Improving Guideline-Recommended Management of Iron Deficiency in Patients with CHF: An Online Educational Intervention

Abstract

BackgroundIron deficiency (ID), independent of anemia is a common co-morbidity present in patients with chronic heart failure (CHF). However, routine screening of ID, independent of anemia in patients with CHF is lacking in clinical practice worldwide despite guideline-recommendations, and, as a consequence, many patients who develop ID are not optimally managed.PurposeTo determine if an online continuing professional development (CPD) intervention could improve knowledge/competence and confidence of cardiologists and primary care physicians related to guideline-recommended diagnosis and management of iron deficiency in the setting of CHF.MethodsCardiologists and primary care physicians electively participated in a 30-minute, video-based activity comprising of 5 mini lectures with synchronized slides by expert faculty on evidence-based diagnosis and treatment of iron deficiency. The effects of education were assessed using a repeated pair, pre-assessment/post-assessment study design. For all questions combined, a chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. Cramer's V was used to assess level of educational effect. The activity launched on March 1, 2019 and data were collected through March 25, 2019.ResultsOverall significant improvements were seen after education for both cardiologists (N=285; P <.001; considerable educational effect, V=.245) and primary care physicians (N=309; P <.001; extensive educational effect, V=.324). Pre-assessment, the average correct response rate was 65% for cardiologists increasing to 86% post-assessment, and 50% for primary care physicians, increasing to 81%. Significant improvements were observed in cardiologists’ and primary care physicians’ knowledge and competence related to the guideline-recommended treatment of ID in the setting of CHF (Table).As a result of the education, 34% of cardiologists and 41% of primary care physicians reported greater confidence in ability to effectively treat ID at the earliest opportunity in patients with CHF.ConclusionThe statistically significant improvements observed in this intervention demonstrate the benefits of using video-based mini lectures with slides to increase knowledge, competence and confidence of cardiologists and primary care physicians and suggest that this type of intervention has the potential to positively impact recognition and guideline-recommended treatment of ID in patients with CHF. Iron deficiency (ID), independent of anemia is a common co-morbidity present in patients with chronic heart failure (CHF). However, routine screening of ID, independent of anemia in patients with CHF is lacking in clinical practice worldwide despite guideline-recommendations, and, as a consequence, many patients who develop ID are not optimally managed. To determine if an online continuing professional development (CPD) intervention could improve knowledge/competence and confidence of cardiologists and primary care physicians related to guideline-recommended diagnosis and management of iron deficiency in the setting of CHF. Cardiologists and primary care physicians electively participated in a 30-minute, video-based activity comprising of 5 mini lectures with synchronized slides by expert faculty on evidence-based diagnosis and treatment of iron deficiency. The effects of education were assessed using a repeated pair, pre-assessment/post-assessment study design. For all questions combined, a chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. Cramer's V was used to assess level of educational effect. The activity launched on March 1, 2019 and data were collected through March 25, 2019. Overall significant improvements were seen after education for both cardiologists (N=285; P <.001; considerable educational effect, V=.245) and primary care physicians (N=309; P <.001; extensive educational effect, V=.324). Pre-assessment, the average correct response rate was 65% for cardiologists increasing to 86% post-assessment, and 50% for primary care physicians, increasing to 81%. Significant improvements were observed in cardiologists’ and primary care physicians’ knowledge and competence related to the guideline-recommended treatment of ID in the setting of CHF (Table). As a result of the education, 34% of cardiologists and 41% of primary care physicians reported greater confidence in ability to effectively treat ID at the earliest opportunity in patients with CHF. The statistically significant improvements observed in this intervention demonstrate the benefits of using video-based mini lectures with slides to increase knowledge, competence and confidence of cardiologists and primary care physicians and suggest that this type of intervention has the potential to positively impact recognition and guideline-recommended treatment of ID in patients with CHF.