The Effects of CME on the Ability of the Interprofessional Hematology/Oncology Care Team to Treat Patients with Multiple Myeloma

Background: The treatment paradigm for multiple myeloma (MM) has been evolving rapidly. There are currently many available treatment options for patients with newly diagnosed and relapsed/refractory (R/R) MM, and the options continue to expand with new therapies, indications and regimens entering the market. Being aware of new and emerging data associated with treatment options for MM is key to the effective integration and sequencing of new therapeutic approaches.[Murray 2014] Additionally, a majority of cancer care in the United States is provided in community-based settings by clinicians who are responsible for treating various types of malignancies and are generally not MM specialists.[COA2017] This makes it challenging for the community-based MM interprofessional care team to stay up to date in this rapidly evolving treatment area.

Methods: The educational analysis consisted of 5 online, CME-certified activities.[Medscape2021] Educational impact was assessed with repeated pre-/post-education including multiple choice knowledge/competence questions and 5-point Likert scale confidence questions. Data from hematologists/oncologists (heme/oncs), nurses, nurse practitioners (NPs), pharmacists, and other members of the MM care team who completed pre- and/or post-education assessments were analyzed. Heme/oncs' pre-/post-education assessment data was aggregated across activities and stratified by both learning theme and learning objective. Absolute changes in percentage of correct responses and clinicians who were confident (value of 4 or 5) were used to measure improvement in knowledge, competence, and confidence. A McNemar's test assessed significant levels of changes reported with P values < .05 considered statistically significant. The activities in this series launched January 2, 2021 through November 12, 2021, with each activity being available to learners for 1-year from launch date; data were collected through June 2022.

Results: Multiple questions were used to aggregate data by theme and learning objective across the 5 activities. Overall, absolute change in knowledge and competence stratified by learning theme for heme/oncs were statistically significant (N range from 60-258; P<.001)(Table 1). Moreover, improvements in absolute change in heme/oncs knowledge by individual learning objective were also observed (Table 1). Heme/oncs demonstrated improvements in knowledge of newly approved therapies, selecting and sequencing R/R MM therapies, and adverse events of MM therapies. 90% of overall learners experienced an improvement in or reinforcement of knowledge/competence from CME, which translated to significant improvements in confidence after education (P<.001). Heme/oncs, nurse/NP, and pharmacist learners also demonstrated improvements in knowledge related specifically to identifying the correct indication for an agent, mitigating health inequities for Black patients, and selecting appropriate MM treatment.

Conclusions: A curriculum-based approach was successful in improving knowledge, competence, and confidence of the MM care team and their ability to equitably personalize care for patients as part of the interprofessional care team. These results show the ability of education to translate to improvements in clinical care for patients with MM. Continued curricula-based education can serve as a comprehensive means to further increase clinicians' abilities in this clinical setting and optimize patient outcomes.

Acknowledgements: These CME activities were supported through independent educational grants from (listed alphabetically) AbbVie, Amgen Biotech Inc, Bristol Myers Squibb, GlaxoSmithKline, Janssen Pharmaceuticals Inc, Karyopharm Therapeutics, Oncopeptides, Sanofi Genzyme, Takeda Pharmaceuticals USA Inc.

References: Murray ME, Gavile CM, Nair JR, et al. CD28-mediated pro-survival signaling induces chemotherapeutic resistance in multiple myeloma. Blood. 2014;123:3770-3779.

Community Oncology Alliance (COA). FACT sheet: what is community oncology? Published 2017. Accessed July 26, 2021. https://www.communityoncology.org/wp-content/uploads/2017/08/What-is-Comm-Onc.pdf

Medscape. Clinical Advances in Multiple Myeloma: Staying Abreast of Best Practices Across the Clinical Continuum. Available at: https://www.medscape.org/sites/advances/multiple-myeloma.

Mikhael:Janssen: Consultancy; Karyopharm Therapeutics: Consultancy; Sanofi: Consultancy; Takeda: Consultancy; GlaxoSmithKline: Consultancy; Amgen: Consultancy; BMS: Consultancy.