Addressing barriers in care management, shared decision-making alignment, and educational needs on novel immunotherapy combinations in melanoma.

Abstract

309 Background: Immunotherapy is being used increasingly to treat patients with locally-advanced unresectable or metastatic melanoma. To optimize patient care, members of the multidisciplinary healthcare team and their patients need up-to-date information about the latest therapies and the myriad factors that can influence outcomes. To assess patient-clinician alignment on perceptions of care, an educational initiative was designed for clinicians and patients/caregivers. Methods: A patient/caregiver educational activity was held in January 2023 in partnership with the Melanoma Research Foundation and remains on-demand at CancerCoachLive.com. An accredited clinician activity was held in February 2023 in collaboration with Partners for Advancing Clinical Education and remains on-demand at OMedLive.com. The Melanoma Action Coalition collaborated on both the patient and clinician activities. Behavioral assessment of preferences, attitudes, and barriers toward managing patients with melanoma were examined throughout the CME and patient/caregiver program. Data from these sessions were analyzed to determine behavioral and/or practice impact. Outcomes from the patient program were analyzed and provided as a supplemental resource for participants in the CME activity. Results: To date, 456 patients and 2,797 clinicians have participated in the educational initiative. Of the patient-reported experiences and preferences: 43% indicated they are under the care of a multidisciplinary team and only 42% were very satisfied with their current treatment regimen. The top two identified barriers in managing melanoma were anxiety about treatment efficacy (33%) and participating in normal activities (25%); these barriers were not aligned with those identified by clinicians. Upon evaluation of confidence in treatment decision-making; 70% of patients were not confident collaborating with their team while 74% of clinicians indicated low confidence in shared decision-making with their patients. At baseline, there was low awareness of safety and efficacy data regarding novel immunotherapy combinations and only 50% were likely to consider administering novel combinations to patients with unresectable locally advanced or metastatic melanoma. Clinicians additionally provided insight into barriers to patient enrollment in clinical trials with lack of trials at their institution being the greatest barrier (56%). Conclusions: Patient and clinician assessments provided an opportunity to determine misalignments in perceptions of barriers and insights into patient care experiences as well as clinician education needs. As novel immunotherapy combinations continue to become available for patients with unresectable melanoma, it is important to increase awareness of the clinical data and foster practical strategies to improve patient-centered care.