Measuring and Improving Physician Knowledge of Safety Risks Using Traditional and Online Methods in Pharmacovigilance

Traditional methods for assessing prescriber knowledge can take several years to deliver results. This study was undertaken to obtain insights into the potential for using existing online communities to educate prescribers on therapy-related safety risks.

The aim of this study was to describe approaches to measuring prescribers' knowledge of safety risk (osteonecrosis of the jaw) outlined in the European Medicine Agency's summary of product characteristics for denosumab (XGEVA^®).

Short multiple-choice online instruments were administered as (1) a two-round cross-sectional survey fielded in January 2013-May 2015 (traditional, nine European countries, study duration: 3 years), (2) a survey targeting the online Medscape community (seven European countries, study duration: 3 weeks), and (3) a continuing medical education module with pre-/post-assessment in an online Medscape community (Medscape Education, USA). All respondents were oncologists; treated five or more patients with bone metastases from solid tumours in the previous 3 months; and prescribed denosumab within the previous 12 months. Medscape (a WebMD company, New York, NY, USA) is the leading online medical information resource, serving approximately 3 million physicians worldwide and 400,000 within Europe.

In the traditional 29-month study, 420 (n = 210 per round; 14% of screened physicians) individuals participated. Knowledge levels exceeded 75% correct on five questions (incidence of osteonecrosis of the jaw, concomitant risk factors and prevention of osteonecrosis of the jaw during denosumab treatment, importance of ensuring oral hygiene, and care for patients who have or develop osteonecrosis of the jaw) with less awareness of optimal osteonecrosis of the jaw treatment. The Medscape survey (n = 207; 32.1% of 645 eligible) provided similar results in a 3-week post-survey launch. The Medscape Education study (n = 264) documented knowledge acquisition.

Assessments that target physicians through online platforms where they seek information about drug-related safety risks may result in increased efficiencies, informing regulators about prescribers' knowledge of safe use within weeks rather than years. Online communities or professional societies may provide venues in which to implement knowledge-acquisition surveys tied to training/education modules that address safety topics.