Is increase in CME consumption associated with practice change in the real world? An empirical study among oncologists treating breast cancer.

Abstract

e23284 Background: Online medical information is important for oncologists to stay current in practice. A worldwide survey of oncologists (n = 57; 54% US) showed 92% look online to inform care for ≥30% of their patients. We hypothesized that oncologists who increase breast cancer continuing medical education (CME) consumption after exposure to our CME intervention would be more likely to change practice than those who did not. Methods: This secondary analysis leveraged oncologist data reflecting changes in real-world claims for evidence- and biology-based treatment selection for patients with early breast cancer 1-month post-participation in a CME intervention. The 9 CME activities posted from Oct to Dec 2023. 1,921 oncologists participated in at least 1 activity from Nov to Dec 2023 and had at least 1 patient eligible for biology-based treatment in the pre and post periods. Oncologists who changed practice were defined as those who had a higher proportion of patients receiving biology-based treatment in the 1-month post- versus pre-participation. Page views (PVs) in breast cancer on a large online educational news, reference, and CME platform were examined for the 6 months pre- and post-participation. Average PVs were calculated for both periods. Logistic regression assessed the hypothesis, with practice change as the dependent variable, and increase in CME with controls for increases in news and reference as independent variables. Results: CME learners who increased CME PVs had a 2.52 greater odds of changing treatment decisions in the real world 1 month post-intervention (Exp ( B ) = 0.926, CI [1.925, 3.111], P < .001). Increasing breast cancer reference PVs also was a positive predictor of practice change, but the effect size was smaller (Exp ( B ) = 0.355, CI [1.128, 1.802], P < .01, OR 1.43). Conclusions: Oncologists who update treatment decisions to be more evidence-based tend to exhibit increased CME and reference breast cancer content consumption. This correlation suggests increased CME engagement on a specific topic may indicate a shift in clinical practice, or that oncologists who alter approaches are more inclined to seek updated information. Limitations of the study include not taking into account other online sources of information and its associative nature, as increases in PVs were observed over 6 months, while practice changes were assessed within a 1-month pre/post period. Additionally, the study did not evaluate the depth of activity engagement. Future research should adopt a time series analysis approach and differentiate number of activities and depth within an activity. Average pageviews (PVs) pre and post breast cancer content type given initial intervention exposure date for oncologists who changed practice versus those who did not. Change Practice (n=358) Do Not Change Practice (n=1563) PVs pre PVs post PVs pre PVs post CME 8 15 8 9 News 7 9 7 10 Reference 5 6 4 4