Using Continuing Medical Education to Promote Shared Decision-Making in Patients Diagnosed with Multiple Myeloma

• Published in: Blood 2016-12, Vol.128 (22), p.2388-2388
• Main Authors: Tariman, Joseph D., Vahey-Marcello, Krista, Huff, Carol Ann, Kumar, Shaji, Vinther, Angelique, Bowser, Andrew D., Quill, Timothy A, Obholz, Kevin L
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V128.22.2388.2388

Background: The process known as shared decision-making (SDM) helps patients and providers make collaborative health care decisions that consider the available clinical evidence as well as the patient's values and preferences. Engaging the patient's participation in their own medical care is also a pillar of the National Strategy for Quality Improvement in Health Care. However, studies have shown a disconnect between provider perception of their ability to engage patients in their own care and patients' perception that their experiences and preferences are not being considered in the treatment decision-making process. Multiple Myeloma (MM) in particular is a complicated disease to manage with rapidly-evolving data and treatment standards. Treatment guidelines list multiple reasonable treatment options and often do not provide recommendations that are specific for individual patients. Therefore, patient-provider collaboration in treatment decision-making is a particularly important aspect of optimal MM care. This report aims to examine whether continuing medical education (CME) programming can help prepare physicians and other care providers to integrate the latest clinical data as well as the preferences of their patients into the decision-making process. Methods: A CME-certified, video-based educational program was developed and posted on the Clinical Care Options' website on July 16, 2015. The educational program covered SDM concepts along with review of the clinical data and treatment guidelines critical to make optimal treatment decisions for patients with MM. Program participants were asked a series of 3 questions at the start of the program (baseline) and again after program completion (post-education). Data were collected from July 16, 2015 to December 4, 2015 from the 1253 program participants (64% MDs/NPs/PAs, 7% nurses; Figure 1) The impact of the education was calculated and reported as a Cohen's d effect using a matched-pair response comparison (n = 85) from the baseline and post-education questions. Results: At baseline, only 24% of program participants indicated that they would consider patient preferences as part of their decision-making process (Table 1). This significantly increased to 69% (45% improvement; P < .0001) among those that completed the program. The second question exposed program participants to a case vignette that challenged their ability to consider the available data along with patient preferences when making a treatment d