Addressing Knowledge Gaps in Acute Myeloid Leukemia to Improve Referral for Hematopoietic Cell Transplantation Consultation
| Autor: | Christa Meyer, Elizabeth Murphy, Ellen M. Denzen, Darlene Haven, Lih-Wen Mau, Ellyce Hayes, Jaime M. Preussler, Linda J. Burns, Heather Moore, Jackie Foster |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Health Knowledge Attitudes Practice medicine.medical_specialty Myeloid Referral Health Personnel MEDLINE Disease 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Practice Patterns Physicians' Child Referral and Consultation business.industry Hematopoietic Stem Cell Transplantation Attendance Focus group Transplantation Leukemia Myeloid Acute medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Needs assessment Clinical Competence business Needs Assessment 030215 immunology |
| Zdroj: | Journal of the National Comprehensive Cancer Network. 17:1473-1481 |
| ISSN: | 1540-1413 1540-1405 |
| DOI: | 10.6004/jnccn.2019.7327 |
| Popis: | Background: Outcomes after hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML) are better when HCT is performed during first complete remission (CR1). This study aimed to identify and address knowledge gaps that affect the timely referral of patients for HCT consultation. Methods: A mixed-methods educational needs assessment included a national survey and focus groups consisting of hematologists/oncologists. An educational intervention of 3 webinars addressed identified knowledge gaps. Results: A total of 150 hematologists/oncologists were recruited for the survey, of whom 20 participated in focus groups. Physicians in practice 0 to 10 years were 4.2 times more likely to refer for HCT consultation in CR1 than those with >10 years in practice (P=.0027). Physicians seeing ≤10 patients with AML in the past year were 3.7 times more likely to refer for HCT consultation in CR1 than those seeing >10 patients (P=.0028). Knowledge gaps included (1) improper classification of molecular/cytogenetic results for risk stratification, (2) lack of understanding that disease stage impacts outcomes, and (3) use of chronologic age alone for referral decision-making. Combined attendance for the webinars was 1,098 clinicians; >74% of participants indicated that they would apply the knowledge they gained in clinical practice. Trends were observed toward improvement in identifying favorable-risk AML, from 48% to 60% (n=85; P=.12); improvement in identifying 2 poor-risk cytogenetic/molecular abnormalities, with the percentage of respondents indicating chromosome 7 deletion increasing from 51% to 70% (n=53; P=.05) and that of respondents indicating TP53 mutation increasing from 42% to 62% (n=62; P=.03); and improvement in identifying which patients with AML aged >60 years were most likely to benefit from HCT based on cytogenetic/molecular features, with the percentage of correct responses increasing from 66% to 81% (n=62; P=.07). Conclusions: The webinars met the educational needs of learners and improved knowledge gaps. This study provided novel insights into the learning needs of clinicians who care for patients with AML and a roadmap for future educational interventions. |
| Databáze: | OpenAIRE |
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