145 Improving Management of Mood Disorders Through an Online Interactive Patient Case Challenge

Abstract

Background

To determine if online continuing medical education (CME) could improve knowledge, competence, and confidence of psychiatrists and primary care physicians (PCPs) in managing patients with major depressive disorder (MDD) and co-occurring hypomanic/manic features.

Methods

• ∙ Physicians participated in a 1-hour text-based, online CME activity composed of 2 patient cases with interactive questions related to diagnosis, assessment, and management of various presentations of MDD

• ∙ Evidence-based educational feedback was provided following each answer

• ∙ Effects of CME were assessed using a repeated-question pairs pre- to post-assessment study design where individual participants served as his/her own control

• ∙ The assessment included 3 multiple-choice knowledge/competence questions and 1 self-efficacy question that rated confidence in managing MDD with mixed features on a 5-point Likert Scale

• ∙ For all questions combined, McNemar’s chi-square test assessed the differences from pre- to post-assessment

• ∙ P values measured significance; P values <.05 were considered statistically significant

• ∙ Effect size was calculated using Cramer’s V by determining the change in proportion of participants who answered questions correctly from pre- to post- assessment

• ∙ Survey data were collected from December 8th, 2016, to January 24th, 2017.

Results

• ∙ Data set included responses from 1454 psychiatrists and 488 PCPs who completed all assessment questions during the study period

• ∙ Psychiatrists: Knowledge/competence improved (P<.001; V=0.54; large educational effect) following participation in the CME activity:

  1. ° While 5% answered all 3 questions correctly on pre-assessment, 70% answered them all correctly on post- assessment, with the largest increases on accurate differentiation between possible signs of mania and depression, accurate diagnosis of bipolar depression, and ability to select treatments for MDD with mixed features

  2. ° 20% reported being more confident in their ability to select treatments for various presentations of mood disorders

• ∙ PCPs: Knowledge/competence improved (P<.001; V=0.49; large educational effect) following participation in the CME activity:

  1. ° While 2% answered all 3 questions correctly on pre-assessment, 48% answered them all correctly on post-assessment, with the largest increases on accurate differentiation between possible signs of mania and depression, accurate diagnosis of bipolar depression, and ability to select treatments for MDD with mixed features

  2. ° 24% reported being more confident in their ability to select treatments for various presentations of mood disorders

Conclusions

Online CME in a clinically relevant interactive case-based format can improve knowledge, competence, and confidence in management of various presentations of mooddisorders and better equip physicians to recognize key features, accurately diagnose, and treat the complex spectrum of this patient population.

Funding Acknowledgements

The educational activity and outcomes measurement were funded through an independent educational grant from Sunovion Pharmaceuticals Inc.