Health Management

Navigate to:  Preventive Health & Lifestyle Medicine | Behavioral Health | Chronic Illness: Autoimmune,  Cardiovascular,  DiabetesHemophilia, Infectious Disease,  Musculoskeletal/Rheumatology,  Neurological,  Pain Management,  Pulmonary, Urology

Preventive Health & Lifestyle Medicine

Addressing the Challenges of Adolescent Vaccinations: Improving Clinical and Economic Outcomes in Immunizations

The world of immunizations in adolescents has changed dramatically over the past 10 years. From newer vaccines to changing guidelines, the landscape has changed for payers, providers and patients. This webcast will take a close look at those changes on immunizations in adolescents. Attendees will be updated on the latest data and guidelines to help increase rates, costs and patient outcomes.

Addressing the Challenges of Adolescent Vaccinations: Improving Clinical and Economic Outcomes in Immunizations is a webcast that will provide attendees with the latest information on immunizations, costs, burdens and strategies to increase the success of immunizations, and more importantly, patient outcomes and quality of life.
Physician, Nursing and CMCN credits valid to September 30, 2019

Addressing the Challenges of Adult Vaccinations: Improving Clinical and Economic Outcomes in Immunizations

The world of immunizations in adults has changed dramatically over the past 10 years. From newer vaccines to changing guidelines, the landscape has changed for payers, providers and patients. This webcast will take a close look at those changes for adult immunization. Attendees will be updated on the latest data and guidelines to help increase rates, costs and patient outcomes.

Addressing the Challenges of Adult Vaccinations: Improving Clinical and Economic Outcomes in Immunizations is a webcast that will provide attendees with the latest information on immunizations, costs, burdens and strategies to increase the success of immunizations, and more importantly, patient outcomes and quality of life.
Physician, Nursing and CMCN credits valid to September 30, 2019

Behavioral Health

Recognizing Optimal Care Strategies in the Treatment of Major Depressive Disorder

Major depression is a debilitating condition that affects more than 350 million people worldwide. With appropriate treatment, about 75% of individuals with major depressive disorder (MDD) can achieve a significant reduction in symptoms, although as many as 50% of patients may not respond to the initial treatment trial. These numbers are staggering and many of these patients report cognitive difficulties and comorbidities to include alcohol or substance abuse, type 2 diabetes, isolation, work and personal conflicts, and an increased chance of suicide. Measurement-based assessment tools can help screen for and quantify the degree of depression; however, these tools continue to be underutilized in everyday practice. It is important to assess the overall severity of depressive symptoms as symptom severity correlates with suicide risk. Treatment methods for depression are often multi-faceted which may include combining medication with psychotherapy. Pharmacologic antidepressant treatments range from selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical and tricyclic antidepressants, and monoamine oxidase inhibitors. Electroconvulsive treatment (ECT), psychotherapy, and other somatic options are also available. It’s critical to personalize a treatment plan for each patient as the ultimate goal of care providers is to move patients suffering from MDD to remission, then recovery, and to avoid a relapse
Physician, Nursing and CMCN credits valid to January 1, 2020

Implementing Shared-Decision Making Strategies: Screening, Diagnosis, and Treatment
of Major Depressive Disorder

Major depression is a debilitating condition that nearly 20% of the general population in the United States will experience at some point in their life. With appropriate treatment, 70-80% of individuals with major depressive disorder (MDD) can achieve a significant reduction in symptoms. More than 80% of patients with depression have a medical comorbidity or complications that can come from MDD to include alcohol or substance abuse, type 2 diabetes, dyslipidemia, obesity, cardiovascular disease, isolation, work and personal conflicts, and an increased chance of suicide. A diagnosis of clinical depression requires the presence of depressed mood, a loss of pleasure and interest, decreased energy, changes in sleep patterns, and feelings of worthlessness, hopelessness, or guilt for a period of at least 2 weeks. The disease leaves the patient with significant distress and impairs their ability to function. Measurement-based assessment tools can help quantify the degree of depression and it is important to utilize a focused severity assessment for hopelessness, suicidal ideation, and psychotic symptoms since these factors independently increase the risk for suicide.

Treatment may be multi-faceted, combining medication with psychotherapy however treatment may change several times as different medications affect people in different ways. Treatments for MDD range from psychotherapy, antidepressants, electroconvulsive treatment (ECT), and other somatic therapies. Antidepressant treatments include selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), atypical and tricyclic antidepressants, monoamine oxidase inhibitors and other medications. Combination can affect multiple monoamine targets which can produce greater efficacy. While there are many options available, the need to personalize a treatment plan for each individual patient is important as the ultimate goal of care is to move patients suffering from MDD to remission, then recovery, and to avoid a relapse.

Physician, Nursing and CMCN credits valid to August 15, 2019

Chronic Illnesses

 

Navigate to:  Preventive Health & Lifestyle Medicine | Behavioral Health | Chronic Illness: Autoimmune,  Cardiovascular,  DiabetesHemophilia, Infectious Disease,  Musculoskeletal/Rheumatology,  Neurological,  Pain Management,  Pulmonary, Urology

 

Navigate to:  Preventive Health & Lifestyle Medicine | Behavioral Health | Chronic Illness: Autoimmune,  Cardiovascular,  DiabetesHemophilia, Infectious Disease,  Musculoskeletal/Rheumatology,  Neurological,  Pain Management,  Pulmonary, Urology

AutoImmune

Exploring the Evolving Treatment Paradigm in the Management of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic, frequently progressive condition that affects approximately 1.6 million people in the United States. This lifelong, systemic autoimmune illness often strikes patients at a young age and must be managed across a lifetime. According to the Crohn’s and Colitis Foundation of America, there are as many as 70,000 new cases diagnosed in a year. Within IBD, there are two types that fall under its umbrella – Crohn’s disease and Ulcerative colitis. Ulcerative colitis causes inflammation and sores in the innermost lining of your large intestine and rectum. Crohn’s disease causes inflammation of your digestive tract which can cause abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.

The treatment goal for IBD is to reduce the inflammation, in hopes of achieving reduced symptoms and possibly remission. Immediate goals are to control the symptoms, induction of remission, and to help improve a patient’s quality of life, while long-term goals include maintenance of a corticosteroid-free clinical remission, mucosal healing, endoscopic remission, prevention or cure of complications, restoration, and maintenance of proper nutrition. The first step for IBD treatment is aminosalicylates, which are useful for treating flares of IBD and for maintaining remission. Antibiotics can also be used to treat bacterial infections that may result from abscesses or fistulas. Corticosteroids are rapid-acting anti-inflammatory agents and are indicated for acute flares of disease only. They have no role in the maintenance of remission. Immunomodulators have a slower onset of action and work to reduce patients’ overactive immune system but unlike corticosteroids, they can be used as a long-term treatment. And the fifth way to treat the disease is with biologics, which are proteins that stop certain molecules in the body from causing inflammation in the GI tract. These are usually prescribed to those living with moderate to severe cases of IBD who haven’t responded to other types of treatment.

There is now an understanding of the pathogenesis of IBD and the development of appropriate management that is helping to target the inflammatory pathways which is now considered a high priority. An increasing number of clinical trial options have shown favorable short- and long-term outcomes, and as clinicians continue to find the right strategy to treat IBD, new and emerging treatment strategies may offer additional therapeutic options to address the unmet needs of these patients. Clinicians have recently been equipped with more treatment options, including janus kinase (JAK) inhibitors. Several others have just completed late stage clinical trials and are currently undergoing regulatory review. These new options have shown improved efficacy and safety in IBD, and healthcare professionals must be educated on these agents and the potential risks that come along with any treatment option.
Physician, Nursing and CMCN credits valid to August 1, 2020

Current and Novel Treatment Advances and their Impact on the Management of Psoriasis

Psoriasis is a an under-diagnosed, complex, chronic, immune-mediated inflammatory disease that affects approximately 7 million, or just over 2%, of the population in the United States. Psoriasis patients experience periodical flare-ups of sharply defined red patches, covered by a silvery, flaky surface. The disease can be quite itchy and most commonly appears on the skin of the scalp, elbow, knees, and lumbosacral areas of the body. It is a complex disease to manage and the goal should be a patient-centered treatment that reduces disease burden, improves quality-of-life, and addresses the risks of systemic complications and comorbid conditions. Co-morbidities include psoriatic arthritis, cardiovascular disease, type 2 diabetes, depression, and obesity among others. Traditional treatment options include topical creams, over the counter (OTC) medications, phototherapy, and systemic medication, which may be prescribed orally or by injection. Novel therapies include oral, small molecule medications and biologics, which are derived from living cells that have been cultivated in a laboratory. Biologics are administered subcutaneously or intravenously and target specific areas of the immune system. Recent research indicates that both IL-23 and IL-17 play important, and perhaps integral, roles in the development of psoriatic plaques. Treatments such as briakinumab, guselkumab and tildrakizumab targeting IL-23 and brodalumab, ixekizumab, and secukinumab targeting IL-17 have shown safety and good efficacy in clinical trials of moderate-to-severe plaque psoriasis, but long-term safety still needs to be established.
Physician, Nursing and CMCN credits valid to August 1, 2020

Latest Updates in the Treatment and Management of Psoriatic Arthritis

Psoriatic arthritis is a debilitating disease that may affect up to 1 million adult men and women in the United States. Psoriatic arthritis is highly underdiagnosed and is a progressive, inflammatory disease that is associated with a number of dermatologic and musculoskeletal manifestations. Patients often experience fatigue, extreme joint pain, permanent joint damage and dysfiguration that may affect their quality of life, physical function, and ability to work. Approximately 30% to 40% of people with psoriasis will also develop psoriatic arthritis and diagnosis may be easier to confirm if psoriasis coexists with symptoms of arthritis however signs of psoriatic arthritis appear before symptoms of psoriasis. Measuring rheumatoid factor and anti–cyclic citrullinated peptide (anti-CCP) may aid in diagnosis. Looking for key characteristics and patterns of the disease in addition to reviewing the patient’s medical history and utilizing magnetic resonance imaging (MRI) and x-rays of the involved joints, along with a dermatologic evaluation may be used to diagnose psoriatic arthritis. Traditional treatment includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) which can reduce inflammation, pain, swelling and stiffness. Many of the medications suppress the immune system and lead to a potential increase risk of infections. Newer biologic treatments have been developed and block the IL-12 and IL-23 proteins to help with the disease. Secukinumab is a novel biologic which blocks IL-17A to help reduce inflammation and is given by a subcutaneous injection and is producing promising results that treat the skin and arthritis.
Physician, Nursing and CMCN credits valid to August 1, 2020

Utilizing Immunoglobulin Replacement Therapy to Improve Clinical and Economic Outcomes in the Management of Primary Immunodeficiency Diseases (PIDD)

Primary immunodeficiency diseases (PIDD) are a group of more than 300 rare, chronic disorders in which part of the body’s immune system is missing or functions improperly. While not contagious, these diseases are caused by hereditary or genetic defects however they all share one common feature: each result from a defect in one of the functions of the body’s normal immune system. The primary treatment for these patients with antibody deficiencies is lifetime administration of immunoglobulin (Ig) replacement therapy; a therapeutic substance derived from human blood plasma and made up of immunoglobulin. Ig replacement is usually necessary for the patient’s lifetime since therapy only replaces the missing end product and does not correct the patient’s defect in antibody production. Although approximately 150,000 patients are likely to benefit from Ig replacement, only an estimated 35,000 to 55,000 receive ongoing therapy. A lack of awareness and depth of understanding contribute to this underserved population of individuals with PI.
Physician, Nursing and CMCN credits valid to August 1, 2020

Optimizing Clinical and Economic Outcomes in the Management of Moderate-to-Severe Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues, effecting an estimated 1.3 million people in the United States. It typically results in warm, swollen, and painful joints, and pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Diagnosis is done through examination, including x-rays and ultrasounds, and blood testing for certain indications. There is no cure for RA thus the focus of treatment is to control the disease, it’s symptoms, and to prevent joint damage during flare ups where the pain and inflammation are much worse. Some patients experience “remission” where the pain and inflammation disappear or almost disappear. Despite the currently available non-biologic and biologic therapies, only about 1/3 of patients treated for RA ever achieve clinical remission. Other patients experience continuous disease progression and disability. In addition, many patients will have an inadequate response or can become intolerant to the widely used anti-TNF therapies. Consequently, the patient’s health-related quality of life may continue to be significantly reduced. Fortunately, new and emerging treatment strategies, including IL-6 receptor antagonists, have shown improved efficacy and safety in RA.
Physician, Nursing and CMCN credits valid to August 1, 2020

Recent Advances in the Treatment and Management of Moderate-to-Severe Atopic Dermatitis: What’s New in Biologic Therapies

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease characterized by periods of acute disease flare that may include painful burning sensations and persistent itching. AD occurs more frequently in adulthood, is often accompanied by co-morbidities such as rhinitis and asthma and can severely affect quality of life. AD is the leading cause of non-fatal disease burden of skin conditions, effecting approximately 27.6 million people with moderate to severe eczema or atopic dermatitis in the United States with an estimated annual direct and indirect cost of $5 billion dollars. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Current atopic dermatitis treatments attempt to reduce inflammation and itchiness to maintain the protective integrity of the skin and have shown the ability to manage the disease in the short term but have had troubles with long term efficacy. Thankfully advances in the understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. Fortunately, several new treatments, including novel monoclonal antibodies or targeted therapies, such as Janus Kinase Inhibitors (JAK) and PDE4 inhibitors, have shown improved efficacy and safety, offering patients the potential for improved outcomes and quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2020

New Horizons in the Management of Hereditary Angioedema (HAE):What Managed Care Needs to Know About Novel Therapies in an Evolving Treatment Paradigm

Hereditary angioedema (HAE) is a rare autosomal dominant condition characterized by recurrent attacks of edema at different locations of the body. This potentially life-threatening disease affects approximately 1 in 67,000 individuals. HAE is characterized by recurrent edema attacks and the cutaneous attacks can be disabling, with the skin, gastrointestinal tract, and upper airways are most commonly affected. Fortunately, novel therapies have recently become available that have shown improved efficacy and safety with improved administration methods.

This webinar series will feature strategies to overcome challenges in the optimal long-term treatment of HAE, updates on new therapies, and practical managed care approaches to provide cost-effective solutions to improve patient outcomes.
Physician, Nursing and CMCN credits valid to March 1, 2020

A Deeper Look into the Newest Therapies in the Management of Hereditary Angioedema (HAE): Individualizing Treatment for Improved Clinical and Economic Outcomes

Hereditary angioedema (HAE) is a rare autosomal dominant condition characterized by recurrent attacks of edema at different locations of the body. This potentially life-threatening disease affects approximately 1 in 67,000 individuals. HAE is characterized by recurrent edema attacks and the cutaneous attacks can be disabling, with the skin, gastrointestinal tract, and upper airways are most commonly affected. Fortunately, novel therapies have recently become available that have shown improved efficacy and safety with improved administration methods. This webinar series will feature strategies to overcome challenges in the optimal long term treatment of HAE, updates on new therapies, and practical managed care approaches to provide cost-effective solutions to improve patient outcomes.
Physician, Nursing and CMCN credits valid to March 1, 2020

Improving Patient Adherence and Quality of Life in Hereditary Angioedema (HAE): Strategies for Improving Administration of Treatment and Managing Adverse Events

Hereditary angioedema (HAE) is a rare autosomal dominant condition characterized by recurrent attacks of edema at different locations of the body. This potentially life-threatening disease affects approximately 1 in 67,000 individuals. HAE is characterized by recurrent edema attacks and the cutaneous attacks can be disabling, with the skin, gastrointestinal tract, and upper airways are most commonly affected. Fortunately, novel therapies have recently become available that have shown improved efficacy and safety with improved administration methods. This webinar series will feature strategies to overcome challenges in the optimal long term treatment of HAE, updates on new therapies, and practical managed care approaches to provide cost-effective solutions to improve patient outcomes.

This webinar is part 2 of a 3-part live webinar series on novel therapies in HAE. This webinar will focus on improving patient adherence and quality life in HAE patients with a close look at managing side effects of novel therapies.
Physician, Nursing and CMCN credits valid to March 1, 2020

Comparative Effectiveness and Coordinated Care in Hereditary Angioedema (HAE): What Does Managed Care Need to Know about Recently Approved Therapies?

Hereditary angioedema (HAE) is a rare autosomal dominant condition characterized by recurrent attacks of edema at different locations of the body. This potentially life-threatening disease affects approximately 1 in 67,000 individuals. HAE is characterized by recurrent edema attacks and the cutaneous attacks can be disabling, with the skin, gastrointestinal tract, and upper airways are most commonly affected. Fortunately, novel therapies have recently become available that have shown improved efficacy and safety with improved administration methods. This webinar series will feature strategies to overcome challenges in the optimal long term treatment of HAE, updates on new therapies, and practical managed care approaches to provide cost-effective solutions to improve patient outcomes.

This webinar is part 3 of a 3-part live webinar series on novel therapies in HAE. This webinar will focus on managed care considerations and comparative effectiveness among novel therapies.
Physician, Nursing and CMCN credits valid to March 1, 2020

Overcoming Challenges in the Management of Psoriasis: Treatment Advances to Improve Standard of Care

Psoriasis is a complex, chronic, immune-mediated inflammatory disease that affects approximately 7 million, or just over 2%, of the population in the United States. Psoriasis is a periodic flare-up of sharply defined red patches, covered by a silvery, flaky surface. The main disease activity leading to psoriasis occurs in the epidermis, the top five layers of the skin. Psoriasis is a complex disease to manage, but the goal should be a patient-centered treatment that reduces disease burden, improves on quality-of-life, and addresses the risks of systemic complications and comorbid conditions.

There are several treatment options. Topical treatments, from over the counter (OTC) to prescription are usually the first line treatment. Phototherapy may be tried, using controlled times of a special light or sunlight. To treat a chronic localized area, laser therapy may be used. However, should these therapies prove unsuccessful, especially in moderate to severe psoriasis, other treatments may be utilized. These treatments include traditional systemic medication, which may be prescribed orally or by injection, newer oral medications which are targeted small molecule medications, and biologics, which are derived from living cells that have been cultivated in a laboratory. Recent research indicates that both IL-23 and IL-17 play important, and perhaps integral, roles in the development of psoriatic plaques. Treatments such as guselkumab and tildrakizumab targeting IL-23 and brodalumab, ixekizumab, and secukinumab targeting IL-7 have shown safety and good efficacy in clinical trials of moderate-to-severe plaque psoriasis, but long-term safety still needs to be established.
Physician, Nursing and CMCN credits valid to February 1, 2020

Implementing Newer Therapies to Improve Economic and Clinical Outcomes in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. It typically results in warm, swollen, and painful joints, and pain and stiffness often worsen following rest. The disease may also affect other parts of the body, which results in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. There is no cure for RA. Treatment includes controlling the pain, during flair ups especially, and preventing joint damage. Many patients will have an inadequate response or can become intolerant to the widely used anti-TNF therapies. Consequently, the patient’s health-related quality of life may continue to be significantly reduced. Fortunately, new and emerging treatment strategies may offer additional therapeutic options to address the unmet needs of these patients. Clinicians have recently been equipped with more treatment options, including janus kinase (JAK) inhibitors, and several more have just completed late stage clinical trials and are currently undergoing regulatory review. These new options have shown improved efficacy and safety in RA, and healthcare professionals should be educated on these options, guidelines, and strategies for implementing them into the treatment paradigm.
Physician, Nursing and CMCN credits apply. Each session has its own specific valid dates.

Overcoming Challenges in the Clinical and Economic Management of Primary Immunodeficiency Diseases (PIDD): What Does Managed Care Need to Know About Immunoglobulin Replacement Therapy?

Primary immunodeficiency diseases (PIDD) represent a myriad of life-long conditions that result when a component of the immune system is absent or does not function properly due to a primary or inherited defect. The primary treatment for these patients with antibody deficiencies is lifetime administration of immunoglobulin replacement therapy; a therapeutic substance derived from human blood plasma and made up of immunoglobulin. Since Ig only replaces the missing end product but does not correct the patient’s defect in antibody production, Ig replacement is usually necessary for the patient’s lifetime. Although approximately 150,000 patients are likely to benefit from Ig replacement, only an estimated 35,000 to 55,000 receive ongoing therapy. A lack of awareness and depth of understanding contribute to this underserved population of individuals with PI. This presentation will explore the available immunoglobulin replacement therapy options, the economic burden of undertreatment and strategies for improving patient outcomes and quality of life.
Physician, Nursing and CMCN credits valid to January 31, 2020

Key Insights into the Diagnosis and Treatment of Inflammatory Bowel Disease (IBD)

According to the Crohn’s and Colitis Foundation of America, there are as many as 70,000 new cases of Inflammatory bowel disease (IBD) diagnosed in a year. This chronic, frequently progressive condition affects approximately 1.6 million people in the United States. IBD often strikes patients at a young age, thereby making the management of this disease a lifetime endeavor. The first step for IBD treatment is aminosalicylates, which are useful for treating flares of IBD and for maintaining remission. There are also the uses of antibiotics that are used to treat bacterial infections that may result from abscesses or fistulas. While corticosteroids, rapid-acting anti-inflammatory agents, are indicated for acute flares of disease, they have no role in the maintenance of remission. Immunomodulators have a slower onset of action and work to reduce patients’ overactive immune system but unlike corticosteroids, they can be used as a long-term treatment. And the final way to treat IBD is with biologics, which are proteins that stop certain molecules in the body from causing inflammation in the GI tract. These are usually prescribed to those living with moderate to severe cases of IBD who haven’t responded to other types of treatment. This presentation will provide clinical data and evidence needed to help optimize the current treatments and educate clinicians and healthcare professionals on the novel biologics.
Physician, Nursing and CMCN credits valid to January 31, 2020

Optimizing Clinical and Economic Outcomes in the Management of Moderate to Severe Atopic Dermatitis: Taking a Closer Look at the Role of Biologic Therapies

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease characterized by periods of acute disease flare that may include painful burning sensations and persistent itching. AD occurs more frequently in adulthood, is often accompanied by co-morbidities such as rhinitis and asthma, and can severely affect quality of life. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States with an estimated annual direct and indirect cost of approximately $5 billion dollars. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Current atopic dermatitis treatments attempt to reduce inflammation and itchiness to maintain the protective integrity of the skin and have shown the ability to manage the disease in the short term but have had troubles with long term efficacy. Thankfully advances in the understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. Fortunately, several new treatments, including novel monoclonal antibodies or targeted therapies, such as JAK and PDE4 inhibitors, have shown improved efficacy and safety, offering patients the potential for improved outcomes and quality of life.
Physician, Nursing and CMCN credits valid to January 1, 2020

Evolving Treatment Paradigms in Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): Managed Care Considerations on Immunoglobulin Replacement Therapy

Effective and timely treatment of primary immunodeficiency diseases can greatly improve the quality of life and outcomes in CIDP patients. With the advancement and complexity of different treatment options, including immunoglobulin replacement therapies that have become available recently in different administration methods, it is critical that medical directors, payers, practicing physicians, nurse case managers and other HCPs are educated on the role of immunoglobulin replacement therapy and understand all of the safety and efficacy data to make appropriate formulary and clinical decisions. Recent surveys, research and evaluations from our activities have shown that these healthcare professionals need updates on these novel options, and how they can integrate them into the treatment paradigm and optimize costs. This webcast activity will feature strategies to overcome challenges in the optimal treatment of CIPD, updates on immunoglobulin replacement therapies, and practical managed care approaches to provide cost-effective solutions to improve both clinical and economic outcomes.
Physician, Nursing and CMCN credits valid to February 1, 2020

Best Practices in the Treatment and Management of Systemic Lupus Erythematosus (SLE): Addressing Disease Activity and Flares for Improved Clinical and Economic Outcomes

Systemic lupus erythematosus (SLE), also known simply as lupus, is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary between people and may be mild to severe. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. Often there are periods of illness, called flares, and periods of remission during which there are few symptoms. Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests. Systemic lupus erythematosus (SLE) is the most common form of lupus and affects approximately 70 percent of an estimated 5 million people with lupus worldwide. Approximately 170,000-200,000 Americans live with SLE. Fortunately, over the past decade several new agents have become available, or are on the horizon. These options have proven to reduce lupus disease activity, and developments have been made to make administration easier for improving patient adherence and quality of life. With these recent developments, it is imperative to provide medical directors, primary care physicians, rheumatologists, and others on the interprofessional management team with updated guidelines and strategies for optimizing patient adherence and quality of life, with the ultimate goal of improving patient outcomes.
Physician, Nursing and CMCN credits valid to September 30, 2019

Addressing Disease Activity and Flares for an Individualized Approach to Managing Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE), also known simply as lupus, is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary between people and may be mild to severe. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. Often there are periods of illness, called flares, and periods of remission during which there are few symptoms. Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests. Systemic lupus erythematosus (SLE) is the most common form of lupus and affects approximately 70 percent of an estimated 5 million people with lupus worldwide. Approximately 170,000-200,000 Americans live with SLE. Fortunately, over the past decade several new agents have become available, or are on the horizon. These options have proven to reduce lupus disease activity, and developments have been made to make administration easier for improving patient adherence and quality of life. With these recent developments, it is imperative to provide medical directors, primary care physicians, rheumatologists, and others on the interprofessional management team with updated guidelines and strategies for optimizing patient adherence and quality of life, with the ultimate goal of improving patient outcomes.
Physician, Nursing and CMCN credits valid to September 30, 2019

A Managed Care Evaluation of Current Therapies and Updates in the Management of Systemic Lupus Erythematosus (SLE)

Systemic lupus erythematosus (SLE), also known simply as lupus, is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary between people and may be mild to severe. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. Often there are periods of illness, called flares, and periods of remission during which there are few symptoms. Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests. Systemic lupus erythematosus (SLE) is the most common form of lupus and affects approximately 70 percent of an estimated 5 million people with lupus worldwide. Approximately 170,000-200,000 Americans live with SLE. Fortunately, over the past decade several new agents have become available, or are on the horizon. These options have proven to reduce lupus disease activity, and developments have been made to make administration easier for improving patient adherence and quality of life. With these recent developments, it is imperative to provide medical directors, primary care physicians, rheumatologists, and others on the interprofessional management team with updated guidelines and strategies for optimizing patient adherence and quality of life, with the ultimate goal of improving patient outcomes.
Physician, Nursing and CMCN credits valid to September 30, 2019

Improving Patient Adherence and Quality of Life in SLE: Strategies for Improving Administration and Managing Adverse Events

Systemic lupus erythematosus (SLE), also known simply as lupus, is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary between people and may be mild to severe. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. Often there are periods of illness, called flares, and periods of remission during which there are few symptoms. Diagnosis can be difficult and is based on a combination of symptoms and laboratory tests. Systemic lupus erythematosus (SLE) is the most common form of lupus and affects approximately 70 percent of an estimated 5 million people with lupus worldwide. Approximately 170,000-200,000 Americans live with SLE. Fortunately, over the past decade several new agents have become available, or are on the horizon. These options have proven to reduce lupus disease activity, and developments have been made to make administration easier for improving patient adherence and quality of life. With these recent developments, it is imperative to provide medical directors, primary care physicians, rheumatologists, and others on the interprofessional management team with updated guidelines and strategies for optimizing patient adherence and quality of life, with the ultimate goal of improving patient outcomes.
Physician, Nursing and CMCN credits valid to September 30, 2019

Optimizing Clinical and Economic Outcomes in the Management of Primary Immunodeficiency Diseases: Taking a Closer Look at the Role of Immunoglobulin Replacement Therapy

Primary immunodeficiency diseases (PIDD) are a group of more than 300 rare, chronic disorders in which part of the body’s immune system is missing or functions improperly. While not contagious, these diseases are caused by hereditary or genetic defects, and, although some disorders present at birth or in early childhood, the disorders can affect anyone, regardless of age or gender. Some affect a single part of the immune system; others may affect one or more components of the system. And while the diseases may differ, they all share one common feature: each results from a defect in one of the functions of the body’s normal immune system. Fortunately for patients with primary immunodeficiency disorders, the treatment paradigm has exploded in the past 10 years, giving medical directors and clinicians many more options in managing the PIDD patient population. The primary treatment for these patients with antibody deficiencies is lifetime administration of immunoglobulin replacement therapy; a therapeutic substance derived from human blood plasma and made up of immunoglobulin. These therapies have shown improved efficacy and safety for patients with PIDDs. Since Ig only replaces the missing end product but does not correct the patient’s defect in antibody production, Ig replacement is usually necessary for the patient’s lifetime. Although approximately 150,000 patients are likely to benefit from Ig replacement, only an estimated 35,000 to 55,000 receive ongoing therapy. A lack of awareness and depth of understanding contribute to this underserved population of individuals with PI thus it’s imperative healthcare professionals who manage PIDD patient populations have a solid understanding of differing options to optimize both costs and patient outcomes in their therapeutic application.
Physician, Nursing and CMCN credits valid to August 1, 2019

Personalized Treatment Strategies for IBD: Improving Patient Care and Outcomes

Inflammatory bowel disease (IBD) is a chronic, systemic autoimmune illness often strikes patients at a young age and the diagnosis of IBD is most commonly based on imaging, a critical role in the initial diagnosis, to assess the portions of the small bowel that is inaccessible to optical endoscopic visualization. This may also include a combination of endoscopy and histopathology. Immediate goals are to control the symptoms, achieve remission, and to help improve a patient’s quality of life, while long-term goals include maintenance of a corticosteroid-free clinical remission, mucosal healing, endoscopic remission, prevention or cure of complications, restoration, and maintenance of proper nutrition. The first pharmacological option are aminosalicylates, which are useful for treating flares and maintaining remission. Antibiotics may also be used to treat bacterial infections that may result from abscesses or fistulas. Corticosteroids are rapid-acting anti-inflammatory agents and are indicated for acute flares of disease only and have no role in the maintenance of remission. Immunomodulators have a slower onset of action and work to reduce patients’ overactive immune system. Finally, the use of biologics, which are proteins that stop certain molecules in the body from causing inflammation in the GI tract, are usually prescribed to those living with moderate to severe cases of IBD who haven’t responded to other types of treatment. Now that there is a better understanding of the pathogenesis of IBD, the development of new therapies targeting the inflammatory pathways is considered a high priority.
Physician, Nursing and CMCN credits valid to August 15, 2019

Novel Treatment Advances and Approaches in Rheumatoid Arthritis: Personalizing Therapy for Improved Clinical and Economic Outcomes

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. It typically results in warm, swollen, and painful joints, and pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body, which results in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Diagnosis is done through examination, including x-rays and ultrasounds, and blood testing for certain indications and to rule out other possible causes for the symptoms. There is no cure for RA, treatment is to control the pain, during flair ups especially, and to prevent joint damage. Rheumatoid arthritis varies greatly from patient to patient, and with each patient it varies over time. There may be flare-ups, where the pain and inflammation are much worse, or times of “remission” where the pain and inflammation disappear or almost disappear. In addition, many patients will have an inadequate response or can become intolerant to the widely used anti-TNF therapies. Clinicians have recently been equipped with more treatment options, including janus kinase (JAK) inhibitors, and several more have just completed late stage clinical trials and are currently undergoing regulatory review. These new options have shown improved efficacy and safety in RA.
Physician, Nursing and CMCN credits valid to August 10, 2019

Implementing Newer Biologic Therapies to Improve Economic and Clinical Outcomes in Patients with Moderate to Severe Atopic Dermatitis

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease characterized by periods of acute disease flare that may include painful burning sensations and persistent itching. AD occurs more frequently in adulthood, is often accompanied by co-morbidities such as rhinitis and asthma, and can severely affect quality of life. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States with an estimated annual direct and indirect cost of approximately $5 billion dollars. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Current atopic dermatitis treatments attempt to reduce inflammation and itchiness to maintain the protective integrity of the skin and have shown the ability to manage the disease in the short term but have had troubles with long term efficacy. Thankfully advances in the understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. Fortunately, several new treatments, including novel monoclonal antibodies or targeted therapies, such as JAK and PDE4 inhibitors, have shown improved efficacy and safety, offering patients the potential for improved outcomes and quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2019

Exciting Perspectives on Treating Psoriatic Arthritis: Exploring Personalized Treatment Strategies

Psoriatic arthritis (PsA) is a progressive, inflammatory disease that is associated with a number of dermatologic and musculoskeletal manifestations that often lead to extreme pain and joint damage that may affect a patient’s quality of life, physical function, and ability to work. This potentially disfiguring condition remains underdiagnosed and symptoms include fatigue, joint inflammation, and potentially progressive, irreversible joint damage. Diagnosing PsA can be very complex and may be easier to confirm if psoriasis coexists with symptoms of arthritis, however symptoms of PsA appear before symptoms of psoriasis. A careful medical history, physical examination, blood tests, magnetic resonance imaging (MRI), and x-rays of the involved joints along with a dermatologic evaluation may be used to diagnose PsA. The goals of treatment for PsA include early diagnosis, with early aggressive treatment aimed at limiting joint damage and clearing psoriasis. The treatment recommendations for PsA include the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and traditional disease-modifying antirheumatic drugs (DMARDs). Fortunately, novel biologic treatments have been developed and proven to stop joint damage, pain, and swelling in moderate to severe disease. These treatments include adalimumab, etanercept, golimumab, certolizumab, and infliximab. Other biologics have been produced that help block proteins IL-12, IL-23, and IL-17. These biologics reduce inflammation, are given by a subcutaneous injection, and are producing results that treat the skin as well as arthritis.
Physician, Nursing and CMCN credits valid to July 31, 2019

 

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Cardiovascular

Optimal Management Strategies for Reducing the Cardiovascular Risk in Patients with Hypertriglyceridemia

Hypertriglyceridemia refers to a condition in which patients have high levels of triglycerides, which is the most abundant fatty molecule in the bloodstream of most organisms. Triglyceride levels provide important information as a marker associated with the risk for heart disease and stroke, particularly in the setting of low high-density lipoprotein (HDL) cholesterol levels and/or elevated low-density lipoprotein (LDL) cholesterol levels. The main treatment focus of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet and reducing the risk of cardiovascular events through lipid management, and statin therapy has the potential to reduce the risks associated with cardiovascular disease (CVD). The greater the baseline level of triglycerides the greater the percent triglyceride reduction will be with statin treatment. In addition to statin treatment, 3 classes of medications are appropriate for the management of major triglyceride elevations and they include fibric acid derivatives, niacin, and omega-3 fatty acids. Recent clinical trials have shown that omega-3 fatty acids have the ability to lower CV risk in patients with high triglycerides and mixed dyslipidemia. Continued studies have shown that icosapent ethyl capsules, which are the latest addition to the omega 3 fatty acid treatment regimen, have demonstrated the ability to reduce triglyceride levels without elevation in levels of LDL-C.
Physician, Nursing and CMCN credits valid to August 1, 2020

Clinical Advances in the Treatment and Management of Pulmonary Arterial Hypertension (PAH)

Pulmonary Arterial Hypertension (PAH) is a progressive vascular disorder where continuous, exceedingly high blood pressure exists in the pulmonary artery – the blood vessel that carries blood from the right ventricle of the heart into the small arteries in the lungs. Over time, the heart muscle can become so weakened that its ability to pump enough blood through the body is lost, leading to heart failure – the most common cause of death for PAH patients. Though relatively rare PAH is a very serious, life threatening condition that worsens over time and for which there is no cure. Additionally, PAH often leads to the onset of co-morbidities associated with the disease. Accurate classification and early diagnosis and are essential to managing the disease and its associated costs. There are several treatments for PAH depending on the severity and the patient’s profile. These include monotherapy and combination therapies that can include prostacyclin/prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. Treatment guidelines continue to be updated. Because of the rarity of PAH, clinicians need to understand the risk factors and symptoms of the disease, along with the importance of diagnosing the patient in the appropriate class, so as to apply treatment algorithms accordingly for pharmacologic decisions.
Physician, Nursing and CMCN credits valid to December 31, 2019

Practical Strategies for Improving Diagnosis and Treatment of PAH

Pulmonary Arterial Hypertension (PAH) is a very serious, life threatening condition that worsens over time and for which there is no cure. Approximately half of people diagnosed with PAH will not live past five years, while those with untreated PAH have an average survival expectancy of approximately three years following diagnosis. PAH is a progressive vascular disorder where continuous, exceedingly high blood pressure exists in the pulmonary artery – the blood vessel that carries blood from the right ventricle of the heart into the small arteries in the lungs. As arteries narrow, they are more resistant to blood flow, which can cause stiffening or even the formation of tiny blood clots, sometimes causing blockages as the heart works harder to pump blood into the lungs. Over time, the heart muscle can become so weakened that its ability to pump enough blood through the body is lost, leading to heart failure – the most common cause of death for PAH patients. Additionally, PAH often leads to several co-morbidities associated with the disease, which not only puts the patient at higher risk but also increases the costs to the healthcare system. Early diagnosis and accurate classification are keys to managing the disease and its associated costs.
Physician, Nursing and CMCN credits valid to August 31, 2019

What Managed Care Needs to Know in the Evolving Treatment of Heart Failure: Novel Therapies for Improved Clinical and Economic Outcomes

Heart failure (HF) is a common condition that affects approximately 5.7 million people in the United States, and the prognosis for patients with heart failure has traditionally been poor. HF is responsible for over one million hospitalizations in the U.S. per year which attributes to an estimated $31 billion in costs. While recent efforts have focused on improving the outlook for patients with chronic heart failure, mortality and morbidity following admission for acute heart failure remain significant. In recent decades, an improved understanding of the pathobiology of HF has led to the introduction of several new classes of medications that have shown improved clinical outcomes in patients with HF. Although these new and emerging therapeutic options have shown to lower mortality their application in clinical practice have been less than ideal as the 5-year mortality rate and patient readmissions for HF remain unacceptably high. In fact, HF is the leading cause of hospitalization among adults over the age of 65 in the U.S. Thus, it is critical that physicians and healthcare providers implement individualized treatment strategies, promote shared decision-making with patients and, ultimately, enhance patient quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2020

A Deeper Look into the Newest Therapies in the Management of Heart Failure: Individualizing Therapy for Improved Clinical and Economic Outcomes

Heart failure (HF) is a common condition that affects approximately 5.7 million people in the United States, and the prognosis for patients with heart failure has traditionally been poor. HF is responsible for over one million hospitalizations in the U.S. per year which attributes to an estimated $31 billion in costs. While recent efforts have focused on improving the outlook for patients with chronic heart failure, mortality and morbidity following admission for acute heart failure remain significant. In recent decades, an improved understanding of the pathobiology of HF has led to the introduction of several new classes of medications that have shown improved clinical outcomes in patients with HF. Although these new and emerging therapeutic options have shown to lower mortality their application in clinical practice have been less than ideal as the 5-year mortality rate and patient readmissions for HF remain unacceptably high. In fact, HF is the leading cause of hospitalization among adults over the age of 65 in the U.S. Thus, it is critical that physicians and healthcare providers implement individualized treatment strategies, promote shared decision-making with patients and, ultimately, enhance patient quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2020

Comparative Effectiveness and Coordinated Care in Heart Failure: What Does Managed Care Need to Know about Novel Therapies?

Heart failure (HF) is a common condition that affects approximately 5.7 million people in the United States, and the prognosis for patients with heart failure has traditionally been poor. HF is responsible for over one million hospitalizations in the U.S. per year which attributes to an estimated $31 billion in costs. While recent efforts have focused on improving the outlook for patients with chronic heart failure, mortality and morbidity following admission for acute heart failure remain significant. In recent decades, an improved understanding of the pathobiology of HF has led to the introduction of several new classes of medications that have shown improved clinical outcomes in patients with HF. Although these new and emerging therapeutic options have shown to lower mortality their application in clinical practice have been less than ideal as the 5-year mortality rate and patient readmissions for HF remain unacceptably high. In fact, HF is the leading cause of hospitalization among adults over the age of 65 in the U.S. Thus, it is critical that physicians and healthcare providers implement individualized treatment strategies, promote shared decision-making with patients and, ultimately, enhance patient quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2020

Improving Patient Adherence, Quality of Life and Transitions in Care in Heart Failure Management

Heart failure (HF) is a common condition that affects approximately 5.7 million people in the United States, and the prognosis for patients with heart failure has traditionally been poor. HF is responsible for over one million hospitalizations in the U.S. per year which attributes to an estimated $31 billion in costs. While recent efforts have focused on improving the outlook for patients with chronic heart failure, mortality and morbidity following admission for acute heart failure remain significant. In recent decades, an improved understanding of the pathobiology of HF has led to the introduction of several new classes of medications that have shown improved clinical outcomes in patients with HF. Although these new and emerging therapeutic options have shown to lower mortality their application in clinical practice have been less than ideal as the 5-year mortality rate and patient readmissions for HF remain unacceptably high. In fact, HF is the leading cause of hospitalization among adults over the age of 65 in the U.S. Thus, it is critical that physicians and healthcare providers implement individualized treatment strategies, promote shared decision-making with patients and, ultimately, enhance patient quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2020

The Role of PCSK9 Inhibitors in Lowering LDL-C and Reducing Cardiovascular Risk in Patients with Dyslipidemia: What Managed Care Needs to Know

LDL-C is a major factor in the development of cardiovascular disease (CVD) which effects over 73 million adults in the United States. It is well established that lowering LDL-C in high-risk patients reduces the risk for CVD. Recent studies have begun debates among healthcare professionals about how best to measure LDL in order to identify patients at high risk for CVD and individualize therapy for them. Another area of intense interest is whether directing treatment to additional lipid targets will reduce the risk for CVD. Primary prevention promotes lifestyle behaviors to prevent the development of accelerating risk factors as well as elevated LDL-C. Genetic insights into the study of LDL-C levels have expanded potential targets of drug therapy and led to the development of novel therapeutic agents. Among them are modulators containing lipoproteins production and proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors. These man-made antibodies block a protein that prevents the body from eliminating LDL cholesterol from the bloodstream and offer a new way of fighting the build-up of artery-clogging fatty deposits that put patients at risk of heart attacks. They work differently from widely-used statins which inhibit the liver’s production of LDL cholesterol in the first place, and to which some patients don’t respond well. Recent data has shown that these PCSK9 agents cut levels of LDL cholesterol by close to 70 percent, more than statins alone.
Physician, Nursing and CMCN credits valid to August 1, 2020

A Late-Breaking Update on PCSK9 Inhibitors and Recent Cardiovascular Outcomes Data: Individualizing Therapy for Improved Clinical and Economic Outcomes

LDL-C is a major factor in the development of cardiovascular disease (CVD) which effects over 73 million adults in the United States. It is well established that lowering LDL-C in high-risk patients reduces the risk for CVD. Recent studies have begun debates among healthcare professionals about how best to measure LDL in order to identify patients at high risk for CVD and individualize therapy for them. Another area of intense interest is whether directing treatment to additional lipid targets will reduce the risk for CVD. Primary prevention promotes lifestyle behaviors to prevent the development of accelerating risk factors as well as elevated LDL-C. Genetic insights into the study of LDL-C levels have expanded potential targets of drug therapy and led to the development of novel therapeutic agents. Among them are modulators containing lipoproteins production and proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors. These man-made antibodies block a protein that prevents the body from eliminating LDL cholesterol from the bloodstream and offer a new way of fighting the build-up of artery-clogging fatty deposits that put patients at risk of heart attacks. They work differently from widely-used statins which inhibit the liver’s production of LDL cholesterol in the first place, and to which some patients don’t respond well. Recent data has shown that these PCSK9 agents cut levels of LDL cholesterol by close to 70 percent, more than statins alone.
Physician, Nursing and CMCN credits valid to August 1, 2020

A Managed Care Evaluation of PCSK9 Inhibitors in the Management of Dyslipidemia

LDL-C is a major factor in the development of cardiovascular disease (CVD) which effects over 73 million adults in the United States. It is well established that lowering LDL-C in high-risk patients reduces the risk for CVD. Recent studies have begun debates among healthcare professionals about how best to measure LDL in order to identify patients at high risk for CVD and individualize therapy for them. Another area of intense interest is whether directing treatment to additional lipid targets will reduce the risk for CVD. Primary prevention promotes lifestyle behaviors to prevent the development of accelerating risk factors as well as elevated LDL-C. Genetic insights into the study of LDL-C levels have expanded potential targets of drug therapy and led to the development of novel therapeutic agents. Among them are modulators containing lipoproteins production and proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors. These man-made antibodies block a protein that prevents the body from eliminating LDL cholesterol from the bloodstream and offer a new way of fighting the build-up of artery-clogging fatty deposits that put patients at risk of heart attacks. They work differently from widely-used statins which inhibit the liver’s production of LDL cholesterol in the first place, and to which some patients don’t respond well. Recent data has shown that these PCSK9 agents cut levels of LDL cholesterol by close to 70 percent, more than statins alone.
Physician, Nursing and CMCN credits valid to August 1, 2020

Breaking Down the Barriers to PCSK9 Inhibitor Use in Clinically Appropriate Patients: Bringing the Team Together to Improve Patient Outcomes

LDL-C is a major factor in the development of cardiovascular disease (CVD) which effects over 73 million adults in the United States. It is well established that lowering LDL-C in high-risk patients reduces the risk for CVD. Recent studies have begun debates among healthcare professionals about how best to measure LDL in order to identify patients at high risk for CVD and individualize therapy for them. Another area of intense interest is whether directing treatment to additional lipid targets will reduce the risk for CVD. Primary prevention promotes lifestyle behaviors to prevent the development of accelerating risk factors as well as elevated LDL-C. Genetic insights into the study of LDL-C levels have expanded potential targets of drug therapy and led to the development of novel therapeutic agents. Among them are modulators containing lipoproteins production and proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors. These man-made antibodies block a protein that prevents the body from eliminating LDL cholesterol from the bloodstream and offer a new way of fighting the build-up of artery-clogging fatty deposits that put patients at risk of heart attacks. They work differently from widely-used statins which inhibit the liver’s production of LDL cholesterol in the first place, and to which some patients don’t respond well. Recent data has shown that these PCSK9 agents cut levels of LDL cholesterol by close to 70 percent, more than statins alone.
Physician, Nursing and CMCN credits valid to August 1, 2020

 

Navigate to:  Preventive Health & Lifestyle Medicine | Behavioral Health | Chronic Illness: Autoimmune,  Cardiovascular,  DiabetesHemophilia, Infectious Disease,  Musculoskeletal/Rheumatology,  Neurological,  Pain Management,  Pulmonary, Urology

Diabetes

Examining the Impact of Cardiovascular Safety in the Management of Type 2 Diabetes: Managed Care Considerations in an Evolving Treatment Paradigm

The American Diabetes Association (ADA) estimates that 9.4% of the U.S. population has diabetes. About 90-95% of adults who have diabetes have type 2 Diabetes Mellitus (DM). According to the Centers for Disease Control (CDC), uncontrolled type 2 DM (T2DM) doubles a person’s risk for death, and on average individuals with T2DM lose 10-15 years of life. While the prevalence of diabetes continues to rise, a new generation of treatments has become available that allow the individualization of T2DM in the past few years. There have been many questions in member surveys and past program evaluations about the best practices in regards to the role of combination therapies comprised of SGLT-2 inhibitors in the management of type 2 diabetes. Additionally, new clinical trial data has become available for antidiabetic therapies that have shown improved outcomes for reducing macrovascular risk factors associated with T2DM, including hypertension and heart failure.
Physician, Nursing and CMCN credits valid to August 1, 2020

Hemophilia

Redefining Clinical Outcomes in Hemophilia: The Impact of Personalized Treatment Strategies

Hemophilia is an inherited disorder caused by a defect in one of the X chromosomes resulting in excessive bleeding and easy bruising. While females are typically carriers of the genetic defect, the majority of cases are seen in males and it’s believed that around 1 in 5,000 males are born with it every year. Bleeding can be external or internal and bleeding into the joints is especially a problem as it can cause long term damage if not treated quickly. Bleeding in the brain is an even more serious problem for those with severe hemophilia, since it can be caused by a simple head bump. Hemophilia A is more common than B and each type require different treatments. Hemophilia is diagnosed through blood tests to determine the severity of the disease and discover which clotting factor is low or missing. Replacement therapy remains the mainstay of treatment which contain concentrates of clotting factor which is infused and can be synthetic or made with human blood. Early treatment and prophylactic therapy is critical to effectively managing the disease and improving patient outcomes by preventing joint damage. Demand therapy is done on an as needed basis. Patient education is also critical as infusions can be taught to patients and done at home, alleviating unnecessary doctor appointments and lowering the cost of treatment. Replacement therapy can be taught to a capable person, and infusions can be done at home, making for quicker treatment with less stress, less visits to the doctor, and less cost.
Physician, Nursing and CMCN credits valid to August 1, 2019

 

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Infectious Disease

Managed Care Considerations in HPV: Overcoming Barriers for Improved Patient Outcomes

Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States, as well as a cause of various types of cancer. An estimated 79 million people in the United States are infected with some type of HPV, and approximately 50% of new infections occur in individuals before the age of 24. Despite the availability of safe and effective vaccines, HPV vaccination coverage remains low. There are various reasons why the vaccination rates are low, including patients’ and/or parents’ lack of knowledge about HPV and their discomfort with talking to health care providers about sexual activity, affordability, among other reasons.
Physician, Nursing and CMCN credits valid to May 1, 2020

Recent Updates on Vaccinations in HPV: Key Considerations for Improved Patient Outcomes

Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States, as well as a cause of various types of cancer. An estimated 79 million people in the United States are infected with some type of HPV, and approximately 50% of new infections occur in individuals before the age of 24. Despite the availability of safe and effective vaccines, HPV vaccination coverage remains low. There are various reasons why the vaccination rates are low, including patients’ and/or parents’ lack of knowledge about HPV and their discomfort with talking to health care providers about sexual activity, affordability, among other reasons.
Physician, Nursing and CMCN credits valid to May 1, 2020

Addressing the Challenges of HPV Vaccinations: Strategies for Overcoming Barriers

Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States, as well as a cause of various types of cancer. An estimated 79 million people in the United States are infected with some type of HPV, and approximately 50% of new infections occur in individuals before the age of 24. Despite the availability of safe and effective vaccines, HPV vaccination coverage remains low. There are various reasons why the vaccination rates are low, including patients’ and/or parents’ lack of knowledge about HPV and their discomfort with talking to health care providers about sexual activity, affordability, among other reasons.
Physician, Nursing and CMCN credits valid to May 1, 2020

What Does Managed Care Need to Know about Vaccinations in the Management of HPV?

Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States, as well as a cause of various types of cancer. An estimated 79 million people in the United States are infected with some type of HPV, and approximately 50% of new infections occur in individuals before the age of 24. Despite the availability of safe and effective vaccines, HPV vaccination coverage remains low. There are various reasons why the vaccination rates are low, including patients’ and/or parents’ lack of knowledge about HPV and their discomfort with talking to health care providers about sexual activity, affordability, among other reasons.
Physician, Nursing and CMCN credits valid to May 1, 2020

New Therapeutic Options in the Management of Hepatitis C (HCV): Optimized Clinical and Economic Strategies for Improved Patient Outcomes

Hepatitis C virus (HCV) infection is the most common chronic blood borne infection in the United States. Today, approximately 3.5 million persons in the United States are chronically infected with this disease and are at risk for the development of extrahepatic manifestations, compensated and decompensated cirrhosis, and hepatocellular carcinoma. Fortunately for patients with HCV, newer treatments have become available or are undergoing regulatory review, with shorter treatment time, increased efficacy and fewer side effects. Direct acting antiviral agents (DAA’s) are oral drugs that have fewer major side effects. In recent clinical trial data, some newer combination treatments have shown the ability to provide a virologic cure in as little as 8 weeks, significantly reducing the time that patients would need to be on a treatment regimen, thus making patient compliance much easier to maintain and improving patient outcomes. It is critical that health care professionals are updated on all the new data and information surrounding these new options.
Physician, Nursing and CMCN credits valid to February 1, 2020

Novel Treatment Advances in the Management of Serious Gram-Negative Bacterial Infections: Expert Strategies for Improved Patient Outcomes

The program will be on newer therapies in Gram-Negative Bacterial Infections, with a close look at options such as such as ceftolozane/tazobactam. The program will discuss how these newer option fits into the established paradigm and what healthcare professionals need to know about this option. The webcast will focus on how to manage gram-negative infections.
Physician, Nursing and CMCN credits valid to November 26, 2019

Novel Treatment Advances and Approaches in the Prevention and Management of Cytomegalovirus (CMV) Infection

Cytomegalovirus (CMV) infection remains a frequent complication in hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) recipients. In addition to causing a variety of end-organ diseases, CMV infection is also associated with rejection after SOT and with graft versus host disease (GVHD) after HSCT. Antiviral prophylaxis is effective against direct and indirect effects of CMV infection. Preemptive therapy, more commonly used after HSCT, is based on surveillance, and targets therapy to patients at highest risk. Novel antiviral therapies with different mechanisms of action have recently become available giving healthcare professionals new options in the management of this infection. This program will take a look at those advances and provide up to date strategies for the management of CMV infection.
Physician, Nursing and CMCN credits valid to September 30, 2019

Informed Decision-Making in the Management of HIV/AIDS: Expert Strategies for Individualized Treatment

The human immunodeficiency virus (HIV) is a lentivirus that causes HIV infection and over time acquired immunodeficiency syndrome (AIDS). AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. HIV infects vital cells in the human immune system such as helper T cells, macrophages, and dendritic cells. HIV infection leads to low levels of CD4+ T cells through a number of specific mechanisms. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. The CDC estimates that 1,218,400 persons in the United States aged 13 years and older are living with HIV infection. Additionally, an estimated 6,955 people died from HIV and AIDS in 2017. HIV treatment focuses on controlling the disease and living longer, healthier lives. One of the biggest challenges for clinicians is individualizing the care of HIV-positive patients and understanding when certain ART therapies and strategies are appropriate, and when they are not. Numerous studies have shown that ART must be tailored to the individual patient and his or her abilities and diverse needs. Fortunately, new treatments have become available over the past couple of years offering physicians additional options to address the unmet needs of these HIV patients, including combination regimens.
Physician, Nursing and CMCN credits valid to August 10, 2019

 

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Musculoskeletal & Rheumatology

Implementing Newer Therapies to Improve Economic and Clinical Outcomes in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. It typically results in warm, swollen, and painful joints, and pain and stiffness often worsen following rest. The disease may also affect other parts of the body, which results in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. There is no cure for RA. Treatment includes controlling the pain, during flair ups especially, and preventing joint damage. Many patients will have an inadequate response or can become intolerant to the widely used anti-TNF therapies. Consequently, the patient’s health-related quality of life may continue to be significantly reduced. Fortunately, new and emerging treatment strategies may offer additional therapeutic options to address the unmet needs of these patients. Clinicians have recently been equipped with more treatment options, including janus kinase (JAK) inhibitors, and several more have just completed late stage clinical trials and are currently undergoing regulatory review. These new options have shown improved efficacy and safety in RA, and healthcare professionals should be educated on these options, guidelines, and strategies for implementing them into the treatment paradigm.
Physician, Nursing and CMCN credits apply. Each session has its own specific valid dates.

 

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Neurological

Best Approaches for Diagnosing, Treating, and Managing Patients with Major Depressive Disorder

Major depression is a debilitating condition that nearly 20% of the general population in the United States will experience at some point in their life. More than 350 million people worldwide suffer from depression. With appropriate treatment, 70-80% of individuals with major depressive disorder can achieve a significant reduction in symptoms, although as many as 50% of patients may not respond to the initial treatment trial. These numbers are staggering, and many of these patients report cognitive difficulties. More than 80% of patients with depression have a medical comorbidity. Comorbidities or complications that can come from MDD include alcohol or substance abuse, type 2 diabetes, isolation, work and personal conflicts, and an increased chance of suicide.

Treatment is based on severity of depression and episode types, and may be multi-faceted, combining medication with psychotherapy. There are several treatment methods for major depression disorder, including psychotherapy, antidepressant medications, and other somatic therapies. Antidepressant treatments include selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, atypical and tricyclic antidepressants, monoamine oxidase inhibitors and other medications. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy. While there are many options out there, the need to personalize a treatment plan for each individual patient is important as the ultimate goal of care providers is to move patients suffering from MDD to remission, then recovery, and to avoid a relapse.
Physician, Nursing and CMCN credits valid to August 1, 2020

Optimizing Switching and Sequencing Strategies for Improved Clinical and Economic Outcomes in the Management of Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic progressive disease. Over the past decade, there have been numerous revisions to MS diagnostic criteria and the development of multiple new and emerging therapies. Currently treatment is focused on disease-modifying agents, which helps lessen the frequency and severity of relapses, reduce lesions in the brain, and help slow or stop disability. At present time, only one-third to one-half of the 400,000 individuals in the US have received treatment with these disease-modifying agents. While this is not a cure for multiple sclerosis, disease-modifying treatments have greatly improved the quality of life for patients with MS. Effective and timely treatment of relapsing MS can greatly improve the quality of life in MS patients. With the advancement and complexity of different treatment options, including therapies that have recently become available, clinicians are being challenged to quickly diagnose MS and its corresponding symptoms, and provide the correct treatment options that are available to patients. This presentation will update care providers on the current and emerging treatments and strategies in the management of relapsing MS.
Physician, Nursing and CMCN credits valid to August 1, 2020

New Advances in the Diagnosis and Treatment of Narcolepsy

Narcolepsy is a chronic disorder of hypersomnia that affects the brain’s ability to control sleep-wake cycles. For most people, mild sleepiness is apparent only during boring, sedentary situations, however patients with narcolepsy, severe excessive daytime sleepiness (EDS) leads to involuntary somnolence during regular activities that could put the patient and others in a harmful situation, such as driving, eating, or talking. Narcolepsy can interfere with psychological, social, and cognitive function and development and can inhibit academic, work, and social activities. With the potential danger surrounding narcoleptic patients, it is important for clinicians to understand and identify major sleep disorders and the best methods to diagnose and treat them.

Greater awareness of the disorder and its symptoms can help accurately and efficiently diagnosis the disease. As research continues to grow, better treatments for narcolepsy are becoming available. Sleep studies are an essential part of the evaluation and diagnosis of patients with narcolepsy. While in most instances imaging studies do not give an accurate picture of what is going on, a few studies done with an MRI can show structural abnormalities of the brain that will help show what may be the underlying cause of the sleep disorder. Symptoms can include EDS, sleep paralysis, hallucinations, but cataplexy is the most specific symptom and occurs in almost no other diseases. The combination of an overnight polysomnogram (PSG) followed by a multiple sleep latency test (MSLT) can provide the proper evidence of narcolepsy while excluding other sleep disorders.

Treatment of narcolepsy can include both nonpharmacologic and pharmacologic components. One constant is a healthy sleep schedule. Most patients improve if they maintain a regular sleep schedule, which is typically around 8 hours per night. Scheduled naps during the day also may help. Pharmacologic treatment of narcolepsy involves the use of stimulants to the central nervous system such as methylphenidate, modafinil, dextroamphetamine sulfate, methamphetamine, and amphetamine. These medications help reduce daytime sleepiness, improving the symptoms in around 70% of patients. There are newer treatments that are currently undergoing clinical trials and are awaiting approval by the FDA, such as solriamfetol, which would help to treat excessive sleepiness in narcolepsy. With all the literature that continues to surface on the topic of EDS and narcolepsy, it is important that medical directors, clinicians and healthcare professionals are kept up-to-date on the current and emerging treatments.
Physician, Nursing and CMCN credits valid to August 1, 2020

Key Considerations for Preventing Residual Paralysis in the Perioperative Setting: What Managed Care Needs to Know About Neuromuscular Blockade Reversal

Neuromuscular blocking agents (NMBAs) are used in many surgical procedures and have enabled new surgical advances. The expanded landscape of NMB reversal drugs allows for fast and complete neuromuscular blockade (NMB) reversal and the reduction of postoperative complications from residual block. In the United States, neostigmine/ glycopyrrolate and sugammadex are the primary agents for pharmacologic antagonism of NMBAs. While neostigmine and an anticholinergic have been available for decades, sugammadex has only recently become available. This presentation will closely look at these options, determine what managed care needs to know about NMB and reversal, in a variety of surgeries and clinical settings in which the use of NMB reversal agents played a significant role in the patients’ clinical outcome.
Physician, Nursing and CMCN credits valid to August 1, 2020

Exploring New Perspectives in the Treatment and Management of Spinal Muscular Atrophy

Spinal muscular atrophy (SMA) is a genetic disease affecting the part of the nervous system that controls voluntary muscle movement. The disorders are caused by an abnormal or missing gene known as the survival motor neuron gene 1 (SMN1), which is responsible for the production of a protein essential to motor neurons. Without this protein, lower motor neurons in the spinal cord degenerate and die. Without a proper level of SMN protein, motor neurons in the spinal cord will be lost, preventing the body’s muscles from receiving signals from the brain. This can lead to progressive muscle weakness and wasting. The type of SMA (I, II, or III) is determined by the age of onset and the severity of symptoms. Type I is typically evident at birth to the first few months of age. Type II usually begins between 6 and 18 months of age and Type III usually appears between 2 and 17 years of age. Most cases of SMA are inherited as an autosomal recessive trait, although dominant families are known. This neuromuscular disease is the second most common lethal autosomal recessive disorder in white populations with an overall incidence of 1 in 10,000 live births and a carrier frequency of about 1/50.

The first steps in diagnosis of a neuromuscular disease are usually an in-office physical examination with questions centered around family history, and simple blood tests that can indicate whether there are deletions or mutations of the SMN1 gene. Other diagnostic methods include genetic testing, if SMA is suspected, and electromyography. CT Scans, MRIs, and biopsy procedures can also help identify if SMA is present. Treating and managing spinal muscular atrophy requires a collaborative and multidisciplinary approach. Although there is no cure, there are current and emerging treatments that will help manage the symptoms and prevent complications. One such treatment is nusinersen, is an antisense oligonucleotide (ASO) that increases the expression of a functional SMN protein. Treatments also include different muscle relaxants that may reduce spasticity as well as symptoms such as jaw spasms and drooling. And then physical therapy, occupational therapy, and rehabilitation may help to improve posture, prevent joint immobility, and slow muscle weakness and atrophy. Promising results from clinical trials indicate that several additional treatment options, such as gene replacement therapy, could be available for patients with SMA in the near future.
Physician, Nursing and CMCN credits valid to August 1, 2020

Applying Therapeutic Strategies to Improve the Quality of Life in Patients with Alzheimer’s

Affecting an estimated 5 million people in the United States, Alzheimer’s disease is the most common form of dementia. Over time the disease destroys large areas of the brain, resulting in cellular loss and dysfunction, a gradual loss of memory, problems with reasoning or judgment, disorientation, difficulty in learning, loss of language skills, and decline in the ability to perform routine tasks. Currently, 26 million people worldwide have this dementia. And by the year 2050, over 15 million Americans will be affected with the disease. Alzheimer’s disease care costs $172 billion annually in the United States alone.

In clinical practice, the diagnosis is typically made on the basis of the history and findings on a Mental Status Examination. Diagnosing Alzheimer’s requires careful medical evaluation, including medical history, mental status testing, physical and neurological exam, blood tests and brain imaging. The importance of early diagnosis cannot be understated. As the use of biomarkers continues to grow, the potential for catching Alzheimer’s disease even earlier is crucial to improving outcomes. Treatment for Alzheimer’s disease is entering into a promising stage, with several new drugs beginning clinical trials. Many of these new therapies are based on an understanding of the pathogenesis of Alzheimer’s disease, and are designed to try to either slow or halt the progression of the disease. Therapies directed against some aspect of beta-amyloid formation, against neurofibrillary tangle formation and against the inflammatory response are all considered, as are the problems associated with each area.
Physician, Nursing and CMCN credits valid to February 1, 2020

Disease Modifying Therapies in Multiple Sclerosis: Strategies to Optimize Clinical Management

Multiple Sclerosis (MS) is a chronic progressive disease. Over the past decade, there have been numerous revisions to MS diagnostic criteria and the development of multiple new and emerging therapies. Currently treatment is focused on disease-modifying agents, which helps lessen the frequency and severity of relapses, reduce lesions in the brain, and help slow or stop disability. At present time, only one-third to one-half of the 400,000 individuals in the US have received treatment with these disease-modifying agents. While this is not a cure for multiple sclerosis, disease-modifying treatments have greatly improved the quality of life for patients with MS. Effective and timely treatment of relapsing MS can greatly improve the quality of life in MS patients. With the advancement and complexity of different treatment options, including therapies that have recently become available, clinicians are being challenged to quickly diagnose MS and its corresponding symptoms, and provide the correct treatment options that are available to patients. This presentation will update care providers on the current and emerging treatments and strategies in the management of relapsing MS.
Physician, Nursing and CMCN credits valid to February 1, 2020

Improving Treatment Outcomes in the Management of Epilepsy

Epilepsy is a chronic neurological disorder where the nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behavior. Epilepsy affects about 3 million people in the United States and accounts for about $15 billion in medical costs. The diagnosis of epileptic seizures is made by analyzing the patient’s clinical history as well as performing neurophysiological and neuroimaging tests. Treatment of epilepsy involves reducing the number of seizures by administering various antiepileptic drugs (AEDs). This approach requires long-term adherence from patients. Uncontrolled seizures and their associated comorbidities, such as depression, can have detrimental effects on the patient’s quality of life. The development of new AEDs continue to increase and drug therapies can now be individualized to the patient’s symptoms and needs. It is also important to understand the mechanisms of action and the pharmacokinetics of antiepileptic drugs so that these agents can be used effectively in clinical practice, especially in the combined therapeutic strategies.
Physician, Nursing and CMCN credits valid to February 1, 2020

New Therapeutic Options in the Prevention and Management of Migraines: How Emerging CGRP Therapies Could Change the Treatment Paradigm

According to the World Health Organization (WHO), Migraine is ranked in the top fifteen most disabling medical conditions. It is a major neurological disease and affects more than 36 million people in the United States. It is believed that a substantial number of people with the condition remain undiagnosed, which stresses the importance of proper screening and diagnostic tools and strategies. Patients with frequent migraines and/or who experience functional disability need preventative migraine treatment. The fact that diagnosis is based entirely on clinical history poses a challenge for healthcare professionals, as migraine is only 1 of approximately 300 headache disorders. A new class of therapy is emerging that has shown to offer vastly improved efficacy and safety over traditional treatment regimens. Calcitonin gene-related peptide (CGRP) monoclonal antibodies are under clinical investigation and look to offer healthcare professionals a new and improved armamentarium in the treatment and prevention of migraines. CGRP monoclonal antibodies are specifically designed to bind to and inhibit the activity of CGRP that may prevent or significantly reduce the frequency of monthly migraine headache days in patients with episodic and chronic migraine and cluster headache. The role of CGRP in migraine has been verified by basic research and several therapies are currently undergoing late stage clinical trials.
Physician, Nursing and CMCN credits valid to January 1, 2020

Individualizing Therapy in the Management of Relapsing Multiple Sclerosis: Expert Strategies for Improved Patient Outcomes

Multiple Sclerosis (MS) is a chronic progressive disease and is the most common neurological cause of disability among young adults in the United States with a prevalence of approximately 400,000 cases. Multiple sclerosis may not be diagnosed for months to years after the onset of symptoms and some strategies for diagnosis include a careful medical history, a neurologic exam and various tests, including magnetic resonance imaging (MRI), evoked potentials (EP) and spinal fluid analysis. Although there is no cure for MS, many advances in treatment options have arrived in recent years, allowing patients to manage these symptoms and improve their quality of life. A number of factors must be considered when selecting a treatment regimen for patients with MS, including variations in clinical and MRI evidence of disease. Treatment is focused on disease-modifying agents, which helps lessen the frequency and severity of relapses, reduce lesions in the brain, and help slow or stop disability. Many therapeutic and technological advances are improving our understanding of the complex mechanisms involved in multiple sclerosis (MS) immunopathophysiology. Several investigational agents that have recently completed clinical trials that focus on Sphingosine-1-phosphate (S1P) signaling. S1P-based therapeutics in current clinical trials have shown improved efficacy, safety and deliverability.
Physician, Nursing and CMCN credits valid to August 1, 2019

Exploring Treatment Advances in Epilepsy: Keys to Optimizing Adherence and Patient Outcomes

Epilepsy is a chronic neurological disorder where the nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behavior. Epilepsy affects about 3 million people in the United States and accounts for about $15 billion in medical costs. The diagnosis of epileptic seizures is made by analyzing the patient’s clinical history as well as performing neurophysiological and neuroimaging tests. Treatment of epilepsy involves reducing the number of seizures by administering various antiepileptic drugs (AEDs). This approach requires long-term adherence from patients. Uncontrolled seizures and their associated comorbidities, such as depression, can have detrimental effects on the patient’s quality of life. The development of new AEDs continues to increase and drug therapies can now be individualized to the patient’s symptoms and needs. It is also important to understand the mechanisms of action and the pharmacokinetics of antiepileptic drugs so that these agents can be used effectively in clinical practice, especially in the combined therapeutic strategies.
Physician, Nursing and CMCN credits valid to August 15, 2019

 

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Pain Management

New Frontiers in the Treatment and Prevention of Migraines: A Closer Look at the Role of Emerging CGRP Targeted Therapies

Migraine is a major neurological disease that affects more than 36 million men, women and children in the United States. Migraine headache is the most common type of headache presented by patients that seek medical treatment, and the World Health Organization (WHO) has ranked migraine in the top fifteen most disabling medical conditions. In many patients with migraine headache, their pain is unrelieved, and recurrence of migraine is a common reason for patient dissatisfaction with treatment. The diagnosis of a migraine is based on signs and symptoms and neuroimaging tests are not necessary to diagnose migraine but may be used to find other causes of headaches in those whose examination and history do not confirm a migraine diagnosis. Patients with frequent migraines and/or who experience functional disability need preventative migraine treatment however currently available migraine therapy is often inadequate. Fortunately for patients who suffer from migraine headaches, a new class of therapy is emerging that has shown to offer vastly improved efficacy and safety over traditional treatment regimens. Calcitonin gene-related peptide (CGRP) monoclonal antibodies are under clinical investigation and look to offer healthcare professionals a new and improved armamentarium in the treatment and prevention of migraines. CGRP monoclonal antibodies are specifically designed to bind to and inhibit the activity of CGRP that may prevent or significantly reduce the frequency of monthly migraine headache days in patients with episodic and chronic migraine and cluster headache. The role of CGRP in migraine has been verified by basic research and several therapies are currently undergoing late stage clinical trials.
Physician, Nursing and CMCN credits valid to July 31, 2019

 

Navigate to:  Preventive Health & Lifestyle Medicine | Behavioral Health | Chronic Illness: Autoimmune,  Cardiovascular,  DiabetesHemophiliaInfectious Disease,  Musculoskeletal/Rheumatology,  Neurological,  Pain Management,  Pulmonary, Urology

Pulmonary

Optimizing Treatment Strategies in the Management of Pulmonary Arterial Hypertension to Improve Patient Outcomes

Pulmonary Arterial Hypertension (PAH) is a progressive vascular disorder where continuous, exceedingly high blood pressure exists in the pulmonary artery – the blood vessel that carries blood from the right ventricle of the heart into the small arteries in the lungs. As a response to the elevated resistance of blood flow, the pressure increases in the pulmonary artery and causes the right ventricle of the heart to work harder to pump blood into the lungs. Over time, the heart muscle can become so weakened that its ability to pump enough blood through the body is lost, leading to heart failure – the most common cause of death for PAH patients. Though relatively rare – affecting approximately six per one million people – PAH is a very serious, life threatening condition that worsens over time and for which there is no cure. Approximately half of people diagnosed with PAH will not live past five years. Additionally, PAH often leads to the onset of comorbidities associated with the disease, which not only puts the patient at higher risk but also increases the costs to the healthcare system.

Because of the rarity of PAH, clinicians need to understand the risk factors and symptoms of the disease, along with the importance of diagnosing the patient in the appropriate class, so as to apply treatment algorithms accordingly for pharmacologic decisions. Treatment guidelines continue to be updated to find the best treatment for the severity and individual nature of the disease in each patient. These include monotherapy and combination therapies that can include prostacyclin/prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. There are also treatments that can that target a key molecular mechanism and one of these is a director stimulator for soluble guanylate cyclase in an oral form. Optimal treatment, accurate classification, and risk stratification are keys to managing the patient’s health and costs, as incorrect classification can lead to inappropriate treatment decisions.
Physician, Nursing and CMCN credits valid to August 1, 2020

Improving Patient Outcomes in the Treatment and Management of Cystic Fibrosis: What’s New in CFTR Modulator Therapy

Cystic fibrosis (CF), also known as mucoviscidosis, is an autosomal recessive, genetic disorder that affects mostly the lungs but also the pancreas, liver, kidneys, and intestine. caused by the presence of mutations in both copies of the gene for the protein cystic fibrosis transmembrane conductance regulator (CFTR). Those with a single working copy are carriers and otherwise mostly normal. CFTR is involved in production of sweat, digestive fluids, and mucus. When CFTR is not functional, secretions which are usually thin instead become thick. According to the Cystic Fibrosis Foundation, about 30,000 people are currently living with cystic fibrosis, and approximately 1,000 new cases of CF are diagnosed each year. There is no cure for cystic fibrosis, but recent treatment breakthroughs have the ability to provide a greater quality of life and improved outcomes for patients with CF. The condition is diagnosed by a sweat test and genetic testing and screening of infants at birth takes place in some areas of the world.

Long-term issues include difficulty breathing and coughing up sputum as a result of frequent lung infections. Other symptoms include sinus infections, poor growth, fatty stool, clubbing of the finger and toes, and infertility in males among others. The degrees of symptoms vary among patients and fortunately, for about half of CF patients, new treatments have become available for those who have two copies of the F508del mutation in their CFTR gene. This newer CFTR modulation therapeutic focuses on counteracting the damage caused by the disease, enabling patients to breath more easily and stay out of the hospital, improving outcomes and quality of life. This option is a major breakthrough in CF management, because it is the first therapy that specifically targets an important genetic mutation. Additionally, There has been new data presented in recent months in the cystic fibrosis arena, especially as it relates to combination therapies.
Physician, Nursing and CMCN credits valid to August 1, 2020

Exploring New Pathways and Emerging Data for Better Control and Management in the Personalized Treatment of Severe Asthma

Approximately 26 million Americans suffer from asthma with the prevalence of severe asthma being 10% of the asthmatic population. The goal of treatment strategies and controlling a patient’s asthma, preventing the symptoms, and minimizing adverse effects has shifted within the last few years. Today, there is more of an approach to implementing a personalized treatment plan as a key component to patient adherence and overall asthma control. One of these treatment plans includes using pharmacologic management through inhaled corticosteroids (ICS), long-acting beta-2 agonists, theophylline, and leukotriene modifiers. And while these are helping, several new therapies, such as anti-immunoglobulin E and anti-IL- antibodies, are aiming to control and treat asthma, which could improve the lives of patients with uncontrolled persistent asthma. More recent studies and clinical data show that new treatments such as biologics and injectables are set to become available and could help improve lung function, reduce severe exacerbations and decrease rescue bronchodilator use. Patient adherence also plays a key role in satisfaction with a personalized treatment plan. Clinicians can improve patients’ inhaler technique by assessing for and correcting inhaler errors on a regular basis; however, evidence suggests that many clinicians do not perform this guideline-recommended assessment. These new options will also reduce the number of hospital visits and ultimately reduce cost. Patient nonadherence and poor inhaler technique have been linked to higher rates of uncontrolled asthma, with concomitant increases in disease burden and healthcare utilization. With all the recent advances in therapeutic options it is being shown a personalized treatment plan needs to be put in the management strategy.
Physician, Nursing and CMCN credits valid to August 1, 2020

Recent Advances in Personalized Treatment Strategies in Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is a lung disease that results from the formation of scar tissue deep inside the lungs. As the scarring in the lungs progressively gets worse, it makes it difficult for patients to breathe as well as keep adequate levels of oxygen in the bloodstream. IPF typically has a poor prognosis and is difficult to diagnosis early. In recent years, updated guidelines for the management of IPF were published to provide healthcare professionals the best practices in diagnosis and management of IPF. Diagnosis should start with the elicitation of a thorough and extensive medical history that should include review of symptoms or signs suggestive of a systemic disorder, occupational and environmental exposures, use of medications and drugs, and family medical history. Treatment strategies for IPF aim at managing the symptoms and slowing disease progression to best maintain a patient’s quality of life. More recently, therapeutic options for IPF have evolved to include targeted agents that have the ability to individualize treatment for patients. Along with these treatments, the standard of care for IPF includes oxygen supplementation, management of co-morbidities, and lung transplants. Recent clinical trials have identified new treatments for this disease which will lead to the approval of new therapeutic options by the FDA.
Physician, Nursing and CMCN credits valid to February 1, 2020

Optimizing Outcomes with CFTR Modulator Therapy in the Management of Cystic Fibrosis: A Closer Look at the Role of Combination Therapy

Cystic fibrosis (CF) is a genetic, autosomal recessive disorder that mainly affects the lungs but also the pancreas, liver, kidneys, and the intestines. Difficulty breathing and coughing up sputum as a result of frequent lung infections are characteristics of this disease. Other symptoms include sinus infections, poor growth, fatty stool, clubbing of the finger and toes, and infertility in males among others. Patients may have different degrees of symptoms due to several mutation classes in CF. According to the Cystic Fibrosis Foundation, about 30,000 people are currently living with CF and approximately 1,000 new cases are diagnosed each year. Although there is no cure for CF recent treatment breakthroughs have been able to reduce hospital admissions, enable easier breathing, provide a greater quality of life, and improve outcomes for patients. Fortunately for about half of CF patients, a new treatment is available for those who have two copies of the F508del mutation in their CFTR gene. This new CFTR modulation therapeutic focuses on counteracting the damage caused by the disease. This option is a major breakthrough in CF management as it is the first therapy that specifically targets an important genetic mutation.
Physician, Nursing and CMCN credits valid to January 1, 2020

Building a Better Understanding in Asthma Management: Best Practices for Treatment and Control

Characterized by reversible airway obstruction, airway hyper-responsiveness, and the production of specific inflammatory mediators, asthma affects approximately 26 million Americans. Greater attention is needed in appropriate management of this condition to help patients achieve asthma control. There are various problems that affect adherence amongst asthma patients to include inadequate physician-patient communication, absence of a clear treatment plan, and lack of managing lifestyle/environmental triggers. Traditional pharmacologic treatment includes the use of inhaled corticosteroids (ICS), long-acting beta-2 agonists, theophylline, and leukotriene modifiers. Several new therapies, such as anti-immunoglobulin E and anti-IL- antibodies, are aiming to control and treat asthma, which could improve the lives of patients with uncontrolled persistent asthma. More recent studies and clinical data show that new treatments and injectables are set to become available and could help improve lung function, reduce severe exacerbations, and decrease rescue bronchodilator use. Novel biologics are also in development to target inflammatory mediators that explore multiple phenotypes and endotypes of severe asthma. With all the recent advances in therapeutic options, a personalized treatment plan that combines pharmacological treatment and lifestyle modification needs to be integrated into the management strategy.
Physician, Nursing and CMCN credits valid to January 1, 2020

Clinical Advances in Idiopathic Pulmonary Fibrosis: New Treatment Goals and Strategies

Idiopathic pulmonary fibrosis (IPF) is a lung disease that results from the formation of scar tissue deep inside the lungs and is the most common of the idiopathic interstitial pneumonias. IPF is a devastating disease associated with irreversible destruction of the lung as the scarring gets progressively worse which makes it difficult for patients to breathe as well as keep adequate levels of oxygen in the bloodstream. The condition is more common in men than in women, and its frequency increases with age between 40 and 70 years. IPF typically has a poor prognosis and the median survival rate is less than four years or fewer from diagnosis. Most patients with IPF present with a gradual onset, which makes it difficult to diagnosis early. Healthcare professionals are constantly looking at ways to diagnosis the disease much earlier to improve outcomes. It must start with the elicitation of a thorough and extensive medical history that should include review of symptoms or signs suggestive of a systemic disorder, occupational and environmental exposures, use of medications and drugs, and family medical history. Patients may also complain of paroxysmal dry cough, shortness of breath, and fatigue. Despite a growing prevalence, patients with IPF continue to suffer delays in diagnosis which can limit treatment options, as well as increase costs, reduce patient quality of life, and impact survival.
Physician, Nursing and CMCN credits valid to August 1, 2019

Clinical Advances in the Diagnosis, Treatment and Management of COPD

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs and is the third-leading cause of death in the US, following cancer and heart disease. COPD is an incurable and progressive disease so early diagnosis is very important to decrease lung damage and reduce costs. Unfortunately, COPD is substantially under-diagnosed, undertreated, and is devalued as a major health issue. Smoking is the most common contributing cause of COPD in the US and if not treated early on and aggressively, can lead to disability, comorbid conditions, decreased quality of life, and an increased risk of premature death. Spirometry is required for the diagnosis of COPD. Treatment goals of COPD include relieving symptoms, improving health status and quality of life, reducing the number and severity of exacerbations, preventing and treating complications, and ensuring appropriate end-of-life planning and palliation. The recommended guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) share that all COPD patients should continuously be assessed based on their symptoms, the severity of airflow limitation, frequency of exacerbations, and comorbidities. The updated GOLD report further adds a thorough review of nonpharmacologic treatment options, in addition to receiving influenza and pneumococcal vaccinations to decrease the risk for lower respiratory tract infections.
Physician, Nursing and CMCN credits valid to August 1, 2019

Recent Advances in CFTR Modulator Therapy in the Management of Cystic Fibrosis: Best practices for Improved Patient Outcomes

Cystic fibrosis (CF) is a genetic, autosomal recessive disorder that affect the lungs, pancreas, liver, kidneys and intestine. Long-term issues include difficulty breathing and coughing up sputum, sinus infections, poor growth, fatty stool, clubbing of the finger and toes, and infertility in males. CF is caused by the presence of mutations in both copies of the gene for the protein cystic fibrosis transmembrane conductance regulator (CFTR) which is involved in the production of sweat, digestive fluids, and mucus. The condition is diagnosed by a sweat test and genetic testing and screening of infants at birth takes place in some areas of the world. There is no cure for cystic fibrosis but fortunately a new treatment is available for those who have two copies of the F508del mutation in their CFTR gene (about half of patients). This new CFTR modulation therapeutic focuses on counteracting the damage caused by the disease, enabling patients to breath more easily and stay out of the hospital, providing a greater quality of life and improved outcomes.
Physician, Nursing and CMCN credits valid to August 8, 2019

Exploring the Challenges of Severe Asthma: Implementing Personalized Treatment Plans for Improved Patient Outcomes

Approximately 26 million Americans suffer from asthma with the prevalence of severe asthma being 10% of the asthmatic population. The goal of treatment strategies and controlling a patient’s asthma, preventing the symptoms, and minimizing adverse effects has shifted within the last few years. Today, there is more of an approach to implementing a personalized treatment plan as a key component to patient adherence and overall asthma control. One of these treatment plans includes using pharmacologic management through inhaled corticosteroids (ICS), long-acting beta-2 agonists, theophylline, and leukotriene modifiers. And while these are helping, several new therapies, such as anti-immunoglobulin E and anti-IL- antibodies, are aiming to control and treat asthma, which could improve the lives of patients with uncontrolled persistent asthma. More recent studies and clinical data show that new treatments such as biologics and injectables are set to become available and could help improve lung function, reduce severe exacerbations and decrease rescue bronchodilator use. Patient adherence also plays a key role in satisfaction with a personalized treatment plan. Clinicians can improve patients’ inhaler technique by assessing for and correcting inhaler errors on a regular basis; however, evidence suggests that many clinicians do not perform this guideline-recommended assessment. These new options will also reduce the number of hospital visits and ultimately reduce cost. Patient nonadherence and poor inhaler technique have been linked to higher rates of uncontrolled asthma, with concomitant increases in disease burden and healthcare utilization. With all the recent advances in therapeutic options it is being shown a personalized treatment plan needs to be put in the management strategy.
Physician, Nursing and CMCN credits valid to August 3, 2019

 

Navigate to:  Preventive Health & Lifestyle Medicine | Behavioral Health | Chronic Illness: Autoimmune,  Cardiovascular,  DiabetesHemophilia, Infectious Disease,  Musculoskeletal/Rheumatology,  Neurological,  Pain Management,  Pulmonary, Urology

Urology

Overcoming Challenges with a Patient-Centered Approach in the Management of Overactive Bladder

Affecting approximately 33 million people, overactive bladder (OAB) is a highly prevalent condition. It has a significant impact on quality of life (QoL), co-morbidities and cost; sufferers are two to three times more likely to experience disturbed sleep, overeating, poor self-esteem, and depression. Once diagnosed, there are a variety of treatments available. There is a stepwise progression in the management of OAB and multiple options of treatment available in each of the lines of therapy provide for a tailored approach to individualize treatment based upon a patient’s expectation and goal for treatment, their co-morbidities, symptoms, and the side-effects of treatments. What works and does not work will vary patient to patient, and it’s important to keep communications open to determine if a patient is unable to remain compliant to treatment due to side-effects or cost.
Physician, Nursing and CMCN credits valid to February 1, 2020

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