Education, Research, and Quality Improvement: Education and Quality Improvement |

Improving Guideline-Recommended VTE Treatment: Effect of Online CMR FREE TO VIEW

Jelena Spyropoulos
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Medscape LLC, New York, NY

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A230. doi:10.1016/j.chest.2016.02.239
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SESSION TITLE: Education and Quality Improvement

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Guideline recommendations for the use of anticoagulant therapy in patients with venous thromboembolism (VTE) are not routinely incorporated into practice. This study was conducted to determine if an online, case-based continuing medical education (CME) intervention could improve performance of cardiologists and primary care physicians (PCPs) in managing patients with VTE.

METHODS: An online case-based CME activity was developed on the application of clinical guidelines for treatment of VTE. The effects of education were assessed using a linked pre-assessment/post-assessment study design. For all questions combined, the McNemar’s chi-square test was used to assess differences from pre- to post-assessment. P values are shown as a measure of significance; P values <.05 are statistically significant. Cohen’s d was used to calculate the effect size (>0.8 are large, 0.8-0.4 are medium, and <0.4 are small).

RESULTS: Comparison of individually linked pre-assessment question responses to the post-assessment question responses demonstrates statistically significant improvements for both cardiologists (n = 245; P <.05; d= 1.167) and PCPs (n = 460; P <.05; d= 1.08). While only 29 (12%) of cardiologists and 75 (16%) of PCPs answered all 4 questions correctly on the pre-assessment, 168 (69%) and 294 (64%) answered them all correctly on the post-assessment: - 143% increase for cardiologists and a 115% increase for PCPs in identifying the appropriate parenteral anticoagulant for the treatment of incidental PE in a patient with metastatic colon cancer - 32% increase for cardiologists and a 44% increase for PCPs in recognizing guideline recommendations for the treatment of patients with intermediate-high risk PE - 93% increase for cardiologists and a 64% in identifying and appropriate management strategy for a patients with provoked PE Education gaps were identified in the areas of recognizing management approaches for patients with intermediate to high risk PE and in appropriate duration of anticoagulant therapy.

CONCLUSIONS: The statistically significant improvements observed in this online CME activity demonstrate the benefits of using wide-reaching, case-based educational design to improve competence and performance of different specialty groups involved in management of patients with VTE.

CLINICAL IMPLICATIONS: This study also suggests that this type of CME intervention can translate into improvements in guideline-recommended care for patients with VTE.

DISCLOSURE: The following authors have nothing to disclose: Jelena Spyropoulos

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