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影响复发/难治性慢性淋巴细胞白血病和套细胞淋巴瘤治疗决策的知识、技能和信心差距:法国、德国和美国的定量调查研究。

Knowledge, skills, and confidence gaps impacting treatment decision making in relapsed/refractory chronic lymphocytic leukemia and mantle cell lymphoma: a quantitative survey study in France, Germany, and the United States.

机构信息

AXDEV Group Inc, Brossard, QC, Canada.

Université Sorbonne Paris Nord, Bobigny, France.

出版信息

BMC Cancer. 2024 Aug 13;24(1):1003. doi: 10.1186/s12885-024-12745-1.


DOI:10.1186/s12885-024-12745-1
PMID:39138575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11321192/
Abstract

BACKGROUND: With recent advancements in the treatment of chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), healthcare specialists may face challenges making treatment and management decisions based on latest evidence for the optimal care of patients with these conditions. This study aimed to identify specific knowledge, skills, and confidence gaps impacting the treatment of CLL and MCL, to inform future educational activities. METHODS: Hematologists and hemato-oncologists (HCPs, n = 224) from France (academic settings), Germany, and the United States (academic and community settings) responded to a 15-minute quantitative needs assessment survey that measured perceived knowledge, skills, and confidence levels regarding different aspects of treatment and management of CLL and MCL patients, as well as clinical case questions. Descriptive statistics (cross tabulations) and Chi-square tests were conducted. RESULTS: Four areas of educational need were identified: (1) sub-optimal knowledge of treatment guidelines; (2) sub-optimal knowledge of molecular testing to inform CLL/MCL treatment decisions; (3) sub-optimal skills when making treatment decisions according to patient profile (co-morbidities, molecular testing results); and (4) challenges balancing the risk of toxicities with benefits of treatment. Over one-third of the respondents reported skill gaps when selecting suitable treatment options and prescribing therapies and reported a lack in confidence to initiate and manage treatment. Larger gaps in knowledge of guidelines and skills in patient assessment were identified in MCL, compared to CLL. CONCLUSIONS: This study suggests the need for continuing medical education specifically to improve knowledge of treatment guidelines, and to assist clinicians in developing skills and confidence when faced with clinical decision-making scenarios of patients with specific comorbidities and/or molecular test results, for example, through case-based learning activities.

摘要

背景:随着慢性淋巴细胞白血病(CLL)和套细胞淋巴瘤(MCL)治疗的最新进展,医疗保健专家在为这些疾病患者提供最佳护理的基础上,可能会面临根据最新证据做出治疗和管理决策的挑战。本研究旨在确定影响 CLL 和 MCL 治疗的特定知识、技能和信心差距,以为未来的教育活动提供信息。

方法:来自法国(学术环境)、德国和美国(学术和社区环境)的血液学家和血液肿瘤学家(HCP,n=224)回答了一项 15 分钟的定量需求评估调查,该调查衡量了他们对 CLL 和 MCL 患者治疗和管理的不同方面的知识、技能和信心水平,以及临床病例问题。进行了描述性统计(交叉表)和卡方检验。

结果:确定了四个教育需求领域:(1)治疗指南知识不足;(2)根据分子检测结果为 CLL/MCL 治疗决策提供信息的知识不足;(3)根据患者特征(合并症、分子检测结果)做出治疗决策时的技能不足;(4)平衡治疗毒性风险与获益的挑战。超过三分之一的受访者报告在选择合适的治疗方案和开处方治疗方面存在技能差距,并表示在开始和管理治疗方面缺乏信心。与 CLL 相比,MCL 中治疗指南知识不足和患者评估技能不足的差距更大。

结论:本研究表明需要继续医学教育,特别是要提高对治疗指南的认识,并通过基于案例的学习活动等方式,帮助临床医生在面对具有特定合并症和/或分子检测结果的患者的临床决策情景时,发展技能和信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/391c/11321192/0ce0976c1041/12885_2024_12745_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/391c/11321192/e0a1263a65ad/12885_2024_12745_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/391c/11321192/0ce0976c1041/12885_2024_12745_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/391c/11321192/e0a1263a65ad/12885_2024_12745_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/391c/11321192/0ce0976c1041/12885_2024_12745_Fig2_HTML.jpg

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[2]
Venetoclax-based Treatment as Frontline Therapy for Chronic Lymphocytic Leukemia.

Hematol Oncol Stem Cell Ther. 2023-5-23

[3]
Lisocabtagene maraleucel in chronic lymphocytic leukaemia and small lymphocytic lymphoma (TRANSCEND CLL 004): a multicentre, open-label, single-arm, phase 1-2 study.

Lancet. 2023-8-19

[4]
First line therapy of CLL.

Hematol Oncol. 2023-6

[5]
Pirtobrutinib in Covalent Bruton Tyrosine Kinase Inhibitor Pretreated Mantle-Cell Lymphoma.

J Clin Oncol. 2023-8-20

[6]
The Evolution of Therapies Targeting Bruton Tyrosine Kinase for the Treatment of Chronic Lymphocytic Leukaemia: Future Perspectives.

Cancers (Basel). 2023-5-3

[7]
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Healthcare (Basel). 2022-9-3

[8]
NCCN Guidelines® Insights: Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 3.2022.

J Natl Compr Canc Netw. 2022-6

[9]
New Directions for Mantle Cell Lymphoma in 2022.

Am Soc Clin Oncol Educ Book. 2022-4

[10]
Combining BTK inhibitors with BCL2 inhibitors for treating chronic lymphocytic leukemia and mantle cell lymphoma.

Biomark Res. 2022-4-4

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