S3203 Patient Outcomes in IBD: Assessing the Effects of a CME Program and Quality Improvement Activity

Abstract

INTRODUCTION: The management of IBD has improved with the availability of new therapies. These treatments can lead to immune suppression, resulting in increased risk of infection. Many of these infections are preventable with immunizations. Despite the effectiveness of vaccines in preventing these diseases, many patients with IBD are not receiving immunizations in accordance with recommendations of the ACG and ACIP. METHODS: This education teamed a panel of gastroenterologists with PCPs to address best practices in vaccinations, preventative care, and treating patients in coordinated, patient-centered care in IBD. The activity included a quality improvement component for learners (n = 25) to review their patient charts at baseline and post-education for: vaccination documentation/completion rates, rates of screening for comorbidities, and quality of life. Methods for this study included: • Live 90-min CME/CE panel discussion + enduring webcast. • Quality Improvement project with learners. • Quantitative and qualitative data collection and analysis. • Predictive modeling analysis. RESULTS: Increased knowledge: • 59% regarding pneumococcal vaccine schedules for patients with IBD. • 48% about ACG Clinical Guidelines for Preventive Care in IBD. • 56% identifying the impact of the IBD medical home on patients with IBD. Quality Improvement: Learners (n = 25) submitted data from a total of 250 patient charts. Improvements were noted in all areas surveyed for: influenza and pneumococcal vaccination, herpes zoster vaccination, mental health, melanoma and non-melanoma skin cancer, cervical cancer, bone health, and smoking cessation. PredictCME: All else being equal, a clinician’s IBD patient load and not any other education or demographic element predicts appropriate vaccine recommendation and understanding of the role of the IBD medical home. Clinicians who have fewer patients with IBD may be more likely to follow these guidelines to preventive health potentially due to their ability to pay more attention to these patients. CONCLUSION: Overall, learners are 7% more knowledgeable than non-learner controls. The high performance of controls is likely associated with a higher number of gastroenterologists in the control survey compared to the learner survey represented by subscribers that included gastroenterologists and primary care clinicians. While knowledgeable, controls lacked confidence in their abilities. Further education on implementing guidelines will improve confidence and adoption of appropriate guidelines.Figure 1.: Quality Improvement data: Clinicians improved their screening for vaccinations, mental health, cancer, and bone health while also improving upon counseling patients for smoking cessation.