Abstract Number: PB0670
Meeting: ISTH 2021 Congress
Theme: Hemophilia and Rare Bleeding Disorders » Management of Bleeding and Trauma
Background: Patients who experience oral anticoagulant (OAC)-related major bleeding are not always appropriately managed, resulting in poor outcomes. Clinicians need an update on the most recent reversal recommendations and strategies to appropriately manage OAC-related urgent bleeding.
Aims: We sought to determine if online continuing medical education (CME) could improve the knowledge/competence and confidence of emergency medicine physicians and cardiologists regarding guideline-directed management of OAC-related urgent bleeding.
Methods: This CME intervention comprised of a 30-minute online video-based roundtable discussion among experts in the management of OAC-related major bleeding. Responses to 3 multiple-choice, knowledge/competence 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. Confidence improvement was measured using the percentage of physicians with measurable increases in confidence. Data were collected from September through October 2019.
Results: In total, 369 emergency medicine physicians and 521 cardiologists were included in this study. Overall, there were significant knowledge/competence improvements among participants from pre- to post-assessment.
| Topic | Emergency Medicine Physicians (N = 369) Absolute % improvement (pre-assessment vs post-assessment; P-value) |
Cardiologists (N = 521) Absolute % improvement (pre-assessment vs post-assessment; P-value) |
| Knowledge regarding the burden of OAC-related bleeding in the emergency department setting | 45% (19% pre vs 63% post; P<.001) | 45% (23% pre vs 68% post; P<.001) |
| Competence related to selecting the most appropriate guideline-recommended approach to manage patients with OAC-related urgent bleeding | 16% (57% pre vs 67% post; P<.05) | 23% (51% pre vs 67% post; P<.0001) |
Additionally, 46% of emergency medicine physicians and 48% of cardiologists had a measurable increase in confidence in their ability to manage OAC-related urgent bleeding.
This study also uncovered significant knowledge/competence gaps among physicians, as 33% of emergency medicine physicians and 33% of cardiologists failed to select the appropriate guideline-based approach to manage OAC-related major bleeding and 28% of emergency medicine physicians and 24% of cardiologists still remain at only a rating of 1 to 2 on a scale of 1 to 5 in their confidence managing OAC-related urgent bleeding.
Conclusions: This study demonstrates the success of online, CME-accredited, video-based roundtable discussion on significantly improving knowledge/competence and increasing confidence of emergency medicine physicians and cardiologists related to the guideline-directed management of urgent OAC-related bleeding. Continued educational gaps were identified for future educational targets.
To cite this abstract in AMA style:
Harris M, Spyropoulos J, Carothers A, Padbury C. Success of Online CME at Improving Knowledge, Competence, and Confidence around Guideline-directed Management of Oral Anticoagulant-related Urgent Bleeding [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/success-of-online-cme-at-improving-knowledge-competence-and-confidence-around-guideline-directed-management-of-oral-anticoagulant-related-urgent-bleeding/. Accessed November 29, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/success-of-online-cme-at-improving-knowledge-competence-and-confidence-around-guideline-directed-management-of-oral-anticoagulant-related-urgent-bleeding/