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Abstract: SA-PO917

CKD-Related Hyperkalemia: Effectiveness of Online Medical Education on Clinical Decision-Making

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Gitzinger, Susan, Medscape, Lexington, Kentucky, United States
  • Badal, Karen, WebMD, New York, New York, United States
  • Blatherwick, Donald, Medscape, Lexington, Kentucky, United States
Background

Inhibition of the renin-angiotensin-aldosterone system (RAAS) has become a cornerstone of evidence-based therapies in chronic kidney disease (CKD), diabetes, and heart failure. Despite this, RAAS inhibitors remain widely underutilized in current clinical practice. We sought to determine if participating in a case-based online educational intervention related to CKD management improves clinical decision-making of nephrologists and cardiologists in the United States.

Methods

An interactive, case-based, online CME activity was developed. The educational effects were assessed using a repeated pairs pre-assessment/post-assessment study design. For all questions combined, the McNemar’s chi-squared test assessed whether the mean post-assessment score differed from the mean pre-assessment score. P values are shown as a measure of significance; P values <.05 are statistically significant. Cramer's V was used to calculate the effect size (0.06-0.15 is a small effect, 0.16-0.30 medium, and >0.30 large). The activity launched on December 19, 2016, and data were collected through January 24, 2017.

Results

Improved clinical-decision making was seen among nephrologists (n = 130) and cardiologists (n = 107) pre- to post-assessment in (all P<.001):
Causes of CKD progression in individual patients (nephrologists: 73% to 92%, V=0.242; cardiologists: 53% to 81%, V=0.299)
Optimization of RAAS inhibitors in CKD (nephrologists: 55% to 87%, V=0.355; cardiologists: 55% to 79%, V=0.259)
Alternative options for management of hyperkalemia and safe polypharmacy in patients requiring maximization of RAAS inhibition (nephrologists: 64% to 83%, V=0.218; cardiologists: 43% to 68%, V=0.254)

Conclusion

Participation in this interactive, case-based, online CME activity resulted in improved clinical decision-making by nephrologists and cardiologists in the management of patients with CKD particularly in regard to safe and appropriate maximization of RAAS inhibition. Significant improvements were seen in considering causes for CKD progression, the importance of effective RAAS inhibition and RAAS inhibitor maximization, and alternative management strategies in patients with hyperkalemia.

Funding

  • Commercial Support