Abstract 250: Antiplatelet Therapy in Post-Acute Coronary Syndrome: Effect of Education on Physician Knowledge and Competence

Abstract

Background: Decreasing hospital readmission rates resulting from suboptimal antiplatelet therapy requires education to diminish an gap in physician knowledge/competence. We sought to determine if online medical education could improve clinical knowledge/competence regarding dual antiplatelet therapy (DAPT) in post-acute coronary syndrome (ACS) patients among non-United States (US) cardiologists. Methods: The educational activity was a 30-minute online video discussion between 4 experts with synchronized slides. Educational effect was assessed using a 4-question repeated pairs pre-/post-assessment and McNemar’s chi-squared test. P values are shown as a measure of significance; P values <.05 are statistically significant. Cramer’s V statistic indicated the effect size (<0.05 no effect; 0.06-0.15 small effect, 0.16-0.30 medium effect, >0.30 large effect). The activity launched August 23, 2016; data were collected through December 20, 2016. Results: 117 non-US cardiologists completed the study. The change in correct responses from pre- to post-assessment achieved statistical significance (P<.05) for 2 of 3 questions. An average of 26% of cardiologists selected the best response at pre-assessment (range, 9% to 38%); this figure improved to an average of 35% at post-assessment (range, 22% to 55%). Specific improvements were observed in the following areas: The relationship between platelet reactivity and stent thrombosis with DAPT post-drug eluting stent implantation (90% improvement, 29%pre vs 55%post, P = <.001) Optimal treatment strategy with adenosine diphosphate platelet receptor (P2Y12) inhibition in patients with unstable angina or non-ST segment myocardial infarction (144% improvement, 9%pre vs 22%post, P =.007) Conclusion: Participation in a 30-minute online video discussion with synchronized slides resulted in statistically significant improvement in non-US cardiologists’ knowledge and competence regarding DAPT in patients with post-ACS.