Nurse practitioner–directed continuing education leads to knowledge, confidence, and practice changes related to Alzheimer disease early diagnosis and disease-modifying treatments

ABSTRACT: Alzheimer disease (AD) continues to be underdiagnosed and undertreated in primary care despite the high and growing prevalence. Lack of diagnosis becomes more pressing with the availability of disease-modifying therapies (DMTs) that can slow disease progression during a narrow window of time in the course of the disease. Nurse practitioners (NPs) are central to closing these practice gaps, but persistent deficiencies in knowledge and confidence highlight the need for focused continuing education (CE). A 1.6-hour CE activity was developed on the importance of early AD diagnosis, interpretation of DMT clinical trial data, and strategies to improve DMT access. Outcomes were assessed using pre- and post-activity surveys and a 60-day follow-up survey. A total of 6,541 learners completed the program, the majority of whom were practicing NPs providing direct patient care. Collectively, these providers reported caring for over 35,000 patients at risk for cognitive impairment each week. The CE program led to a remarkable 38% improvement in knowledge, with significant gains across all assessment items (p < .001). The greatest gains were in recognizing the prolonged asymptomatic phase of AD (418% improvement) and identifying risk factors for the primary adverse effect of DMTs (50% improvement). Confidence in key domains improved significantly, with 75%-79% of follow-up respondents who see patients reporting sustained confidence gains. At 60 days, 59% had implemented at least one practice change. This CE program reached a large NP audience and improved knowledge, confidence, and reported practice behaviors related to AD early diagnosis and DMTs.