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Improving Comprehension of Graft-Versus-Host-Disease for Enhanced Patient Outcomes

Recently, i3 Health provided an educational activity that challenged knowledge gaps experienced by clinicians regarding improved patient outcomes in graft-versus-host disease (GVHD).  

Graft-versus-host disease is a common complication of allogeneic hematopoietic stem cell transplant (HSCT) and a major contributor to morbidity and mortality. Acute GVHD occurs within 100 days of transplant and typically targets the skin, gastrointestinal tract, and liver. Chronic GVHD often presents within the first year following HSCT but may develop in subsequent years. It most commonly affects the skin; however, involvement of other sites such as the liver, gastrointestinal tract, joints, fascia, and lungs can occur alone or concurrently. In recent years, advances in the management of other HSCT-related complications such as cytomegalovirus and invasive fungal infections have led to substantial reductions in mortality. Despite intensive research, GVHD remains a challenge due to its heterogeneity and complex pathogenesis. Due to this, it is imperative that clinicians receive educational opportunities to remain proficient on improving the outcomes of their patients with GVHD.

To address the knowledge gaps experienced by clinicians regarding patient outcomes in GVHD, i3 Health provided a continuing medical education (CME)–/nursing continuing professional development (NCPD)–approved strategy session and podcast activity. Both the strategy session and podcast were made available starting August 22, 2022, and remained available until August 21, 2023. The activity was led by two leading experts in the field of GVHD: Carrie Kitko, MD, an Associate Professor of Pediatrics and Director of the Pediatric Stem Cell Transplantation Program at Vanderbilt University Medical Center; and Shernan Holtan, MD, an Associate Professor of Medicine in the Division of Hematology, Oncology, and Transplantation at the University of Minnesota Medical School.

Between the strategy session and the podcast, a total of 2,338 individuals participated in the activity and 1,110 participants completed the activity for credit. Most learners were registered nurses and physicians, followed by nurse practitioners, advanced practice nurses, physician assistants, and those who chose "other" as their profession.

The baseline data collected revealed knowledge gaps in the following areas: appraising emerging insights into biomarkers for improved diagnosis and therapy selection in GVHD; assessing recent clinical trial findings on the efficacy and safety of emerging therapies for acute and chronic GVHD; and evaluating the implications of recent clinical advances in GVHD for supporting patients and meeting their individual care needs.

Participants of the strategy session were given a matching pretest and posttest at the beginning and end of the activity, respectively, and those who participated in the podcast were given a posttest assessment to evaluate their knowledge gained. The combined posttest assessment revealed a 48% increase in understanding biomarkers for acute GVHD (pretest 24% versus posttest 72%); a 65% increase in understanding the efficacy of ruxolitinib for chronic GVHD (pretest 28% versus posttest 93%); a 54% increase in understanding the treatment of acute GVHD with the combination of abatacept and a calcineurin inhibitor (pretest 44% versus posttest 98%); and a 65% increase in understanding of the reversal of fibrosis in patients with chronic GVHD (pretest 30% versus posttest 95%).

Upon completion of the activity, 88% of participants reported that they felt more confident in treating their patients with GVHD, and 86% reported that they felt that the material presented would be used to improve the outcomes of their patients.

The data revealed by the posttest assessment affirm the effectiveness of online educational content pertaining to the topic of improved outcomes for GVHD. Based on these data, i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide GVHD education on biomarkers for improved diagnosis and therapy selection; recent clinical trial findings on efficacy and safety of emerging therapies; and clinical advances for supporting patients and meeting their individual care needs.

Resources

i3 Health (2023). New opportunities for improved patient outcomes in graft-versus-host-disease: activity outcomes report. Data on file. 


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