Investigative Ophthalmology & Visual Science Cover Image for Volume 59, Issue 9
July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Factors to consider before switching anti-VEGF treatments in neovascular age-related macular degeneration (nAMD): Effect of online education on physician knowledge and confidence
Author Affiliations & Notes
  • Siggi D Trier
    Medical Education, Medscape LLC, New York, New York, United States
  • Anat Loewenstein
    Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel
  • Deborah Middleton
    Medical Education, Medscape LLC, New York, New York, United States
  • Peter Schoonheim
    Medical Education, Medscape LLC, New York, New York, United States
  • Footnotes
    Commercial Relationships   Siggi Trier, None; Anat Loewenstein, Allergan (C), Bayer (C), For Sight Lab (C), Notal Vision (C), Novartis/Alcon (C); Deborah Middleton, None; Peter Schoonheim, None
  • Footnotes
    Support  Medical education outcome study developed through an independent educational grant from Novartis
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 806. doi:
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      Siggi D Trier, Anat Loewenstein, Deborah Middleton, Peter Schoonheim; Factors to consider before switching anti-VEGF treatments in neovascular age-related macular degeneration (nAMD): Effect of online education on physician knowledge and confidence. Invest. Ophthalmol. Vis. Sci. 2018;59(9):806.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine if online medical education for ophthalmologists (Opht) and primary care physicians (PCPs) could improve their knowledge and confidence when considering switching anti-VEGF agents in treating nAMD and to identify remaining knowledge gaps.

Methods : Participants completed a 3-item, multiple-choice knowledge and competence questionnaire plus a confidence assessment before and after viewing a 30-minute online video panel discussion with synchronized slides. A repeated pair study design was used pre-/post-assessment, with scores compared to assess changes in the proportion of correct responses. A χi-squared test assessed statistical significance (P <.05 level). Launch Dec 16, 2016; data through Jan 25, 2017.

Results : At baseline, 37% of Opht (n=212) and 23% of PCPs (n=57) answered all 3 questions correctly, increasing to 65% (P < 0.001) and 37% on post-assessment. An average of 75% (range 42% to 95%) of Opht and 63% (range 35% to 81%) of PCPs selected the best response on pre-assessment, increasing to 86% (range 70% to 94%) and 69% (range 56% to 79%) on post-assessment. The activity reinforced knowledge among Opht and PCPs of the appropriate setting for switching anti-VEGF agents in patients treated for nAMD, and the findings of real-world switching studies. Significant improvements in knowledge of real-world patient outcomes were also achieved by Opht (P <.05). Knowledge of tachyphylaxis in the context of nAMD, and its relationship to injection frequency and changes in the underlying disease, significantly improved from pre- to post-assessment in both Opht and PCPs (P <.05). Following the education, 44% of both Opht and PCPs reported being more confident; 26% of Opht put themselves in the top tier of confidence on the sliding scale.

Conclusions : Participation in online medical education consisting of a 30-minute video panel discussion with synchronized slides resulted in improvement in knowledge of switching anti-VEGF therapies in nAMD for Opht and PCPs. The activity was confidence-building for both specialties, particularly Opht, a large proportion of whom engage in anti-VEGF switch therapy in their practices. Additional education is warranted to improve familiarity with switching criteria, better utilize real-world evidence and further understand the implications of tachyphylaxis in the context of nAMD.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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