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Accomplishing Knowledge Gains in the Diagnosis and Management of Myelodysplastic Syndromes

A learning opportunity provided by i3 Health has demonstrated significant knowledge gains regarding the latest advances in the treatment of myelodysplastic syndromes. These findings were presented at the 4th Annual Greater Los Angeles Oncology Nursing Society (GLAONS) Oncology Care Summit.

Myelodysplastic syndromes (MDS) are a group of blood cancers characterized by cloning of an abnormal hematopoietic progenitor cell. Myelodysplastic syndromes are diverse and may be characterized by ineffective hematopoiesis, bone marrow disease, and single or multiple cytopenias. MDS has very poor prognosis with a median survival of 5.3 years in lower-risk patients and only 0.8 years in higher-risk categories. In many cases, MDS progresses to acute myeloid leukemia (AML). Because of the heterogeneity of presentation of MDS, and the advanced age and comorbidities of many MDS patients, the diagnosis and appropriate management of MDS are challenging.

To confront the knowledge gaps concerning therapeutic advances in MDS, i3 Health provided an online enduring continuing medical education (CME)- and nursing continuing professional development (NCPD)–approved activity, Virtual Tumor Board: Diagnosis and Management of Myelodysplastic Syndromes. This activity was led by David Steensma, MD, along with Ilene Galinsky, BSN, MSN, ANP-C from the Dana-Farber Cancer Institute and Reza Nejati, MD, Assistant Professor of Pathology from the Fox Chase Cancer Center. Takeda Oncology and Taiho Oncology supported the activity with independent educational grants.

The total number of learners who attended the online activity was 553 with 456 of these learners completing the course for credit. The online activity was available from May 21, 2020 to May 20, 2021. Most learners who participated were registered nurses (83.2%), followed by physicians (8.1%), nurse practitioners (2.7%), physician assistants (0.8%), pharmacists (0.5%), and those who chose "other" as their profession (4.4%). Attendees saw an average of 9.8 patients with MDS per month and had been in practice for an average of 13.7 years.

The baseline data collected, revealed by the pretest scores, demonstrated a shortcoming of knowledge in the following areas: assessing patient and tumor characteristics that can inform personalized care plans for patients with MDS; differentiating emerging data and guideline recommendations on therapeutic approaches for lower-risk, higher-risk, and therapy-related MDS; and evaluating supportive care strategies that can help patients with MDS achieve their goals for therapy. Participants were given an identical pretest and posttest to evaluate knowledge gained throughout the activity.

The activity pretest revealed a shortcoming in knowledge, with 50% of learners being able to identify the most common adverse event associated with deferasirox; only 36% able to determine that luspatercept can help anemic patients with MDS to achieve transfusion independence; 74% identified TP53 mutation as high-risk; 44% able to determine that TP53 mutation can make patients more likely to respond to decitabine; and 49% able to determine that azacitidine or decitabine are appropriate therapies for high-risk MDS in an older patient.

Major knowledge gains took place during the activity as revealed by the posttest: 40% more learners identified diarrhea as a common adverse event associated with deferasirox chelation therapy; 55% more recognized that luspatercept can help anemic patients with lower-risk MDS with ring sideroblasts to achieve transfusion independence; 23% more identified TP53 mutation as high-risk; 49% more were able to determine that TP53 mutation can make patients more likely to respond to decitabine; and 42% more were able to determine that azacitidine or decitabine are appropriate therapies for high-risk MDS in an older patient.

Upon completion of the activity, 84% of learners stated they felt more confident in treating their patients with MDS, and 84% believed that the material presented would be used to improve the outcomes of their patients.

The results revealed by the posttest data confirm the effectiveness of the provided educational content and show the significant increase in learners' knowledge and competence regarding therapeutic advances in MDS. i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide education on the utilization of molecular characteristics to differentiate between subtypes, efficacy and safety data on novel therapies, and strategies to monitor and manage adverse events.

For More Information

i3 Health (2022). Virtual Tumor Board: Diagnosis and Management of Myelodysplastic Syndromes: activity outcomes summary report. Data on file.

Heller EJ, Smith KP & Williams SL (2021). Virtual tumor board improves nurses' knowledge of myelodysplastic syndromes. Presented at: 4th Annual Greater Los Angeles Oncology Nursing Society Oncology Care Summit. 


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