Background
Immune checkpoint inhibitors (ICIs) have changed the landscape of cancer treatment over the past decade. With broaden ICIs use, internal medicine physicians are increasingly encountering them. Our study aims to assess Internal Medicine Resident’s (IMR) knowledge on immune related adverse events irAEs and identify potential gaps
Methods
We designed 21-questions pre-intervention survey in January 2022 assessing IMR knowledge of ICIs and associated irAEs. It assessed the following components regarding ICIs and irAEs: (1) recognition of ICIs, (2) recognition of organ systems associated with irAEs, (3) common timeframe of irAEs, (4) initial management strategies for irAEs, (5) common misconceptions about irAEs, and (6) self-rated physician comfort level on recognition/treatment of irAE. Teaching sessions by medical oncology attending and QI project team residents were conducted after survey. 21-questions post-intervention survey was sent to IMR in September 2022. The results of the surveys were compared.
Results
42 of 57IMRs (73.7%) participated in pre-intervention survey and 45 of 57IMRs (78.9%) participated in post-intervention survey (tables 1 and 2).
Limitations: The length of the survey limited our ability to test regarding a wide variety of ICIs and irAEs.
Conclusions
We identified the knowledge gaps regarding ICIs and irAEs among IMRs. Educational content provided in multiple formats demonstrated increased knowledge. IMRs may benefit from web-based learning tools and algorithms on ICIs/irAEs management.
Abstract 1264 Table 1
Confidence level in recognizing/managing irAEs on scale of 1–5
Pre-intervention Post-intervention Recognizing 1. 13 (31.0%) 3(6.7%) 2. 12(28.6%) 7(15.6%) 3. 17 (40.5%) 11(24.4%) 4. 0(0.0%) 23(51.1%) 5. 0 (0.0%) 1(2.2%) Managing toxicities 1. 15(35.7%) 3(6.7%) 2. 13(31.0%) 10(22.2%) 3. 13(31.0%) 11(24.4%) 4. 1(2.4%) 20(44.4%) 5. 0(0.0%) 1(2.2%)
Abstract 1264 Table 2
Knowledge of irAEs
Variance Ability to identity ICI+ 15.4%Ability to identity agent with highest toxicity+ 39.3%Knowledge about timeline of gastrointestinal toxicity+ 21.5%Knowledge about most common irAEs+ 34.2%Awareness of earliest toxicity+ 30.4%Knowledge about 1st line treatment of immunotherapy rashes+ 32.6%Recognition of investigations for gastrointestinal toxicity+ 32.1%Awareness of when to hold ICIs in setting of gastrointestinal toxicity+ 22.7%Awareness of endocrinologic toxicity+ 19.5%Knowledge about management of dermatological toxicity+ 28.9%Awareness of when to use glucocorticoids in management of immunotherapy related colitis+ 19.4%Knowledge about workup of colitis+ 42.4%Awareness about imaging modality to detect pneumonia+ 27.5%Knowledge about cardiovascular toxicities+ 38.2%Awareness of rheumatologic toxicity+ 31.1%Knowledge about treatment of arthritis+ 36.6%Awareness of neuromuscular toxicity+ 39.8%