AB1339 ONLINE CME IMPROVES ADOPTION OF JAK INHIBITORS IN CLINICAL PRACTICE BY RHEUMATOLOGISTS

Abstract

Background: The treatment landscape for RA is evolving rapidly. The JAK inhibitors are oral small molecules that have recently been approved for use in RA. Objectives: This online CME-accredited educational activity was designed to address the challenges of integrating JAK inhibitors into clinical practice in RA and measure changes in practice Methods: Non-US rheumatologists, dermatologists and primary care physicians (PCPs) participated in an online activity consisting of a 30-minute video roundtable discussion between 4 experts, with synchronized slides, posted online on August 25 2017. A Planned Change Assessment (PCA) survey (data collected through April 3 2018) with qualitative follow-up interviews was used to measure intent to change and actual change in clinical practice following participation in the activity. A 2-question PCA survey in multiple choice format, which was administered immediately following the activity, asked: What will you do differently in your practice as a result of participating in this activity? What do you perceive as barriers to making the above selected changes in your practice? A follow-up survey sent out approximately 8 weeks later included questions about completed changes and barriers to change. Finally, qualitative telephone interviews were conducted to ask learners why certain changes were selected, whether the changes were made and barriers to making the changes. Results: 287 non–US physicians completed the initial PCA survey and 44 completed a follow–up assessment approximately 8 weeks later, resulting in a matched subset of 37 learners. Qualitative interviews were conducted with 13 learners 274 learners (96%) indicated that they intended to make a change as a result of participating in the activity with most learners selecting multiple changes The most common intended changes for rheumatologists were using a JAK inhibitor for the first time (65%) and selecting a JAK inhibitor when oral dosing is preferred (54%) Other than systems barriers such as reimbursement and lack of availability of JAK inhibitors, the most common anticipated barriers to change for rheumatologists related to lack of knowledge about MOA and safety, and lack of confidence in their use 44 learners completed the follow–up assessment: 42 (96%) reported making changes in their clinical practice o For rheumatologists, the most common actual changes were using a JAK inhibitor first–line (55%) and considering a JAK inhibitor when oral dosing is preferred (54%) At follow–up the key barriers reported by rheumatologists related to systems barriers/availability and lack of confidence in using JAK inhibitors Conclusion: Learners in this activity reported increased knowledge about new treatment options for RA and the MOA of JAK inhibitors. The PCA assessment showed that the activity was most effective at prompting rheumatologists to more frequently consider using a JAK inhibitor as a first-line treatment in appropriate patients. Use of new therapeutics, however, may be challenging due to lack of availability of JAK inhibitors in many countries and financial burdens in others. Further education would help rheumatologists to gain confidence in using JAK inhibitors, overcome knowledge gaps, and meet challenges related to lack of access to JAK inhibitors. Disclosure of Interests: None declared