Bcma-directed therapy in multiple myeloma: Effect of online education on clinician knowledge and confidence
Authors: A. Taylor, S. Koekkoek, J. Vandenbroucque, R. Popat
Journal: HemaSphere (2021)

Background: BCMA-directed modalities including CAR T-cell therapy, bispecific antibodies and antibody-directed cytotoxic agents are potentially transformative next steps in managing patients with multiple myeloma. However, beyond expert centres physicians have little experience of such agents to date. Aims: This study aimed to determine whether online continuing medical education could improve the knowledge and confidence of clinicians in their understanding of the rationale for and clinical aspects of different BCMA-directed therapies Methods: Three educational activities were launched for physicians outside the USA during 2020 to a target audience of hematologist/oncologists and ophthalmologists. Activities comprised a 30-minute video lecture, a 15-minute video collegial discussion, and a 30-minute online video panel discussion. Data were collected March to June 2020. For each activity educational effect was assessed with repeated-pairs pre-/ post-activity, where individual participants served as their own control. 3 multiple-choice, knowledge questions and 1 self-efficacy, 5-point Likert scale confidence question were analyzed. Data were subsequently combined and analyzed to provide a summative overview of the effect of the education across the combined knowledge-based learning objectives and confidence questions from the three programs. A McNemar's test was conducted to assess statistical significance of changes from pre- to post-assessment. Results: Between 66 and 103 hematologist/oncologists (combined total n=259) and 39-41 ophthalmologists (combined total n=121) completed pre- and post-activity questions. A statistically significant effect was observed for hematologist/oncologists across all 3 learning objectives (P<0.05-P<0.001) with a relative improvement in % of correct responses ranging from 10-44%. Furthermore, there was an overall improvement in confidence, with a 72% gain in confidence in those reporting increased confidence. The education had less impact on ophthalmologists;while some improvements were noted in individual activities, in the summative overview the greatest improvement was noted in knowledge of AEs associated with BCMA-directed therapies. The summative overview revealed that hematologists/oncologists demonstrated improvements in knowledge across the 3 learning objectives: 10% (P<0.05) regarding rationale and types of BCMA-directed therapies, 44% (P<0.001) regarding AEs associated with BCMAdirected therapies, and 29% (P<0.001) regarding BCMA clinical trials data. Ophthalmologists showed knowledge changes of -2% (NS) regarding knowledge of clinical data and the rationale and type of BCMA-directed therapy, and a 41% (P<0.05) improvement in knowledge of BMCA-therapy associated AEs. In combined self-assessed confidence questions, 51% of hematologist/oncologists had a measurable increase in and 46% maintained confidence. Thirty-three percent of ophthalmologists had a measurable increase in and 59% maintained confidence. All changes in confidence were significant (P<0.01 or P<0.001). At the individual activity level, ~50% of all participants stated that they would modify treatment plans and ~90% were committed to those changes. Summary/Conclusion: These three educational activities resulted in a considerable educational impact, particularly for hematologist/oncologists. Online medical education is valuable in improving knowledge and confidence, as well as identifying areas of continued educational need and potentially improving patient outcomes, of particular importance during the COVID-19 pandemic where in-person conference learning is inaccessible.