Background/purpose Long-term organ damage (LTOD) is a key issue with SLE. SLE is often managed using glucocorticoids (GCs), which can lead to organ damage if used for longer or at higher dosages. It is important that physicians understand how to use GCs, what the drivers and risk factors are for accrual of organ damage, and which treatment strategies can minimize LTOD in clinical practice.
Methods Rheumatologists participated in two online activities: ‘Addressing the Problems of Long-term Organ Damage in SLE’ (launched 15 April 2021, data collection by 29 June 2021) and ‘Appropriate Use of Glucocorticoids in the Treatment of SLE’ (launched 24 June 2021, data collection by 22 September 2021). Educational effect was assessed using a repeated-pair design, pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating. Cohen’s d estimated the effect size of the education on number of correct responses (<0.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). A series of McNemar’s tests were conducted at the question level (5% significance level, P <0.05).
Results Activity 1:
• Rheumatologists (n=71) significantly improved their knowledge of the prevalence of LTOD (P <0.001), the relationship between SDI (Systemic Lupus International Collaborating Clinics [SLICC]/American College of Rheumatology [ACR] Damage Index) and mortality (P <0.001), and the benefits of biologic therapy in improving outcomes in SLE (P <0.05)
• 44% reported improved confidence in optimizing outcomes to minimize LTOD
• Rheumatologists (n=103) showed significant improvements in knowledge regarding the risk of serious infections with GC use in the absence of antimalaria therapy (P <0.001), and the association between immunosuppressant therapy and better disease control + decreased use of GCs (P <0.05)
• Rheumatologists also showed significantly improved competence in the need to reduce the GC dosage for a patient on immunosuppressant therapy who is doing well (P <0.001)
• 39% gained confidence in appropriate use of GCs to manage patients with SLE
Conclusions Participation in these online activities was highly effective in helping rheumatologists understand how to more appropriately use GCs and minimize LTOD. These results suggest that further education would be beneficial to embed knowledge of LTOD and support rheumatologists to translate knowledge of strategies to minimize LTOD into clinical practice.
Acknowledgement Supported by an independent educational grant from GlaxoSmithKline
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