Improving Physician-Patient Decision Making for Treatment of Chronic Lymphocytic Leukemia with BTK Inhibition
Authors: Ackbarali Tariqa A , Davids Matthew S. , Turell Wendy , Arnone Maria , Mato Anthony , Koffman Brian , Del Nido Elizabeth A , Jacobson Kim 
Published: February 2021

Educational Need
Advancements in evidence-based treatment strategies with approved BTK inhibitors ibrutinib and acalabrutinib are improving survival of patients with chronic lymphocytic leukemia (CLL). These advances create knowledge and practice gaps as new BTK inhibitors are introduced to the treatment landscape for clinicians and patients. Education is needed to ensure that clinicians can apply current evidence and stratify patients appropriately. As new data emerges regarding long-term adverse events and the relevance of high-risk prognostic features in treatment selection; patient and provider education is warranted for effective integration of BTK inhibitors, evidence-based management strategies, patient understanding of the factors affecting treatment, improving patient-provider communication, and active participation in care decisions.
Educational Initiative
To meet educational needs, an educational initiative was conducted in August 2020 for HCP and patient/caregiver audiences. Both HCP and patient/caregiver programs feature live-virtual programming with interactive faculty panels, live audience polling, pre-education question submission and live Q&A. All education will remain on-demand for 12 months.
HCP Elements
The live-virtual CME program targets hematologic oncologists, hematologists, oncology advanced practice providers, oncology nurses, and other clinicians who manage patients with CLL. Faculty include two hematologists/oncologists with expertise in the management of patients with CLL. As a companion resource to the live CME program, expert clinical perspective was provided in the form of a patient decision library featuring four 15-minute cases from real patients, presented with interview vignettes and a focus on alignment with treatment recommendations.
Patient/Caregiver Elements
The live-virtual patient and caregiver directed program features a three-person panel, including one hematologist/oncologist, one hematology/oncology nurse practitioner, and one CLL patient. The initiative was conducted in partnership with the CLL Society. The full program will be featured online and will be additionally distributed in smaller chapters on social media, including Facebook and YouTube. Patients will also be invited to engage in the patient decision library to hear the stories of the four patients and the expert commentary on treatment decision-making.
Methods and Anticipated Results
Educational impact evaluation data will be collected through a series of surveys administered to learners prior to and following the educational programs. For the HCP program, questions will be designed to evaluate the effects of learner participation on change in knowledge, competence, and clinical practice behavior parameters. For the patient/caregiver program, questions will be designed to evaluate the effects of participation on change in knowledge, empowerment, and health-related behaviors.
Impact, engagement, and attendance data to date will be reported. Some engagement statistics include total learners, target audience learners, average time in session, total in-session polling responses, question count, and total slide downloads. Impact data will be specifically gathered through an activity pretest, posttest (immediately following activity), and a 2-month follow-up posttest. The 2-month follow-up posttest has a strong focus on behavioral impact of the education and will be composed of open- and closed-ended questions. Open-ended qualitative responses will be grouped by theme. McNemar testing will be conducted on responses to knowledge and competence questions that are repeated at 3 timepoints (pre/post/follow-up) to assess statistical significance; effect size (Cohen's D) will also be reported for these questions.

Disclosures
Davids: TG Therapeutics: Consultancy, Research Funding; Verastem: Consultancy, Research Funding; MEI Pharma: Consultancy, Research Funding; Surface Oncology: Research Funding; AstraZeneca: Consultancy, Research Funding; Ascentage Pharma: Consultancy, Research Funding; Adaptive Biotechnologies: Consultancy; AbbVie: Consultancy; Pharmacyclics: Consultancy, Research Funding; Gilead Sciences: Consultancy; Novartis: Consultancy, Research Funding; BeiGene: Consultancy; Celgene: Consultancy; Eli Lilly: Consultancy; Genentech: Consultancy, Research Funding; Janssen: Consultancy; Bristol Myers Squibb: Research Funding; Merck: Consultancy; Research to Practice: Honoraria; Syros Pharmaceuticals: Consultancy; Zentalis: Consultancy; Sunesis: Consultancy. Mato:AstraZeneca: Consultancy, Research Funding; TG Therapeutics: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; Loxo: Consultancy, Research Funding; Adaptive: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Janssen: Consultancy, Research Funding. Koffman:Astra Zeneca: Speakers Bureau; Miragen Therapeutics Inc: Current equity holder in publicly-traded company; Astra Zeneca: Current equity holder in publicly-traded company; Iovance Biotherapeutics: Current equity holder in publicly-traded company; Synairgen Plc: Current equity holder in publicly-traded company; Pfizer: Current equity holder in publicly-traded company; Oncternal Therapeutics Inc: Current equity holder in publicly-traded company; BeiGene: Current equity holder in publicly-traded company; TG Therapeutics: Speakers Bureau; Humanigen: Current equity holder in publicly-traded company; Bristol-Myers Squib: Speakers Bureau; MEI Pharma: Current equity holder in publicly-traded company; Bristol-Myers Squibb: Current equity holder in publicly-traded company; Sunesis Pharmaceuticals: Current equity holder in publicly-traded company; Abbvie: Current equity holder in publicly-traded company; Johnson & Johnson: Current equity holder in publicly-traded company; Verastem Oncology: Current equity holder in publicly-traded company; Inovio Pharmaceuticals Inc: Current equity holder in publicly-traded company.