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Increasing Knowledge to Improve Patient Outcomes in Multiple Myeloma

Recently, i3 Health provided an educational activity that has challenged knowledge gaps experienced by clinicians regarding practice-changing strategies for improved patient outcomes in multiple myeloma.  

Multiple myeloma is a B-cell neoplasm characterized by aberrant expansion of plasma cells within the bone marrow and extramedullary sites. Approximately 35,780 new cases of multiple myeloma are expected to occur in the United States this year, and around 12,540 people are likely to die of the disease. Although the tumor cells remain primarily within the bone marrow, they can cause several complications, including localized bone destruction, anemia, decreased immunity to infection, and kidney damage. Multiple myeloma is primarily considered a disease of older adults, with a median age at diagnosis of 65 years. Early diagnosis is difficult because symptoms often do not appear until the malignancy is in advanced stages. Due to this, it is imperative that the multidisciplinary cancer care team receive educational opportunities to stay up to date with the rapidly evolving treatment field for multiple myeloma.

To address the knowledge gaps experienced by clinicians regarding practice-changing strategies to improve outcomes in multiple myeloma, i3 Health provided a continuing medical education (CME)-approved two-part enduring strategy session, as well as two live webinars. Part one addressed practice-changing strategies in newly diagnosed multiple myeloma, and part two addressed strategies in relapsed/refractory multiple myeloma.

The live webinars were held on January 11 and 18, 2022. The two-part enduring strategy session was made available February 1, 2022, until January 31, 2023. Both sessions were led by key leaders in the field of multiple myeloma: Sarah Holstein, MD, PhD, an Associate Professor in the Division of Oncology and Hematology at the University of Nebraska Medical Center; and Ashley Rosko, MD, an Associate Professor at The James Comprehensive Cancer Center at The Ohio State University.

Between the enduring activities and the live webinars, there were 1,543 cumulative learners, with 953 participants completing the activities for credit. Most learners were registered nurses and physicians, followed by advanced practice nurses, physician assistants, clinical nurse specialists, pharmacists, and those who chose "other" as their profession. Among those who completed the activity for credit, the average number of patients with multiple myeloma seen per month was 11 and the average number of years in practice was 14.

The baseline data collected revealed knowledge gaps in the following areas: assessing factors that classify patients as high-risk in multiple myeloma development and progression; appraising emerging efficacy and safety data on novel combination therapies for newly diagnosed multiple myeloma in transplant-eligible and transplant-ineligible patients; developing strategies for maintenance therapy that incorporate emerging data; differentiating biochemical versus clinical relapse and indications for the treatment of multiple myeloma progression; appraising emerging efficacy and safety data on novel therapies for early relapse in patients with multiple myeloma; and appraising emerging efficacy and safety data on novel therapies for late relapse in patients with multiple myeloma.

Participants were given a matching pretest and posttest at the beginning and end of each activity, respectively. The posttest assessments for part one and two revealed statistically significant knowledge gains respective to each question and learning objective.

Part one's posttest assessment produced a 73% increase in understanding high-risk disease features in multiple myeloma (pretest 15% versus posttest 88%); a 47% increase in understanding the efficacy of consolidation with autologous stem cell transplant (ASCT) (pretest 46% versus posttest 93%); a 66% increase in understanding adverse events with KR (carfilzomib/lenalidomide) maintenance (pretest 19% versus posttest 85%); a 64% increase in understanding the efficacy of quadruplet versus triplet regimens in high-risk multiple myeloma (pretest 27% versus posttest 91%); and a 20% increase in understanding the efficacy of daratumumab in addition to Rd (lenalidomide/dexamethasone) in transplant-ineligible patients (pretest 75% versus posttest 95%).

Part two's posttest assessment produced a 51% increase in understanding treatment indications for biochemical relapse (pretest 42% versus posttest 93%); a 60% increase in understanding the efficacy of venetoclax plus Vd (bortezomib/dexamethasone) for relapsed multiple myeloma (pretest 29% versus posttest 89%); a 56% increase in understanding the efficacy of sequential treatment with bispecific antibodies (pretest 35% versus posttest 91%); a 72% increase in understanding adverse event monitoring for belantamab mafodotin (pretest 17% versus posttest 89%); and a 15% increase in understanding the risk of cytokine release syndrome (CRS) with bispecific antibodies and chimeric antigen receptor (CAR) T-cell therapy (pretest 80% versus posttest 95%).

Upon completion of the activity, 84% of participants reported that they felt more confident in treating their patients with multiple myeloma, and 85% 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 practice-changing strategies for improved patient outcomes in multiple myeloma. Based on these data, i3 Health has determined that the multidisciplinary team may benefit from CME activities that provide multiple myeloma education on factors for classifying patients as high-risk for development and progression; emerging efficacy and safety data on novel combination therapies for newly diagnosed transplant-eligible and transplant-ineligible patients; strategies for maintenance therapy that incorporate emerging data; differentiation of biochemical versus chemical relapse and indications for treatment of progression; and emerging efficacy and safety data on novel therapies for early and late relapse.

Resources

i3 Health (2023). Expert perspectives on practice-changing strategies for improved patient outcomes in multiple myeloma: activity outcomes report. Data on file.

American Cancer Society (2024). Multiple myeloma. Available at: https://www.cancer.org/cancer/types/multiple-myeloma.html


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