Background: Recent guidance statements recommend the use of direct oral anticoagulants (DOACs) as primary thromboprophylaxis in ambulatory patients with cancer who are starting chemotherapy and in patients with cancer-associated thrombosis (CAT) at low risk of bleeding and no drug-drug interactions. Yet, many clinicians lack knowledge and confidence with integrating DOACs into management strategies for patients with cancer in accordance to guideline recommendations.

Aims: We sought to determine if online continuing medical education (CME) could improve the knowledge and confidence of hematologists/oncologists regarding guideline-directed use of DOACs in the management of CAT.

Methods: This CME intervention comprised of a 30-minute online video-based roundtable discussion among experts in the field of CAT management. Responses to 3 multiple-choice, knowledge questions and 1 self-efficacy, 5-point Likert scale confidence question were analyzed using a repeated pairs pre-/post-assessment study design. A chi-square test (P <.05 is considered significant) assessed pre- to post-activity change. Data were collected December 2019 through February 2020.

Results: In total, 71 hematologists/oncologists were included in this study. Overall, there were knowledge and confidence improvements (reported as relative) seen among participants from pre- to post-assessment:

• 27% (P<.01) improved at identifying appropriate guideline-recommended DOAC therapy for thromboprophylaxis in cancer patients.
• 27% (P<.01) improved at selecting guideline-appropriate treatment options for CAT.
• 44% had an increase in confidence in managing CAT.

Continued educational gaps:

• 25% failed to select guideline-recommended DOAC therapy for thromboprophylaxis in cancer patients. 
• 45% failed to select guideline recommended DOAC therapy for treatment of CAT.
• 66% still remain at only a rating of 1 to 3 on a scale of 1 to 5 in their confidence managing CAT.

Conclusions: This study demonstrates the success of online, CME-accredited, video-based roundtable discussion on significantly improving knowledge and confidence of hematologists/oncologists related to the guideline-recommended use of DOACs in the management of CAT. Continued gaps were identified for future educational targets.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/success-of-online-cme-at-improving-knowledge-and-confidence-around-guideline-directed-management-of-cancer-associated-thrombosis/