Abstract: FR-PO071
Effect of CME on Nephrologists' Knowledge and Confidence Related to Management of Hepatorenal Syndrome Type 1
Session Information
- AKI: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Larkin, Amy, Medscape Education, Nicholasville, Kentucky, United States
- Blatherwick, Donald, Medscape, Medford, New Jersey, United States
- Boutsalis, George, Medscape, Medford, New Jersey, United States
- Velez, Juan Carlos Q., Ochsner Clinic Foundation, New Orleans, Louisiana, United States
Background
As emerging therapies hold promise to improve management of hepatorenal syndrome type 1 (HRS-1), clinicians are in need of improved understanding of these therapies and the current management of HRS. We sought to determine if online continuing medical education (CME) could improve the clinical knowledge and confidence of nephrologist in HRS.
Methods
The online CME activity consisted of a video-based roundtable discussion with leading faculty in the area of HRS-1. The educational effects were assessed using a repeated pairs pre-assessment/post-assessment study design, where individual participants served as his/her own control. For all questions combined, the chi-squared test assessed whether there was improvement in the proportion of participants who answered questions correctly at post as compared to pre. P values <.05 are statistically significant. Cramer's V was used to calculate the effect size (0.06-0.15 is a noticeable effect, 0.16-0.26 considerable, and >0.26 extensive). The activities launched between December 4, 2018 and data were collected through February 14, 2019.
Results
Improved knowledge and confidence was demonstrated among nephrologists:
Overall, the effect of the education was considerable (V=.153, P<.001, N=115)
21% demonstrated improved identification of predictors of death or renal replacement therapy in patients with liver disease and stage 3 acute kidney injury (P<.05, V=.139)
21% demonstrated improved related to timing of dosage adjustment of terlipressin (P=.0727, V=.118)
36% demonstrated improved recognition of the goal of initial vasopressor therapy in HRS-1 (P<.001, V=.330)
38% reported increased confidence in their ability to appropriately diagnosis HRS-1
Persistent knowledge/competence gaps remain:
46% incorrectly identified predictors of death or renal replacement therapy in patients with liver disease and stage 3 acute kidney injury
30% did not understand timing of dosage adjustment of terlipressin
23% failed to recognize of the goal of initial vasopressor therapy in HRS-1
Conclusion
This study demonstrates the success of an online, video-based CME activity on improving knowledge and confidence of nephrologists related to current and emerging treatment for HRS-1. Continued knowledge gaps were identified for future educational targets.
Funding
- Commercial Support – Developed through an independent educational grant from Mallinckrodt