Effect of Continuing Education on Guideline-Based Treatment of Patients with Retinal Diseases: A VISION RELIEF Study

Abstract

Purpose : To analyze change in evidence-based use of anti-vascular endothelial growth factor (VEGF) agents among learners in in VISION RELIEF, a continuing education (CE) initiative.

Methods : Med Learning Group (MLG) conducted 9 live/livestream and 10 online CE programs in 2021 as part of its multi-year VISION RELIEF educational initiative, focusing on timely diagnosis of diabetic retinopathy, age-related macular degeneration, retinal vein occlusion and the appropriate application of anti-VEGF agents for these retinal diseases. Learners in each activity completed pre-/post-tests utilizing knowledge- and case-based questions, with access to the VISION RELIEF website containing supplementary educational tools. MLG provided identifying data on 9,789 retina specialists and ophthalmologists to IQVIA, who then compared 7,827 of these learners to non-learners as a matched pair control. Control match criteria included geography, specialty, new injections with VEGF inhibitors as well as overall treating decile (how many times a learner has prescribed a therapy for a retinal disease), and anti-VEGF agent treating decile (how many times a learner has prescribed an anti-VEGF agent). IQVIA analyzed pre- and post-educational prescription and raw claims data to identify the change in application of recommended VEGF inhibitors among learners versus control.

Results : Among learners who completed both pre-and post-tests, there was a 30% competence gain in ability to appropriately identify patients who would benefit from anti-VEGF agents (N=3,285). Learners demonstrated increased appropriate application of anti-VEGF agents in practice, with incremental total injections for anti-VEGF agents increasing significantly among learners compared to control in 2021 (P=0.0001). Among learners, there were 18,513 incremental new injections; applying the IQVIA refill ratio of 6.86 yields incremental 126,999 total injections annually. The greatest change was among learners who were previously not using injections and were low to medium treaters.

Conclusions : There is under-treatment with anti-VEGF agents in real-world compared to pivotal clinical trials, resulting in less vision gain. Learners in the VISION RELIEF initiative meaningfully enhanced their use of evidence-based anti-VEGF agents post-education compared to a carefully matched control, demonstrating that CE can positively impact real-world medical practice.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.