Background/Purpose: Project ECHO™ in an education model that links experts with community providers through a series of video teleconferences. Each conference involves a brief didactic session followed by a discussion of real patient cases. We piloted the first ECHO in reproductive rheumatology to increase rheumatologists’ knowledge and self-efficacy in providing reproductive health care.

Methods: The Project ECHO guides informed ReproRheum ECHO curriculum development, provider recruitment, logistics, and assessment. All ACR RISE Registry providers received email invitations. The ECHO was evaluated using interviews and pre/post surveys to assess provider knowledge, self-efficacy, and to identify program strengths, weaknesses, and solicit suggestions. Self-efficacy was assessed using a modified validated Self-Efficacy 12 survey.

Results: A total of 12 providers, 8 rheumatology providers (4 MD, 2 NP, 2 fellows) and 4 experts (2 reproductive rheumatologists, 2 MFM), participated in the ReproRheum ECHO’s 6, 1-hour sessions from January-March 2023. Feasibility was demonstrated: all but one provider attended all sessions.

Knowledge of the rate of birth defects after exposure to azathioprine and mycophenolate both significantly increased. Provider self-efficacy increased significantly (6.8 +/- 1.2 pre-ECHO to 8.1 +/- 0.5 post-ECHO, p=0.03). All participants ‘agreed’ or ‘strongly agreed’ that they had increased confidence in their ability to answer colleagues’ questions and guide patients’ choices in contraception and medication in pregnancy.

In interviews, providers described the didactic and case discussion sections as being the most valuable, noting the combination allowed them to apply the knowledge in clinical care. They expressed appreciating the diversity of perspectives and experiences of rheumatologists from across the US and the inclusion of MFM experts. Providers said they were satisfied with the amount of facts and experienced very few barriers to attendance. Providers shared they had increased knowledge, comfort and confidence in speaking with patients about reproductive health. Providers who were not recording reproductive health information routinely before the ECHO said that they had added pregnancy counseling sections to their notes. Nearly all providers viewed the LupusPregnancy.org and ReproRheum.Duke.edu handouts as useful during patient discussions. Some providers said they shared handouts with patients, while others had verbally reviewed them together. Nearly all providers said they would definitely attend future ECHO sessions and that they would definitely recommend the ECHO to other rheumatologists and midlevel providers.

Suggestions for improvement included having patients share their perspective, role-playing patient counseling, and enhancing curricula with articles and summary sheets.

Conclusion: The pilot ReproRheum ECHO was feasible and improved knowledge and self-efficacy among rheumatologists in reproductive health. We hope to expand to multiple audiences using tailored content, including fellows, rural providers and advanced practice providers. This model is a promising approach to improving reproductive health care for women with rheumatic disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/moving-the-acrs-reproductive-health-guidelines-into-practice-assessment-of-a-novel-reproductive-rheumatology-echo/