors and have significantly improved patient prognosis and longevity. Evolving practice standards for diagnostic testing and extensive emerging clinical trial data have left clinicians challenged to apply newer treatments in practice and manage associated side effects. Additionally, improved patient prognosis has created a greater need for survivorship care plans; clinicians must be able to tailor plans to the needs of patients treated with these agents. Education pertaining to biomarker testing, applications of checkpoint inhibitors, adverse event management, and survivorship care is critical to ability to improve patient experience and quality of life.MethodsA 4-hour CME activity was broadcast live-online in June, July, and August 2020 and remained on-demand through February 2021 at OMedLive.com. The program was provided in partnership with the Society for Immunotherapy in Cancer (SITC). The initiative was divided into themes including biomarker usage for checkpoint inhibitor selection, adverse event management, survivorship care, and use of checkpoint inhibitors and combination therapies in the metastatic setting. Knowledge and competence questions were administered pre-, immediate post-, and 2 mos. post-activity. Behavioral impact questions were also asked at follow-up. Data from these questions were analyzed to determine engagement and clinical impact.ResultsFinal program results from 1,909 learners showed that post-activity engagement resulted in 61% reporting a positive impact on patient experience, and 74% reporting a positive impact on clinical practice, with 179 qualitative write-in examples detailing improvements in diagnosis, use of newer therapies, ability to manage adverse events, and patients' tolerance of treatments. All 14 CME test questions reflected statistically significant improvements on biomarker utility, checkpoint inhibitors, combination therapy applications, adverse event management, and survivorship care, with an average of 15% pre to 2-month follow-up improvement. The overall average effect size from pre- to post-test was d = 1.27, and d = 0.429 for pre- to 2-month follow-up point. Practice pattern questions elucidated preferences for biomarker testing, challenges of integrating immunotherapy, areas of difficulty in survivorship care, and challenges enrolling in clinical trials.ConclusionsThe activity was successful in improving clinician understanding of the use of biomarker testing to determine treatment plans, applications of checkpoint inhibitors and combination therapies, adverse event management, and survivorship care planning. Open-ended responses to behavioral impact questions illustrated clear improvements in clinician-reported patient impacts, including improved psychological tolerance of treatment, quality of life, and overall wellness.

Applying treatment advances in castration-resistant prostate cancer: The influence of serial digital education on the uro-oncology team.

20 Background: Improvements in the understanding of prostate tumor development have spurred advances in biomarker testing and new therapies for prostate cancer, providing clinicians with expanded testing and treatment options. However, these changes have led to competence gaps regarding the use of biomarker testing, integration of PARP inhibitors, application of new data for nmCRPC and mCRPC, and adverse event management. To address these needs, a serial educational initiative was designed for the urology-oncology team. Methods: A 4-part CE activity was launched live-online in December, 2020, and remains on-demand through December, 2021 at UroCareLive.com and OMedLive.com. The activity was launched in partnership with Large Urology Group Practice Association (LUGPA) and included case presentations, live polling, and Q&A. Knowledge and competence questions were administered pre-activity, immediate post-activity, and 2-months post-activity. Patient and clinical practice-impact questions were also asked at the 2-month follow-up. Data from these questions were analyzed to determine engagement and clinical impact. Results: To date, 761 clinicians have participated in the activity. All 12 CE test questions reflected improvements in knowledge and competence, 11 of which were statistically significant. Questions focused on: genomic testing, biomarker analysis, recent clinical trial study results, newly approved therapies, and adverse event management. At 2-mos. follow-up, 70% reported improved behavioral impact on clinical practice and 63% reported impact on patient experience and outcomes. Clinicians provided write-in examples of these changes, illustrating improvements in patient-reported satisfaction, genetic testing, and use of newer therapies, including PARP inhibitors. Practice pattern questions pertaining to biomarker testing and the use of emerging therapies showed the majority of post-program respondents (42%) preferred to utilize blood/serum-based biomarker tests for their patient vs urine- or tissue-based tests. The greatest reported challenges to biomarker testing were affordability (30%) and lack of guideline clarity (23%). The top 2 barriers to adoption of new agents were reported as lack of awareness and lack of experience (32% and 20%, respectively). Conclusions: The activity successfully improved uro-oncology team knowledge of genetic testing and newer therapies to manage castration-resistant prostate cancer. Learners demonstrated significant improvements in competence concerning biomarker testing, treatment personalization, and adverse event management. Open-ended responses to behavioral impact questions illustrated improvements in biomarker usage, application of newer therapies, and confidence in patient counseling regarding treatment options.