• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Outcomes: ASH 2010 (Multiple Myeloma)
 

Outcomes: ASH 2010 (Multiple Myeloma)

on

  • 724 views

Outcomes metrics report for ASH 2010 FSS "Strategies to Maximize Response Rates and Outcomes in Multiple Myeloma"

Outcomes metrics report for ASH 2010 FSS "Strategies to Maximize Response Rates and Outcomes in Multiple Myeloma"

Statistics

Views

Total Views
724
Views on SlideShare
723
Embed Views
1

Actions

Likes
0
Downloads
4
Comments
0

1 Embed 1

http://www.slideshare.net 1

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Outcomes: ASH 2010 (Multiple Myeloma) Outcomes: ASH 2010 (Multiple Myeloma) Document Transcript

    • Strategies to Maximize Response Rates and Outcomes inMultiple Myeloma52nd American Society of Hematology Annual Meeting (ASH) CME SatelliteSymposium Held Friday, December 3, 2010 in Orlando, FloridaA Jointly Sponsored Educational Activity by The Multiple Myeloma Research Foundation, PennState College of Medicine, and Curatio CME InstitutePost-Meeting Metrics ReportMarch 3, 2011©2011 Curatio CME Institute Page 1 of 9
    • OUTCOMES SUMMARY• Participation (Level 1) o 45 participants completed the evaluation (33 physicians and 12 non-physicians). o 50 participants completed the presurvey (32 physicians and 18 non-physicians) and 22 participants completed the postsurvey (14 physicians and 8 non-physicians) resulting in 19 sets of matched pre- and postsurveys (15 physicians and 4 non-physicians).• Satisfaction (Level 2) was very high with participants; write-in responses noted that “the speakers were clear/excellent”• Knowledge (Level 3) was improved pre to post activity• Change in competence (Level 4) was positive based on commitments to change listed by participants. The topics reflecting the most practice changes listed by participants to be implemented as a result of participation in the activity include: o Increased use of RVD in newly diagnosed patients o Use of lenalidomide as post-ASCT maintenance therapy• Change in performance (Level 5; surrogate measure) was improved pre to post activity as evidenced by 30% to 41% of participants increasing their level of confidence in their ability to meet the outlined learning objectivesDemographic Information Approximate Number of number of patients years in per week you Profession Type of practice practice manage with MM: • 88% Physician • 56% Community/private • 24% 0–5 • 11% 0 • 0% Resident/fellow • 0% HMO • 6% 6–10 • 29% 0–5 • 0% Physician • 25% Academic • 24% 11–15 • 24% 6–10 assistant • 6% Hospital • 18% 16–20 • 18% 11–15 • 6% Nurse • 13% Other • 28% >20 • 6% 16–20 • 0% Nurse o Pharma • 12% >20 practitioner o Industry • 6% Other (PharmD)EDUCATIONAL IMPACT SUMMARYUsing Moore’s 2009 Levels of Outcomes-Based CME Evaluation Model* as a guide, Curatio has developedoutcomes tools to measure the degree to which our activities achieved their intended level of outcome. Eachactivity is directly measured for the following criteria: participant’s change in knowledge (Level 3; objectiveand subjective data), change in competence (Level 4; subjective data), change in practice performance(Level 5; subjective data), and change in health status of patients due to changes in practice (Level 6;subjective data). 3–6-Month Presurvey/ Evaluation Postactivity Postsurvey Assessment Outcomes Tool Outcome Level 3–5 3–4 3–6*Moore DE, Green JS, Gallis HA. Achieving Desired Results and Improved Outcomes: Integrating Planning and Assessment Throughout Learning Activities. J Contin Educ Health Prof. 2009;29(1):1-15.©2011 Curatio CME Institute Page 2 of 9
    • We were able to show that the participants of this activity were able to improve their professional practicewith respect to knowledge, competence, and performance (see Table 1).Table 1. Overview of Educational Impact Participant Participant Participant Knowledge Competence Performance Improvements Strength of Evidence Objective Subjective SubjectiveLevel 1: Participation Physicians Non-physicians Participants who claimed credit 33 12Level 2: Participant SatisfactionTo assess the degree to which participants were satisfied with their experience with this activity weevaluated the following areas: • Faculty • Learning objectives • Fair balance and commercial biasAs shown in Table 2, participant satisfaction with this activity was very high.Table 2. Participant Satisfaction Mean Score (5=Excellent; 1=Poor) Ability to convey the Content was fair, Content of subject matter balanced, and free presentation clearly of commercial bias Frontline Treatment in Myeloma Patients Not 4.62 4.57 4.76 Eligible for Stem Cell Transplantation Induction Therapy Prior to 4.74 4.79 4.76 Stem Cell Transplantation in Multiple Myeloma Stem Cell Transplantation for 4.68 4.76 4.76 Myeloma: What Have the Phase 3 Trials Taught Us? Management of Relapsed or 4.74 4.74 4.79 Refractory Multiple Myeloma Management of Multiple 4.67 4.56 4.74 Myeloma–Related Bone Disease Mean Score This activity helped me to achieve the following (5=Strongly agree; 1=Strongly objectives disagree)©2011 Curatio CME Institute Page 3 of 9
    • • Interpret the latest clinical trial data and incorporate current treatment advances to achieve best possible care of 4.51 patients with multiple myeloma • Utilize cytogenetics, fluorescence in situ hybridization (FISH), and gene expression profiling to define patient 4.20 prognosis and risk stratification • Outline a treatment plan to achieve durable complete response and extend survival in high-risk and standard-risk 4.62 myeloma patients • Implement evidence-based strategies to prolong the 4.76 duration of response in patients with multiple myeloma Mean Score (5=Strongly agree; 1=Strongly Rate the extent to which you agree or disagree disagree) I am satisfied with the overall quality of this activity. 4.69 The activity presented scientifically rigorous, unbiased, and 4.77 balanced informationLevel 3: Change in Learning/KnowledgeTo assess a change in participant learning and knowledge we used the following tools: • Multiple choice questions asked in the pre- and postsurvey (objective data) • Evaluation of whether participation affected knowledge/attitudes (subjective data)As shown in Table 3, this activity resulted in a positive change in learner knowledge.Table 3. Change in Learning/Knowledge Pre Post Difference n=19 matched data Post minus Pre (% answered Multiple Choice Questions correctly) Which of the following post-autologous stem cell transplantation (ASCT) maintenance therapies is associated with increases in 70% 87% +17% complete response (CR) rate and progression-free survival (PFS)? THALIDOMIDE, LENALIDOMIDE Which of the following agents has been shown to exhibit an anti- myeloma effect contributing to improvement in overall survival 59% 94% +35% independent of skeletal-related event prevention? ZOLEDRONIC ACID Prior to (ASCT), the achievement of very good partial response (VGPR) or CR is considered a strong predictor of positive outcome. 88% 94% +6% TRUE Primary therapy with novel agents such as MPT, MPV, Ld, in patients who are not eligible for ASCT yields response rates and PFS that are 71% 76% +5% comparable to those achieved with ASCT in younger patients. TRUE Which salvage treatment(s) would you consider for a multiple myeloma patient who had relapsed from frontline therapy and had 81% 100% +19% experienced peripheral neuropathy? LENALIDOMIDE + DEXAMETHASONE & THALIDOMIDE + DEXAMETHASONE Mean Score Rate the extent to which you agree or disagree (5=Strongly agree;©2011 Curatio CME Institute Page 4 of 9
    • 1=Strongly disagree) Participation in this activity changed my knowledge/attitudes 4.33Level 4: Change in CompetenceChange in CompetenceTo assess a change in participant competence we used the following tools: • Evaluation of whether information provided will change clinical practice (subjective data) • On the postsurvey, asked participants to make a commitment to change and list changes they will make post activity (subjective data) • Also on the postsurvey, asked participants to identify any barriers that might prevent them from making changes in their practiceAs shown in Table 4, this activity resulted in a positive change in participant competence; 8 participantscommitted to make at least one specific change in their practice.Table 4. Change in Competence Mean Score (5=Strongly agree; 1=Strongly Rate the extent to which you agree or disagree disagree) I will make a change in my practice as a result of participation in 4.14 this activity Please identify three (3) changes you will implement in your Are there any barriers or problems practice as a result of this activity (based on 8 respondents) that might prevent you from implementing changes in your practice? • Increase use of RVD in myeloma pts (2) • Difficulty obtaining lenalidomide • Start using RVD as induction regimen for lower socioeconomic class of • Use lenalidomide as post-ASCT maintenance therapy (2) pts • Maintenance with lenalidomide • Mediocre research funding • Assess pts risk factors and treatment • Lenalidomide drug program • Consider use of bendamustine in refract/relapsed pts usually involves a lot of paperwork • Development of immunotherapy for myeloma • Time constraints • Discontinue zoledronic acid @ 2 years • Evaluate SCT therapy • Improve outcome allogeneic transplant therapy • Pursue new therapies • RD for pts with neuropathy • Refer pts for clinical trials • Referral to ASCT even if no RR • Treat with bone protecting agents • Watching the progress on new (novel) agentsLevel 5: Change in Practice PerformanceTo assess a change in participant performance we used the following tools: • Perceived importance and self-efficacy questions asked in the pre- and postsurvey (subjective data)As shown in Table 5, participants considered the key educational objectives of this activity to be of greatimportance, but confidence in their own ability to achieve those objectives was at a lower level. Immediatelyafter completing this activity, participants had greater confidence in their abilities. See Appendix for thepotential impact of positive changes in physician performance on patients.©2011 Curatio CME Institute Page 5 of 9
    • Table 5. Perceived Importance and Self-Efficacy Questions Mean Score 5=Very Important/Very Confident; 1=Not Important/Not confident Pre Pre Post Confidence How important is it to be able Importance Confidence Confidence Difference to:/How confident are you in your n=17 Post minus Pre ability to: matched data Interpret the latest clinical trial data and incorporate current treatment advances 4.63 4.19 4.44 +0.25 to achieve best possible care of patients with multiple myeloma Utilize cytogenetics, fluorescence in situ hybridization (FISH), and gene 4.56 4.00 4.38 +0.38 expression profiling to define patient prognosis and risk stratification Outline a treatment plan to achieve durable complete response and extend 4.63 4.19 4.50 +0.31 survival in high-risk and standard-risk myeloma patients Implement evidence-based strategies to prolong the duration of response in 4.75 4.25 4.50 +0.25 patients with multiple myelomaLevel 6: Impact on Patient Health StatusTo assess the impact on patient health status due to practice behavior changes, we will evaluate via ourscheduled follow-up survey (subjective data) whether the identified changes in practice implemented byparticipants has affected the health status of their patients.©2011 Curatio CME Institute Page 6 of 9
    • APPENDIXBased on the data collected from our pre/post survey, we were able to quantify the potential impact ofpositive changes in physician performance on patients based on the self-reported numbers of patients thateach learner revealed was under their care. Pre/Post Change in Confidence in ability to interpret the latest clinical trial data and incorporate current treatment advances to achieve best possible care of patients with multiple myeloma (n=17) 80% 70% 60% 53% These 6 respondents hav e increased their % of respondents 50% confidence. They see a combined total of 35 to 56 pts w ith MM a w eek (self-reported). 40% 30% 24% 20% 12% 10% 6% 6% 0% 0% 0% 0% 0% -4 -3 -2 -1 0 +1 +2 +3 +4 36% of respondents increased their level of confidence rating (n=6) 53% of respondents did not change their confidence rating (n=9) 12% of respondents decreased their level of confidence (n=2)©2011 Curatio CME Institute Page 7 of 9
    • Pre/Post Change in Confidence in ability to utilize cytogenetics, fluorescence in situ hybridization (FISH), and gene expression profiling to define patient prognosis and risk stratification (n=17) 80% 70% 59% These 7 respondents hav e increased their 60% confidence. They see a combined total of 30 % of respondents 50% to 51 pts w ith MM a w eek (self-reported). 40% 35% 30% 20% 10% 6% 0% 0% 0% 0% 0% 0% 0% -4 -3 -2 -1 0 +1 +2 +3 +4 41% of respondents increased their level of confidence rating (n=7) 59% of respondents did not change their confidence rating (n=10) 0% of respondents decreased their level of confidence (n=0) Pre/Post Change in Confidence in ability to outline a treatment plan to achieve durable complete response and extend survival in high-risk and standard-risk myeloma patients (n=17) 80% 70% These 7 respondents hav e increased their 60% confidence. They see a combined total of 20 53% % of respondents to 40 pts w ith MM a w eek (self-reported). 50% 40% 35% 30% 20% 10% 6% 6% 0% 0% 0% 0% 0% 0% -4 -3 -2 -1 0 +1 +2 +3 +4 41% of respondents increased their level of confidence rating (n=7) 53% of respondents did not change their confidence rating (n=9) 6% of respondents decreased their level of confidence (n=1)©2011 Curatio CME Institute Page 8 of 9
    • Pre/Post Change in Confidence in ability to implement evidence-based strategies to prolong the duration of response in patients with multiple myeloma (n=17) 80% 70% 65% 60% % of respondents 50% These 5 respondents hav e increased their confidence. They see a combined total of 19 40% to 35 pts w ith MM a w eek (self-reported). 30% 18% 20% 10% 6% 6% 6% 0% 0% 0% 0% 0% -4 -3 -2 -1 0 +1 +2 +3 +4 30% of respondents increased their level of confidence rating (n=5) 65% of respondents did not change their confidence rating (n=11) 6% of respondents decreased their level of confidence (n=1)©2011 Curatio CME Institute Page 9 of 9