Session Information
Date: Monday, November 9, 2015
Title: ARHP II: Lupus
Session Type: ARHP Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background/Purpose: The heterogeneity and
non-specific features of lupus may delay diagnosis. This delay can lead to
accrual of organ damage and an increased risk of death. Early detection by
frontline providers (primary care and emergency room physicians, physician
assistants, nurses, medical students) is critical to decrease the referral time
for diagnosis and treatment. Average time devoted to lupus education in the
first 2 years of medical school is 45 minutes and lupus education in years 3
and 4 is elective so frontline providers may not have the knowledge to
recognize the disease. Given the shortage and high demand of rheumatologists,
this project enlisted rheumatology fellows to deliver a standardized presentation.
Methods: Four cities were selected as pilot
sites based on minority populations served, availability of rheumatology fellows,
and local lupus experts. Fellows were trained to deliver standardized content developed
material from the Lupus Initiative to provide a live presentation to frontline
providers. Local lupus agencies assisted with outreach to schedule seminars. A
voluntary, anonymous, paper-based pre/post assessment was used to evaluate
changes in knowledge and confidence and to collect other qualitative data. A
paired t-test was used to analyze the continuous variables and frequency tables
were used for categorical variables.
Results: Preliminary data from 339 matched
pre/post assessments were analyzed and scored on a 10 point scale. Total mean
score increased 1.59 (p<.0001). Mean score improvement was greatest among nurses
and physician assistants (3.09, 2.71 respectively; p<.0001) and providers in
community health centers (3.00; p<.0001). 94% of participants gained
confidence in knowing when to consider lupus based on patient history and exam and
93% in recognizing signs and symptoms. Over 90% were satisfied with the
content, pace, and delivery of the seminar and 89% would attend another seminar
led by a fellow. 100% of participating fellows noted the project as a positive
experience.
Conclusion: Rheumatology fellows can
effectively educate frontline providers about lupus recognition using a
standardized presentation. Further dissemination and evaluation of this
program is warranted.
|
Table 1. Comparison of Pre and Post Assessment Scores |
|||
|
Characteristics |
N |
Total Score Mean Diff (SD) |
P-Value |
|
Total Matched Assessments |
339 |
1.59 (1.65) |
<0.0001 |
|
Location |
|
||
|
Atlanta |
96 |
1.18 (1.43) |
<0.0001 |
|
Chicago |
53 |
1.17 (1.49) |
<0.0001 |
|
New York |
149 |
1.87 (1.76) |
<0.0001 |
|
San Francisco |
41 |
2.10 (1.66) |
<0.0001 |
|
Profession |
|||
|
Doctors/ Residents |
181 |
1.25 (1.48) |
<0.0001 |
|
Physician Assistant/ Nurse Practitioner |
17 |
2.71 (1.72) |
<0.0001 |
|
Nurses |
21 |
3.09 (1.61) |
<0.0001 |
|
Medical Students |
49 |
1.71 (1.54) |
<0.0001 |
|
Place of Practice |
|||
|
Emergency Room |
46 |
1.15 (1.61) |
<0.0001 |
|
Primary Care Office |
41 |
1.88 (1.86) |
<0.0001 |
|
Hospital |
47 |
1.35 (1.30) |
<0.0001 |
|
Community Health Center |
16 |
3.00 (1.59) |
<0.0001 |
|
Multiple Locations |
71 |
1.59 (1.50) |
<0.0001 |
|
Table 2. Confidence and Satisfaction |
|
|
Confidence Change (Among respondents who were “Not Very” and “Not At All” Confident on Pre-assessment) |
N (%) |
|
Confidence knowing when to consider lupus based on patient history exam (N=140) |
131 (93.6) |
|
Confidence to recognize signs and symptoms of lupus (N=120) |
111 (92.5) |
|
Confidence to appropriately refer patients (N=90) |
81 (90.0) |
|
Satisfaction |
N (%) |
|
Very/Somewhat Satisfied with Content (N=288) |
277 (96.2) |
|
Very/Somewhat Satisfied with Pace (N=288) |
269 (93.4) |
|
Very/Somewhat Satisfied with Delivery of Content (N=288) |
268 (93.1) |
|
Highly Likely/Somewhat Likely to attend another seminar led by a Fellow (N=288) |
255 (88.5) |
To cite this abstract in AMA style:
Caron A, Lim SS, Rene L, Gross D, Dall'Era M, Ramsey-Goldman R, Sammut A. Teaching Fellows in Lupus: Rheumatology Fellows Are Successful Educators in Improving Lupus Recognition By Frontline Healthcare Providers [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/teaching-fellows-in-lupus-rheumatology-fellows-are-successful-educators-in-improving-lupus-recognition-by-frontline-healthcare-providers/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/teaching-fellows-in-lupus-rheumatology-fellows-are-successful-educators-in-improving-lupus-recognition-by-frontline-healthcare-providers/