Continuing Medical Education Improves Gastroenterologists’ Compliance with Inflammatory Bowel Disease Quality Measures
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Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists.
We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities.
Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists’ performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure.
The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013).
QI-focused CME improves community-based gastroenterologists’ compliance with IBD quality measures and measures aligned with NQS priorities.
KeywordsInflammatory bowel disease Quality improvement Physician quality reporting system Continuing medical education
AbbVie, Inc. and Takeda Pharmaceuticals U.S.A., Inc. for providing funding of the study on which the article is based.
Tamar Sapir, Jeffrey D. Carter, Kathleen Moreo, Laurence Greene, Barry Patel, and Peter D.R. Higgins were involved in Study and educational design. Barry Patel, Jeffrey Carter, Tamar Sapir, and Laurence Greene were associated with Chart review and analysis. Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter, and Peter D.R. Higgins did Development and presentation of educational activities. Jeffrey D. Carter, Laurence Greene, Barry Patel, Tamar Sapir, Kathleen Moreo, and Peter D.R. Higgins were involved in Data interpretation and statistical analysis. Laurence Greene, Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter, and Barry Patel contributed to Manuscript drafting. Peter D.R. Higgins, Laurence Greene, Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter, and Barry Patel were involved in Manuscript review and revision.
Compliance with ethical standards
Conflict of interest
Tamar Sapir, Kathleen Moreo, Jeffrey Carter, and Laurence Greene represent PRIME Education, Inc., a healthcare education company that received independent educational grants from AbbVie, Inc. and Takeda Pharmaceuticals U.S.A., Inc. to conduct the quality improvement project described in this article. The funders had no role in the study design or execution, and the grants did not include support for writing this manuscript. Barry Patel represents Indegene Total Therapeutic Management, a research company contracted by PRIME Education to perform the reviews of patient charts for this study. Peter D.R. Higgins, MD, has received honoraria from PRIME Education, Inc. for participation as faculty in the educational activities described in this article. Dr. Higgins was a prior consultant for AbbVie, Inc.
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