Continuing Medical Education and Patient Education on Follicular Lymphoma: Changes in Clinician Practice, Patient Behaviors, and Knowledge across Clinicians and Patients

BACKGROUND: Recent advances on follicular lymphoma (FL) have led to significant changes in disease management. Healthcare providers (HCPs) and their patients face multiple challenges, from treatment initiation, to navigating, selecting and sequencing treatment options while balancing the efficacy and toxicities of available options in the first‐line setting and beyond. To address these needs, in partnership with the Leukemia & Lymphoma Society, we created and measured the impact of continuing medical education (CME) to HCPs and healthcare education directed to patients.

METHODS: A 1-hour online video-based CME activity for HCPs and 1-hour healthcare education activity for patients were created in 2018 to address identified practice and knowledge needs among HCPs, and knowledge, communication and self-efficacy behaviors among patients. Each activity consisted of slides, polling and live questions, and were broadcast live and on-demand for 6 months at www.OMedLive.com for HCPs, and CancerCoachLive.com, www.LLS.org and Facebook Video for patients. Test questions were administered at 3 time points (pre-, immediate post-, and 2 mos. post-activity). Data from these test questions, responses to live polling questions, and learner-submitted questions during live Q&A were analyzed to determine engagement, lessons learned and continuing education gaps.

RESULTS: As of July 2019, 655 HCPs and 12,198 patients took part in the activities. HCPs reported the activity had a positive impact on patient clinical outcomes (58%) and clinical experience (60%). Significant gains in knowledge/competence were observed in 4 of 8 comparisons (avg. pre-post gain 40.75%, avg. Cohen's d effect size .789) on: immunotherapy, clinical trial data, treatment initiation, and disease progression with immunochemotherapy. With patient learners, 47% reported improved communication with their healthcare providers, 49% increased feeling in control of health care decisions, 40% improved their health-related behaviors, and 17% improved engagement in shared decision making. Significant gains in knowledge were observed in 3 of 8 comparisons (avg. pre-post gain 19.25%, avg. Cohen's d effect size .298) on: treatment for untreated advanced-stage FL, and steps to improve patient care.

CONCLUSIONS: CME and patient education can yield gains in clinical practice behaviors, patient healthcare communication and self-efficacy, and treatment knowledge of FL. Together, aligned education directed to HCPs and patients can improve the ability to provide individualized treatment for patients. Continuing education for HCPs is advised on prognostic factors and initial treatment choice for untreated advanced stage FL, post-induction and management strategies for early relapse, emerging agents for FL, and balancing patient desire for therapy where observation is still viable option. For patients, further education is recommended on elements of disease monitoring, pharmacologic and non-pharmacologic treatment options for FL, side effects of therapy, strategies to address relapse, benefits of shared decision-making, and access to specialists and support groups.