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Closing Nurses’ Knowledge Gaps Regarding Treatment of Castration-Resistant Prostate Cancer

An educational live and enduring activity provided by i3 Health has demonstrated knowledge gains and learning outcomes for nurses treating patients with castration-resistant prostate cancer (CRPC).

Prostate cancer is the most common tumor type in men, affecting one in eight men in the United States. The estimate for 2022 is expecting 268,490 new cases of prostate cancer, with 34,500 of those cases resulting in death. The typical treatment for progressive prostate disease is androgen deprivation therapy (ADT); however, it is common for prostate cancer to become castration-resistant or resistant to ADT. The transition from castration-sensitive to castration-resistant disease has yet to be understood. Nonmetastatic CRPC is a highly heterogeneous disease process with a lack of effective treatment options. The median overall survival remains less than 2 years.

To address the knowledge gaps regarding the treatment of individuals with CRPC, i3 Health provided a nursing continuing professional development (NCPD)–approved live, virtual, and enduring educational activity, Enhancing Treatment Experiences in Castration-Resistant Prostate Cancer: The Nurse's View, led by Brenda Martone, MSN, ANP-BC, AOCNP®, Nurse Practitioner at Northwestern Medicine; Theresa Gillespie, PhD, MA, BSN, Professor of Medicine at Emory University School of Medicine; and Kathleen Burns, NP, Professor of Pathology at Harvard Medical School. This activity saw support from Bayer Healthcare Pharmaceuticals and Sanofi/Genzyme.

The combined total of learners who attended the live and online enduring activity was 497, with 433 of those learners completing the course for credit. The live activity was offered 12 times between December 5, 2019, and May 20, 2021, while the online enduring activity was made available from December 16, 2019, to December 15, 2020. Most learners who participated were registered nurses (92.6%), followed by nurse practitioners (3.2%), clinical nurse specialists (0.4%), and those who chose "other" as their career (3.8%). Attendees had been in their practice for an average of 28.1 years and saw an average of 9.8 patients with CRPC per month.

The baseline data collected, revealed by the pretest scores, revealed a shortcoming of knowledge in the following areas: identifying patient and tumor characteristics that can tailor CRPC treatment plans to individual patients, distinguishing the safety and efficacy profiles of novel therapies for nonmetastatic and metastatic CRPC, and applying strategies to manage adverse events associated with novel therapies for nonmetastatic and metastatic CRPC. Participants were given an identical pretest and posttest to evaluate knowledge gained throughout the activity.

Prior to the start of the activity, the pretest revealed that only 47% of learners successfully identified that observation should not be used on a patient with CRPC and a prostate-specific antigen doubling time (PSADT) of less than 10 months; only 22% were successful in identifying 40.4 months as the expected metastasis-free survival of a patient with nonmetastatic CRPC who receives darolutamide; 57% were able to identify fatigue and asthenic conditions as the most likely adverse events for the patient receiving darolutamide; only 31% were successful in establishing that a patient treated with radium-223 should have their treatment discontinued if their hematologic values do not recover within eight weeks; and 35% of learners successfully identified that there is not a significant increase in overall survival whether a patient is treated with cabazitaxel or docetaxel.

Significant learning took place during the activity, with major knowledge gains being made within each key learning objective as revealed by the posttest data: 42% more learners successfully identified the correct use of observation for a patient with a PSADT of less than 10 months; 60% more learners were successful when identifying darolutamide efficacy; 34% more learners successfully identified the most common adverse events from treatment with darolutamide; 63% more learners successfully identified the correct radium-223 adverse event management; and 54% more learners successfully identified the efficacy between the use of cabazitaxel or docetaxel.

Upon completion of the activity, 89% of learners reported that they felt more confident in treating their patients with CRPC, and 86% felt that the material provided would be useful to improve the outcomes of their patients.

The data revealed by the posttest assessment affirm the effectiveness of the educational content and show significant gains in knowledge and proficiency regarding strategies for the optimization of treatment for patients with CRPC. i3 Health has determined that the multidisciplinary team may benefit from continuing medical education (CME)/NCPD activities that provide education regarding strategies to tailor treatment to individual patients, novel therapeutic options, and management of adverse events.

References

i3 Health (2021). Enhancing treatment experiences in castration-resistant prostate cancer: the nurse's view: activity outcomes report. Data on file.

American Cancer Society (2022). Key statistics for prostate cancer. Available at: https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html


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