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Confronting Educational Needs in Treatment of Myelofibrosis

An educational live and enduring activity provided by i3 Health has demonstrated significant learning outcomes for the management and treatment of patients with myelofibrosis.

Myelofibrosis, considered a form of chronic leukemia, is a rare type of myeloproliferative neoplasm. An estimated one-third of individuals who have myelofibrosis will not show any symptoms in the early stages of the disorder, which can last many years. However, as the disease develops, they will begin to exhibit symptoms such as anemia, pale skin, enlarged spleen, portal hypertension, and other conditions. In addition, approximately 12% of all cases will progress to acute myeloid leukemia, where the 5-year overall survival rate is only 27%. Therefore, timely and optimal management is necessary.

To address the knowledge gaps surrounding the management and treatment of myelofibrosis, a continuing medical education (CME)–approved activity, New Clinical Perspectives in the Management of Myelofibrosis, was provided. The activity was chaired by Srdan Verstovsek, MD, PhD, Professor of Medicine at MD Anderson Cancer Center, with live meetings presented by Ruben A. Mesa, MD, FACP, Professor of Medicine at University of Texas Health, San Antonio, and Raajit Rampal MD, PhD, Clinical Director of the Leukemia Service at Memorial Sloan Kettering Cancer Center, with commercial support from Celgene and Incyte.

A total of 467 learners participated in the activity, with 276 completing the activity for credit. The live activity consisted of 10 in-person or virtual meetings that took place between October 23, 2019, and November 16, 2021, and the enduring activity was available online from October 1, 2019 to September 30, 2020. Most learners were registered nurses (50.1%) and physicians (30.8%), followed by nurse practitioners (3.7%), pharmacists (0.5%), physician assistants (1.0%), and those who chose "other" as their profession (13.9%). Attendees saw an average of 203 patients weekly with myelofibrosis.

The baseline data collected demonstrated a significant shortcoming of knowledge in the management and treatment of myelofibrosis, including proficiency of treatment selection for intermediate- and high-risk myelofibrosis, clinical trial selection for high-risk myelofibrosis, assessing predictive and prognostic markers to inform personalized care planning, applying emerging data to improve survival and quality of life of patients, and understanding the clinical implications of research advancements in myelofibrosis. Participants in both the live and enduring activities were given a matching pretest and posttest assessment to gauge the learning gaps and knowledge gains during the activity.

Prior to the start of the live meetings, 65.7% of learners correctly identified CALR-positive primary myelofibrosis (PMF) as good prognosis; 79.1% were successful in acknowledging ruxolitinib as the best intervention for a patient with high-risk myelofibrosis; 36.4% of learners identified that intermediate-1­–risk PMF treated with ruxolitinib does not cause a greater likelihood of experiencing 3/4 anemia; 64.6% were successful in indicating that 400 mg of fedratinib has a 30% response rate in reducing spleen volume upon failure of ruxolitinib; and 46.9% of learners were correct in identifying that sotatercept has a higher degree of efficacy as a monotherapy for patients with high-risk myelofibrosis.

Significant learning and knowledge gains were revealed in the live activity posttest data, including a 17.6% increase in knowledge for learners in identifying the better treatment selection for a patient with high-risk myelofibrosis; an 18.7% increase in knowledge regarding the better treatment selection for intermediate-risk myelofibrosis; and a 12.8% increase of knowledge regarding the better clinical trial selection for high-risk myelofibrosis. A significant learning increase was not observed in the other categories.

Prior to the start of the online enduring activity, the pretest data revealed that 69.7% of learners were correct in identifying predictive markers for myelofibrosis; 46.3% correctly identified the better treatment plan for high-risk myelofibrosis; 19.7% successfully identified the safety of ruxolitinib for treatment of myelofibrosis; 54.4% were correct when indicating treatment selection for intermediate-risk myelofibrosis; and 62.7% correctly identified the best clinical trial selection for high-risk myelofibrosis.

The online enduring activity saw even more significant knowledge gains with a 28.4% increase in knowledge regarding predictive markers for myelofibrosis; a 47.9% increase in knowledge regarding treatment selection for high-risk myelofibrosis; a 64.9% increase in knowledge regarding the safety of ruxolitinib for treatment of myelofibrosis; a 39.8% increase in knowledge regarding treatment selection for intermediate-risk myelofibrosis; and a 31.9% increase in knowledge regarding clinical trial selection for high-risk myelofibrosis.

Upon completion of the activity, 87.5% of participants felt more confident in treating their patients with myelofibrosis, and 87.5% felt the material presented would be used to improve the outcomes of their patients with myelofibrosis.

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 strategies for the treatment of myelofibrosis. i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide education of the management and treatment of myelofibrosis on the following topics: assessing predictive and prognostic markers that can inform personalized care planning, applying emerging data to improve survival and quality of life, and understanding the clinical implications of research advances in myelofibrosis.

References

I3 Health (2022). New Clinical Perspectives in the Management of Myelofibrosis: activity outcomes summary report. Data on file.

Cleveland Clinic (2022). Myelofibrosis. Available at: https://my.clevelandclinic.org/health/diseases/15672-myelofibrosis


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