Optimizing evidence-based, patient-centered care in bladder cancer in community-based settings: A Project ECHO initiative.

Abstract

e16607 Background: There has been a significant shift in the treatment landscape for bladder cancer (BC) with the incorporation of immunotherapy (IO) into perioperative management of muscle-invasive bladder cancer (MIBC) and the adoption of IO-combination regimens for locally advanced/metastatic BC. Appropriate integration of this evolving evidence into clinical practice is crucial to optimize outcomes. Implementation of multidisciplinary care models is also vital to advance equitable, high-quality BC care for all patients, regardless of geographic location. Methods: The Extension for Community Healthcare Outcomes (Project ECHO) model was used to provide expert support to 72 rural community healthcare professionals (HCPs) managing BC at 8 rural US clinics. This program utilized real-world, case-based live interactive educational sessions led by an academic BC expert oncologist to deliver actionable, patient-centric, and evidence-based management strategies, emphasizing effective care coordination and shared decision-making. Pre- and post-activity surveys measured the impact on knowledge, confidence, and competence. In addition, 90-day follow-up surveys will assess performance. Results: Top HCP-reported barriers in incorporating evidence-based strategies for pts with BC included keeping up with FDA approvals and guidelines (47%) , selecting therapies based on individual and disease factors (42%) , and lack of resources for care coordination (25%) . During the sessions, the expert addressed questions from rural HCPs on collaborating with academic practices and urologists for intravesical therapy, strategies to improve rural patients' access to subspecialists for assistance with adverse event (AE) management, and engaging oncology nurses in managing AEs and providing comprehensive patient support. Following the sessions, HCPs demonstrated increases in confidence (41%), knowledge (75%), and competence (89%), as measured by responses to pre- and post-intervention questions, focused on their ability to identify and apply outcomes from key trials to effectively individualize treatment selection. Additionally, HCPs identified their top two priorities for improvement: increasing patient education to raise awareness of disease and treatment-related AE (65%) and educating team members on evidence-based treatment selection (50%). Conclusions: Project ECHO-based education resulted in a measurable impact on knowledge, competence, and confidence of HCPs and identified actionable strategies to advance evidence-based treatment and AE management for patients with BC. Full findings will detail long-term impacts on practice and inform future community-based ECHO initiatives This approach offers a scalable framework for implementation in oncology clinics across the US, supporting improved care delivery in underserved settings.