Health Management


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Preventive Health & Lifestyle Medicine

Immunizations, Prevention, Lifestyle, & Wellness:  Optimizing Health, from Prevention through Lifestyle

This program on Immunizations, Prevention and Lifestyle will provide medical directors, clinicians, nurses and other healthcare professionals with the information they need to address and close these gaps in knowledge regarding immunization percentages, improved screenings, and improved knowledge of lifestyle medicine. Participants will receive instruction on immunization and screening prevention guidelines and lifestyle medicine and how they can help patients and clinicians increase knowledge about preventive and lifestyle medicine.
Physician Nursing and CMCN credits valid to October 31, 2017

Behavioral Health

Improving Diagnosis & Treatment Strategies for Major Depressive Disorder

Major depression is a treatable cause of pain, suffering, disability and death, yet primary care clinicians detect major depression in only one-third to one-half of their patients with major depression. In 2010, The World Health Organization (WHO) released date from their study of depression and mental disorders in the United States and found that MDD accounts for 8.31 percent of US years lived with disability (YLDs). YLDs are the prevalence of MDD times the short- or long-term loss of health. To help put this in perspective, anxiety disorders, the second highest YLDs, account for 5.09%, with drug use disorders accounting for 3.53%. MDD also accounts for 3.7 percent of all US disability-adjusted life years (DALYs), that being the total number of years lost to illness, disability, or premature death. While drug use disorders account for 2.61% and anxiety disorders account for 2.28%. Comorbidities or complications that may arise from MDD include alcohol abuse or substance abuse, stroke, type 2 diabetes, isolation, work and personal conflicts, and an increased chance of suicide.

Major depression disorder can be effectively treated and allow the patient to live without debilitating depression. Newer antidepressant medications have been shown to effectively decrease the symptoms of MDD. Treatment is based on severity of depression, and episode types. Treatment may be multi-faceted, combining medication with psychotherapy. Treatment may change several times as different medications affect people in different ways. Treatment may start with a selective serotonin reuptake inhibitor (SSRI), but if there is no effect, or if the side effects are adverse enough to affect patient adherence, then treatment may change to a serotonin and norepinephrine reuptake inhibitor (SNRI) or a norepinephrine and dopamine reuptake inhibitor (NDRI). Some effective treatments, specifically antidepressants, are currently limited by factors that affect treatment adherence and bring about different side-effects. Recent data showing antidepressant combinations with different mechanisms of action can be a better strategy prior to augmentation with other drug classes. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy.
Physician, Nursing and CMCN credits valid to August 1, 2018

Identification and Treatment of Major Depressive Disorder

Major depressive disorder (MDD) is treatable and the earlier treatment starts, the better the outcomes. More than 80% of patients with depression have a medical comorbidity and recent studies show that prolonged depression may raise the risk of stroke and type 2 diabetes. Isolation, personal conflicts, an increase in the use of alcohol or substance abuse and an chance of suicide are also a major concern. These studies show the importance of using approved evidence-based guidelines to choose an appropriate treatment management plan. MDD can be effectively treated and allow the patient to live without debilitating depression as there are several different treatment programs; usually medication and psychotherapy are effective. Newer antidepressant medications have been shown to effectively decrease the symptoms of MDD. Some effective treatments, specifically antidepressants, are currently limited by factors that affect treatment adherence and bring about different side-effects. Recent data showing antidepressant combinations with different mechanisms of action can be a better
strategy prior to augmentation with other drug classes. Combination therapies, including multiple pharmacological actions, can affect multiple monoamine targets which can produce greater efficacy.

Physician, Nursing and CMCN credits valid to January 31, 2018

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

Chronic Illness

AutoImmune

Individualizing Therapy in the Management of Rheumatoid Arthritis: A Closer Look at Emerging Therapeutic Options

According to the American College of Rheumatology (ACR), it is estimated that over 1.3 million people suffer from Rheumatoid arthritis (RA) in the United States. Rheumatoid arthritis varies greatly from patient to patient, and with each patient it varies over time. Diagnosis is done through examination to including x-rays, ultrasounds, and blood testing for certain indications and to rule out other possible causes for the symptoms. There is no cure for RA, and the goal of treatment is to control the pain, especially during flair ups, and to prevent joint damage. However, even with all of the currently available non-biologic and biologic therapies, only about 1/3 of patients treated for RA ever achieve clinical remission. The remaining patients can 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 may offer additional therapeutic options to address the unmet needs of these patients. Clinicians have recently been equipped with more treatment options, including IL-6 receptor antagonists, and several more have just completed late stage clinical trials and are currently undergoing regulatory review.
Physician, Nursing and CMCN credits valid to August 1, 2018

Improving Management Strategies and Patient Adherence in the Treatment of Psoriasis

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. The disease most commonly appears on the skin of the scalp, elbow, knees, and lumboscaral areas of the body. Psoriasis is a complex disease to manage with a greatly undeserved patient population, and 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. Early diagnosis and treatment may help to reduce the economic burden. Physicians usually classify the disease as mild to severe which can help determine the best treatment strategies for the patient.

Treatment options are based on the severity of the disease and may include topical treatments, phototherapy, and laser therapy. 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. Biologics require a reliable baseline of laboratory tests, regular blood testing, and patient education regarding the effect of biologics on their immune system and what vaccines they can have or must avoid. Biologics can be very effective in the treatment of psoriasis, but proper management must be done in order to assure the best safety and efficacy for the patient. Although biologic therapies are becoming more available and represent a significant safety advance over traditional systemic therapies, most of the patients receiving current systemic agents are not being treated with biologics.
Physician, Nursing and CMCN credits valid to August 1, 2018

What’s New in the Evolving Treatment Landscape for Moderate-to Severe Atopic Dermatitis

Atopic dermatitis is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. 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. Fortunately, several new treatments, including novel monoclonal antibodies or targeted therapies, 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, 2018

Novel Therapeutic Options for the Management of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic inflammation of all or part of the digestive tract. IBD is primarily considered to be ulcerative colitis (UC) and Crohn’s disease (CD). There is no cure for IBD and treatment strategies include two major goals with one being trying to achieve clinical remission and the other being the prevention of disease flare ups. The top-down approach is considered to be the first way to treat patients by giving them an early introduction to biologics and immunodulators. The care of a patient with IBD can be either medical or surgical in nature or, commonly, a combination of both. The medical approach for patients with IBD is symptomatic (flaring) care and generally follows a step-wise approach to medication therapy, with progression of the medical regimen until a response is achieved. Long term control of inflammatory bowel diseases can be achieved with regular doses of medication, known as maintenance therapy, to keep flare-ups at bay and reduce the risk of more serious complications developing. For many patients with IBD, therapeutic options are limited to immunosuppressive therapy or biologic therapy with anti–tumor necrosis factor-alpha (TNF-α) agents. The continued advances in biologics are helping clinicians begin to shift their goals of IBD from clinical remission to complete remission which includes a combination of clinical remission, laboratory normalization and mucosal healing. An increasing number of clinical trial options have shown favorable short and long term outcomes.
Physician, Nursing and CMCN credits valid to August 1, 2018

Overcoming Challenges in the Emerging Biosimilar Landscape

A biosimilar is a biologic drug that is developed to be highly similar, but not identical, to an existing biologic. The FDA looks at biosimilars as a biological product that is similar to a US licensed biological product not including minor differences in clinically inactive components, as well as having no clinically meaningful differences between the biological product and the reference product in terms of the safety, efficacy and potency of the product. Biologic agents have revolutionized the treatment of many diseases, including breast cancer, lung cancer, non-Hodgkin’s lymphoma, hepatitis, inflammatory bowel disease (IBD), rheumatoid arthritis, and many more. Now, with patents continuing to expire on these first biologics, biosimilar products are becoming available. These agents are expected to have a significant impact on healthcare but present a unique set of challenges for regulators, clinicians, payers, and consumers.
Physician, Nursing and CMCN credits valid to August 1, 2018

A 4-Part Series:  New Horizons in the Treatment and Management of Atopic Dermatitis (AD): How Novel Therapies are Changing the Treatment Paradigm

Atopic dermatitis is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Our improved understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States. Current treatments adequately care for patients with atopic dermatitis, but have shown problems with sustained efficacy in patients with severe eczema or atopic dermatitis. Fortunately for patients with this disease, several new treatments have recently undergone late stage clinical trials that have shown improved efficacy and safety, offering patients the potential for improved outcomes and quality of life. This activity will focus on the latest clinical data on these evolving options, how clinicians can potentially integrate them into the treatment paradigm, options for patients who have received prior therapies, and information on the mechanisms of action of these agents.

Current atopic dermatitis treatments attempt to reduce inflammation and itchiness to maintain the protective integrity of the skin. These treatments have shown the ability to managed the disease in the short term, but have had troubles with long term efficacy. A recent update to the American Academy of Dermatology guidelines of care for the management of adult and pediatric patients recommends a proactive approach for long-term disease management versus episodic management of flares with an emphasis on clinical assessment of disease severity. Several treatments, including novel monoclonal antibodies, have shown the ability in late stage clinical trials to block various proteins that mediate inflammation and immune responses, potentially arresting development and progression of the disease at various pathogenic steps. These new options have shown improved efficacy and safety in atopic dermatitis, and medical directors, practicing physicians, nurses and other healthcare professionals must be educated on these options and how they might affect the current treatment paradigm.

This multi-part program on new horizons and novel therapies in atopic dermatitis will provide medical directors, practicing physicians and nurses with the latest clinical data on novel treatments that have recently completed late stage clinical trials. Clinicians need to be updated on these treatment options and the potential integration of newer agents, in order to optimize the care of their patients, especially in the area of inadequately controlled moderate-to-severe atopic dermatitis patients.
Physician, Nursing and CMCN credits apply.  Each session has its own specific valid dates.

What’s on the Horizon in Atopic Dermatitis (AD): A Closer Look at Integrating Emerging Targeted Therapies into the Treatment Paradigm

Atopic dermatitis (AD) is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Our improved understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States. This session will address the novel and emerging therapies available for AD.
Physician, Nursing and CMCN credits valid to April 30, 2019

Managing Inadequate Response in Moderate-to-Severe AD: Strategies for Patients whose Disease is Not Controlled by Standard Therapy

Atopic dermatitis is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Our improved understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States. This session will address how to manage patients not controlled by standard therapy, the challenges, tailored treatment plans and continued patient assessments.
Physician, Nursing and CMCN credits valid to April 30, 2019

Recent Advances in Understanding the Pathogenesis of Atopic Dermatitis

Atopic dermatitis is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Our improved understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States. This session will address the role of emerging therapies and their pathophysiologic mechanisms that block IL-4/IL-13 pathways.
Physician, Nursing and CMCN credits valid to April 30, 2019

New Horizons in the Treatment and Management of Atopic Dermatitis (AD): What Managed Care Needs to know about Novel Therapies in the Evolving Management of Atopic Dermatitis

Atopic dermatitis is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. This condition evolves from a combination of skin barrier defects and immune-mediated responses involving activated T-helper cells and related cytokines. Our improved understanding of the pathophysiology underlying atopic dermatitis is resulting in the development of targeted therapies for children and adult patients with this disease. There are approximately 17.8 million people with moderate to severe eczema or atopic dermatitis in the United States. This session will provide attendees with perspectives and strategies used to manage an AD population by managed care organizations.

Physician, Nursing and CMCN credits valid to April 30, 2019

Clinical Advances in Atopic Dermatitis: Novel Therapies for Improved Patient Outcomes

Atopic dermatitis (AD) is a common chronic inflammatory skin disease characterized by persistent itching that can severely affect quality of life. 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. Fortunately several new treatments, including novel monoclonal antibodies or targeted therapies, 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 31, 2018

Shaping the Future of Psoriasis through Advanced Therapeutic Strategies

Psoriasis is a complex, chronic, immune-mediated inflammatory disease presenting with periodic flare-up of sharply defined red patches, covered by a silvery, flaky surface and affects approximately 7 million people in the US. The disease most commonly appears on the skin of the scalp, elbow, knees, and lumboscaral areas of the body. Many patients are not receiving the appropriate treatment discussed in the current guidelines and standards of care. Psoriasis is a very expensive disease for the American health system and is difficult to manage thus the goal should be patient-centered treatment that reduces cost, disease burden, improves quality-of-life, and addresses the risks of systemic complications and comorbid conditions. There are several treatment options to include topical treatments, from over the counter (OTC) to prescription, phototherapy, laser therapy and traditional systemic medication. Emerging options such as Biologics can be very effective but proper management must be done in order to assure the best safety and efficacy for the patient.
Physician, Nursing and CMCN credits valid to January 31, 2018

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

Exploring the Role of PCSK9 Inhibitors in the Reduction of LDL-C in Patients with Dyslipidemia

Current guidelines agree that LDL-C is a major factor in the development of cardiovascular disease (CVD). In addition, it is well established that lowering LDL-C in high-risk patients reduces the risk for CVD. The discovery of statins has contributed a very effective approach to help battle the irregular levels of LDL-C. However, many patients do not achieve the recommended goals for LDL-C levels. Available agents combined with statins can provide additional LDL-C reduction. In fact, 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. The mechanism of action of PCSK9 agents are different than that of 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. The PCSK9, 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. In earlier mid-stage studies, when combined with statins, alirocumab and the PCSK9 drug cut levels of LDL cholesterol by close to 70 percent, more than statins alone.
Physician, Nursing and CMCN credits valid to August 1, 2018

Updates in the Management of Pulmonary Arterial Hypertension (PAH)

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, while those with untreated PAH have an average survival expectancy of approximately three years following diagnosis – and even with aggressive management, PAH has a 15% annual mortality rate. Associated treatment costs have risen with the expansion of treatment options, ranging from $18,000 to $244,000 annually per patient. Additionally, PAH often leads to the onset of 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 costs, as incorrect classification can lead to inappropriate treatment decisions and unnecessary costs to the health care system. Emerging treatments including prostanoids are changing the way patients are being treated and clinicians need to understand how to apply treatment algorithms accordingly for pharmacologic decisions.
Physician, Nursing and CMCN credits valid to January 31, 2018

Optimal Anticoagulation Strategies for Stroke Prevention in Atrial Fibrillation

Atrial fibrillation (AF) is a common type of arrhythmia affecting both men and women, and the incidence increases with age. AF may be diagnosed based on tests, such as an EKG (electrocardiogram), ECG (echocardiography), stress test, blood tests, chests x-rays, a special monitor to record the heart’s rhythms, by physical exam, and medical and family histories. Preventing blood clots (thromboembolism), and thus strokes, may be the most important part of treating atrial fibrillation. The proven therapy is to prescribe anticoagulants, or blood thinners, to prevent blood clots. However studies have found that a significant number of patients in the US do not receive adequate therapy for stroke prevention and additionally, there are multiple concerns regarding blood thinners. Updates for emerging therapeutic agents for stroke prevention in AF patients will be reviewed along with newer anti-coagulants and management/treatment algorithms.
Physician, Nursing and CMCN credits valid to January 31, 2018

Updated Treatment Strategies in the Management of Obesity

Obesity has been shown to be a risk factor for a number of conditions, among them: coronary heart disease, type 2 diabetes, hypertension, stroke, and certain types of cancer. Fortunately, new pharmacologic agents have become available, giving physicians more management options, in addition to a reduced-calorie diet and exercise. Lifestyle changes are extremely important to treating obesity and should always be recommended in conjunction with the medication and require a lifetime behavioral modification which may be boosted with education, the use of support groups, counseling, and perhaps meeting with a dietitian. In light of the increasing prevalence of obesity in the United States, and the challenges in identifying treatment strategies for overweight and obese patients that will produce enduring weight loss, there is an urgent need for evidence-based education on these emerging treatments and strategies that physicians can apply to achieve clinically meaningful weight loss in individuals who meet medical criteria for pharmacologic intervention.
Physician, Nursing and CMCN credits valid to December 31, 2017

Advances in LDL-C Reduction: A Strategic Look at the Effectiveness of PCSK9 Inhibitors

Current guidelines agree that LDL-C is a major factor in the development of cardiovascular disease (CVD). In addition, it is well established that lowering LDL-C in high-risk patients reduces the risk for CVD. Primary prevention promotes lifestyle behaviors to prevent the development of accelerating risk factors as well as elevated LDL-C. Statins have typically been the first-line therapy and the choice of statins depends on availability, costs, and tolerability. In patients who are statin intolerant, several options are available and 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. Despite significant advances in the number of treatment options for advanced LDL-C management, there is a clear need for better education and the understanding of these new and emerging therapies that will improve outcomes.
Physician, Nursing and CMCN credits valid to December 31, 2017

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

Individualizing Treatment in T2D Management: Novel Therapies for Improved Patient Outcomes

While the prevalence of diabetes continues to rise, a new generation of treatments has become available in the past few years. Despite new regimens, barriers to care, such as patient adherence and economic burden, still exist. It has been estimated that people diagnosed with diabetes, on average, have medical expenditures that are approximately 2.3 times higher than what expenditures would be in the absence of diabetes. The price tag associated with treatment of type 2 DM increases with disease severity, as more and more dollars are spent managing the significant comorbidities associated with advanced type 2 DM. The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in treatments for Type 2 Diabetes have given healthcare professionals the ability to individualize care. New data and guideline updates offer best practices in regard to the role of mono and combination therapies. Treatments have become available that allow the individualization of T2DM management. There have been many questions in member surveys and past program evaluations about the best practices in regard to the role of combination therapies comprised of SGLT-2 inhibitors in the management of type 2 diabetes, and new data and guidelines updates showing the benefits and risks of these new therapies.
Physician, Nursing and CMCN credits valid to August 31, 2018

A 4-Part Series: New Horizons in the Treatment and Management of Type 2 Diabetes; Individualizing Therapy with Novel Options for Improved Patient Outcomes

Description:  The American Diabetes Association (ADA) estimates that more than 25.8 million people in the United States, or 8.3 percent of the population, have diabetes, and that one in three Americans born in 2016 will develop diabetes sometime during their lifetime. 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 doubles a person’s risk for death, and on average individuals with type 2 DM lose 10-15 years of life. The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in treatments in type 2 diabetes management have given healthcare professionals the ability to shrink this clinical practice gap.

Upon completion of these activities, it is anticipated that learners will be better able to identify the potential consequences of inadequate control of T2DM, apply objective disease-activity measures to determine whether patients are meeting treat-to-target goals, develop management plans for treating to target and advancing of novel therapies to achieve continued control of T2DM, and evaluate the role of the medical director, pharmacy director and nurse case manager in improving outcomes and costs in a population of T2DM patients.
Physician, Nursing and CMCN credits apply. Each session has its own specific valid dates.

Improving Glycemic Control and Cardiovascular Risk with Novel Therapies

The American Diabetes Association (ADA) estimates that more than 25.8 million people in the United States, or 8.3 percent of the population, have diabetes, and that one in three Americans born in 2016 will develop diabetes sometime during their lifetime. 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 doubles a person’s risk for death, and on average individuals with type 2 DM lose 10-15 years of life. The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in treatments in type 2 diabetes management have given healthcare professionals the ability to shrink this clinical practice gap. This session, Part 1 of our series, will provide participants with the confidence and knowledge on new therapies in diabetes, patient identification for use of these therapies and the impact on clinical inertia.
Physician, Nursing and CMCN credits valid to March 30, 2019

GLP-1 Agonists, Insulin and SGLT-2 Inhibitors in the Changing Treatment Paradigm: What are the Benefits, Risks and Outcomes in Patients with Type 2 Diabetes?

The American Diabetes Association (ADA) estimates that more than 25.8 million people in the United States, or 8.3 percent of the population, have diabetes, and that one in three Americans born in 2016 will develop diabetes sometime during their lifetime. 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 doubles a person’s risk for death, and on average individuals with type 2 DM lose 10-15 years of life. The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in treatments in type 2 diabetes management have given healthcare professionals the ability to shrink this clinical practice gap. This session, Part 1 of our series, will provide participants with the confidence and knowledge on new therapies in diabetes, patient identification for use of these therapies and the impact on clinical inertia.
Physician, Nursing and CMCN credits valid to March 30, 2019

What Managed Care Needs to Know About Novel Therapies in the Evolving Management of Type 2 Diabetes

The American Diabetes Association (ADA) estimates that more than 25.8 million people in the United States, or 8.3 percent of the population, have diabetes, and that one in three Americans born in 2016 will develop diabetes sometime during their lifetime. 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 doubles a person’s risk for death, and on average individuals with type 2 DM lose 10-15 years of life. The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in treatments in type 2 diabetes management have given healthcare professionals the ability to shrink this clinical practice gap. This session, Part 1 of our series, will provide participants with the confidence and knowledge on new therapies in diabetes, patient identification for use of these therapies and the impact on clinical inertia.
Physician, Nursing and CMCN credits valid to March 30, 2019

Improving Patient Outcomes with Individualized Therapy in the Management of Type 2 Diabetes

The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in treatments in Type 2 Diabetes management have given healthcare professionals the ability to shrink this clinical practice gap. Fortunately, recent advances in individualizing treatment through basal insulin therapy and GLP-1 analogs in Type 2 Diabetes management have given healthcare professionals the ability to shrink this clinical practice gap, particularly when they are combined. This session will review novel treatments and identify which patients are most likely to benefit from their use, which will help them achieve tighter glucose control and better clinical outcomes.
Physician, Nursing and CMCN credits valid to December 31, 2017

Updated Treatment Strategies in the Management of Obesity

Obesity has been shown to be a risk factor for a number of conditions, among them: coronary heart disease, type 2 diabetes, hypertension, stroke, and certain types of cancer. Fortunately, new pharmacologic agents have become available, giving physicians more management options, in addition to a reduced-calorie diet and exercise. Lifestyle changes are extremely important to treating obesity and should always be recommended in conjunction with the medication and require a lifetime behavioral modification which may be boosted with education, the use of support groups, counseling, and perhaps meeting with a dietitian. In light of the increasing prevalence of obesity in the United States, and the challenges in identifying treatment strategies for overweight and obese patients that will produce enduring weight loss, there is an urgent need for evidence-based education on these emerging treatments and strategies that physicians can apply to achieve clinically meaningful weight loss in individuals who meet medical criteria for pharmacologic intervention.
Physician, Nursing and CMCN credits valid to December 31, 2017

Effective A1c Reduction in Type 2 Diabetes: A Closer Look at Combination Insulin Therapy

According to the CDC, uncontrolled type 2 DM doubles a person’s risk for death, and on average individuals with type 2 DM lose 10-15 years of life. The management of type 2 DM remains a major challenge as many patients continue to struggle with achieving therapeutic goals, including control of A1C level, blood pressure, cholesterol, and weight. Fortunately, recent advances in individualizing treatment through basal insulin therapy and GLP-1 analogs in Type 2 Diabetes management have given healthcare professionals the ability to shrink this clinical practice gap, particularly when they are combined.
Physician, Nursing and CMCN credits valid to February 28, 2018

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

Optimizing Treatment Strategies in the Management of HIV/AIDS: Individualizing Therapy for Improved Patient Outcomes

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. Fortunately for patients with HIV, several new therapies have recently become available for clinicians. Treatment regimens vary and carry important differences between therapeutic options that are clinically relevant to healthcare professionals. HIV treatment focuses on controlling the disease and living longer, healthier lives. Antiretroviral therapy (ART) has evolved considerably over the past three decades with many antiretroviral (ARV) drugs, combinations, and classes available. Cobicistat-boosted protease inhibitors (PI) are also evolving and one of the biggest challenges for clinicians is individualizing care and understanding when certain ARV therapies and strategies are appropriate, and when they are not. Numerous studies have shown that ARV therapy must be tailored to the individual patient and his or her abilities and diverse needs. Options for HIV prevention and treatment continue to expand at a rapid pace.
Physician, Nursing and CMCN credits valid to August 1, 2018

Improving Patient Outcomes with Individualized Therapy in the Management of HIV/AIDS

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. Fortunately for patients with HIV, several new therapies have recently become available for clinicians. Antiretroviral therapy (ART) has evolved considerably over the past three decades with many antiretroviral (ARV) drugs, combinations, and classes available. Cobicistat-boosted protease inhibitors (PI) are also evolving and one of the biggest challenges for clinicians is individualizing care and understanding when certain ARV therapies and strategies are appropriate, and when they are not. Numerous studies have shown that ARV therapy must be tailored to the individual patient and his or her abilities and diverse needs. Options for HIV prevention and treatment continue to expand at a rapid pace.
Physician, Nursing and CMCN credits valid to December 31, 2018

Treatment of Chronic Hepatitis C Virus Infection

Hepatitis is the inflammation of the liver. There are several types of HCV, genotype 1A is the most prevalent in the US, and it’s been the most difficult to treat and cure. There are approximately 3.2 million people in the US with chronic Hepatitis C (CHC) infection. There could be many more, as HCV infections usually show mild to no symptoms. The most prevalent population believed to be infected with the hepatitis C virus (HCV) were born from 1945 to 1965 and probably infected during the 1970’s and ‘80’s, and many of them still are undiagnosed due to the lack of symptoms. Fortunately for patients with hepatitis C, several new treatment options have become available, giving physicians individualized options with vastly increased cure rates.

This program on overcoming challenges in HCV management with novel therapies will take a close look at genotype 1 and 4 HCV, providing attendees with education that will assist them in developing the best strategy to improve outcomes for their Hepatitis C member population. Attendees will leave with ability to increase screening protocols for Hepatitis C, and understand treatment barriers and solutions for patient adherence, as well as the ability to help educate both their staff and colleagues, which will ultimately increase organizational quality and, most importantly, improve outcomes and quality of life in patients.
Physician, Nursing and CMCN credits valid to December 31, 2018

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Musculoskeletal & Rheumatology

A 4-Part Series:  New Horizons in the Treatment and Management of Rheumatoid Arthritis

Description:  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. According to the American College of Rheumatology (ACR), it is estimated that over 1.3 million people suffer from RA in the United States. 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. Fortunately for patients with RA, a new class of treatments called janus kinase (JAK) inhibitors have become available recently. Some have been approved for use and some showing improved safety and efficacy have just completed late stage clinical trials and are awaiting regulatory review. With so many new options becoming available for clinicians, it is critical that rheumatologists, primary care physicians, managed care medical directors, payers, case managers, nurses, and other healthcare professionals (HCPs) are updated on these emerging options and guidelines and strategies for implementing them into the treatment paradigm, which will ultimately improve patient outcomes.
Physician, Nursing and CMCN credits apply. Each session has its own specific valid dates.

Exploring Mechanisms of Action in JAK Inhibitors and the Role of the JAK/STAT Pathway in the Pathogenesis of RA

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. Per the American College of Rheumatology (ACR), it is estimated that over 1.3 million people suffer from RA in the United States. Fortunately for patients with RA, a new class of treatments called janus kinase (JAK) inhibitors have become available recently. Some have been approved for use and some showing improved safety and efficacy have just completed late stage clinical trials and are awaiting regulatory review. Significant developments have taken place in the treatment paradigm with the emergence of JAK inhibitors in the past few years, which has created knowledge gaps for translating these developments into managed care and clinical decision making. This session will provide the mechanism of action, the role and differences of JAK inhibitors.
Physician, Nursing and CMCN credits valid to April 30, 2019

Where Do JAK inhibitors Fit in the Emerging Treatment Paradigm in the Management of RA

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. Per the American College of Rheumatology (ACR), it is estimated that over 1.3 million people suffer from RA in the United States. Fortunately for patients with RA, a new class of treatments called janus kinase (JAK) inhibitors have become available recently. Some have been approved for use and some showing improved safety and efficacy have just completed late stage clinical trials and are awaiting regulatory review. Significant developments have taken place in the treatment paradigm with the emergence of JAK inhibitors in the past few years, which has created knowledge gaps for translating these developments into managed care and clinical decision making. This session will provide the mechanism of action, the role and differences of JAK inhibitors.
Physician, Nursing and CMCN credits valid to April 30, 2019

How to Improve Patient Adherence and Safety in RA: Strategies to Monitor and Manage Adverse Events Associated with Emerging JAK Inhibitors

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. Per the American College of Rheumatology (ACR), it is estimated that over 1.3 million people suffer from RA in the United States. Fortunately for patients with RA, a new class of treatments called janus kinase (JAK) inhibitors have become available recently. Some have been approved for use and some showing improved safety and efficacy have just completed late stage clinical trials and are awaiting regulatory review. Significant developments have taken place in the treatment paradigm with the emergence of JAK inhibitors in the past few years, which has created knowledge gaps for translating these developments into managed care and clinical decision making. This session will provide the mechanism of action, the role and differences of JAK inhibitors.
Physician, Nursing and CMCN credits valid to April 30, 2019

What Managed Care Needs to Know About JAK Inhibitors in the Evolving Management of RA

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues. Per the American College of Rheumatology (ACR), it is estimated that over 1.3 million people suffer from RA in the United States. Fortunately for patients with RA, a new class of treatments called janus kinase (JAK) inhibitors have become available recently. Some have been approved for use and some showing improved safety and efficacy have just completed late stage clinical trials and are awaiting regulatory review. Significant developments have taken place in the treatment paradigm with the emergence of JAK inhibitors in the past few years, which has created knowledge gaps for translating these developments into managed care and clinical decision making. This session will provide the mechanism of action, the role and differences of JAK inhibitors.
Physician, Nursing and CMCN credits valid to April 30, 2019

Recent Advances in the Management of Rheumatoid Arthritis: A Closer Look at Emerging Therapies

Rheumatoid arthritis (RA) is a long-lasting autoimmune disorder that occurs when the immune system mistakenly attacks the body’s own tissues which typically result in warm, swollen, and painful joints. Additionally, systemic complications and comorbid conditions make the disease difficult to manage. There is no cure for RA thus treatment focuses on managing the disease and controlling symptoms. Fortunately, several new medications have become available as many patients 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 which are changing the way RA patients are treated.
Physician, Nursing and CMCN credits valid to January 31, 2018

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Neurological

Exploring New Advances in Current & Novel Treatments for 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. Patients experiencing seizures, particularly those that are not easily controlled, need to seek out neurological guidance as more antiepileptic drugs (AEDs), in addition to anticonvulsants are becoming available. The goal for neurologists is to achieve a seizure-free status for their patients without adverse effects. Treatment of epilepsy involves reducing the number of seizures by administering various AEDs. This approach requires long-term adherence from patients. The development of new AEDs continues to increase and drug therapies can now be individualized to the patient’s symptoms and needs. Uncontrolled seizures and their associated comorbidities, such as depression, can have detrimental effects on the patient’s quality of life.
Physician, Nursing and CMCN credits valid to August 1, 2018

Improving Patient Outcomes with Novel Treatment Strategies in the Management of Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic progressive disease and is the most common neurological cause of disability among young adults throughout the United States. In many cases, multiple sclerosis may not be diagnosed for months to years after the onset of symptoms. 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 there have been numerous revisions to MS diagnostic criteria as many advances in treatment have arrived in recent years, allowing patients to manage their symptoms and improve their quality of life. These agents provide physicians with even more options and delivery methods for managing MS. Clinical data shows these agents have the ability to improve outcomes in efficacy as it relates to the management of patients with MS. 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.
Physician, Nursing and CMCN credits valid to August 1, 2018

7-Part Series: New Horizons in the Treatment and Management of Multiple Sclerosis: Best Practices for Improved Patient Outcomes

New Horizons in the Treatment and Management of Multiple Sclerosis is a 7-part series that will provide participants with the latest information in MS management. By clicking on each of the titles, you will be able to participate in each part. It is not required that you participate in all 7 or in order. These are archives of live webinars held between December 7, 2016 and February 1, 2017.
Physician, Nursing and CMCN credits

Managing Relapse in MS: Strategies for Switching Therapy after Inadequate Response to Previous Treatment Regimens

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. As part of a multi-part webinar program this session will focus on managing relapse and switching therapy. It is critical that HCPs who will be in attendance for the live webinar, or participate in any of the enduring materials, learn about these emerging agents and how to incorporate them into their respective management strategies.
Physician, Nursing and CMCN credits valid to January 31, 2019

Oral Therapies, Autoinjectors and Dosing/Administration in the Changing MS Management Paradigm: Overcoming Barriers to Treatment

Although there is still no cure for MS, many advances in MS treatment have arrived in recent years, allowing patients to manage these symptoms and improve their quality of life. Lack of early implementation of appropriate interventions based on a balance of efficacy and safety of current and emerging therapies, updated guidelines and the newest clinical data leads to inadequate control of MS. This session will provide attendees with an updated review of therapies, dosing methods, overcoming potential barriers and how these affect patient adherence.
Physician, Nursing and CMCN credits valid to March 31, 2018

What’s on the Horizon in MS: A Review of Novel Therapies and Emerging Approaches

Although there is still no cure for MS, many advances in MS treatment have arrived in recent years, allowing patients to manage these symptoms and improve their quality of life. Lack of early implementation of appropriate interventions based on a balance of efficacy and safety of current and emerging therapies, updated guidelines and the newest clinical data leads to inadequate control of MS. This session will provide attendees with an updated review of therapies, dosing methods, overcoming potential barriers and how these affect patient adherence.
Physician, Nursing and CMCN credits valid to March 31, 2018

Insights on the Interplay of B cells and T cells in Therapeutic MS Management

Although there is still no cure for MS, many advances in MS treatment have arrived in recent years, allowing patients to manage these symptoms and improve their quality of life. Lack of early implementation of appropriate interventions based on a balance of efficacy and safety of current and emerging therapies, updated guidelines and the newest clinical data leads to inadequate control of MS. This session will provide attendees with an updated review of therapies, dosing methods, overcoming potential barriers and how these affect patient adherence.
Physician, Nursing and CMCN credits valid to March 31, 2019

What’s on the Horizon in MS: What Managed Care Needs to Know in the Evolving Management of MS

Although there is still no cure for MS, many advances in MS treatment have arrived in recent years, allowing patients to manage these symptoms and improve their quality of life. Lack of early implementation of appropriate interventions based on a balance of efficacy and safety of current and emerging therapies, updated guidelines and the newest clinical data leads to inadequate control of MS. This session will provide attendees with an updated review of therapies, dosing methods, overcoming potential barriers and how these affect patient adherence.
Physician, Nursing and CMCN credits valid to March 31, 2018

New Horizons in the Treatment and Management of Multiple Sclerosis: The Role of Vitamin D in Multiple Sclerosis Pathology and Treatment

Although there is still no cure for MS, many advances in MS treatment have arrived in recent years, allowing patients to manage these symptoms and improve their quality of life. Lack of early implementation of appropriate interventions based on a balance of efficacy and safety of current and emerging therapies, updated guidelines and the newest clinical data leads to inadequate control of MS. This session will provide attendees with an updated review of therapies, dosing methods, overcoming potential barriers and how these affect patient adherence. This session will provide attendees with the role and impact of vitamin D on clinical outcomes and neuroprotective mechanisms in MS.
Physician, Nursing and CMCN credits valid to March 31, 2018

Advanced Insights into the Prevention, Treatment and Management of Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia, a cognitive disorder that includes behavioral impairment that interferes with social and occupational functioning. 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. Today, there is no treatment that can reverse the disease, and all the available treatments to Alzheimer’s are symptomatic therapies. The standard medical treatments include cholinesterase inhibitors, a partial N-methyl-D-aspartate (NMDA) antagonist and memantine, which helps with brain cell communication. With that being said, 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. Currently, an autopsy or brain biopsy is the only way to make a definitive diagnosis of Alzheimer’s disease. In clinical practice, the diagnosis is typically made on the basis of the history and findings on Mental Status Examination in addition to neurological exam, blood testing and brain imaging. There is no single test that can show whether a person has Alzheimer’s.

PCPs are increasingly called on to provide care for cognitively impaired individuals, playing critical roles in detecting early symptoms of dementia, communicating with patients and caregivers about the disease, coordinating with specialists on multimodal therapeutic plans, and following up to tailor treatment, minimize complications, and head off medical crises.
Physician, Nursing and CMCN credits valid to August 1, 2018

Evaluation and Management of Overactive Bladder

Overactive bladder (OAB) is a highly prevalent condition that occurs about twice as frequently in women as in men, and while OAB is not considered a normal part of aging, it does become more prevalent with advanced age. OAB 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. Despite its impact, OAB remains underdiagnosed and undertreated thus screening and evaluating patients is of utmost importance in order to improve diagnosis and patient QoL. Fortunately there are a variety of treatments available from behavioral modification (drink less fluid, caffeine…etc.) to antimuscarinic agents and ß3-adrenoceptor agonists. 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.
Physician, Nursing and CMCN credits valid to December 31, 2017

Seizure & Epilepsy Care

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. Some drugs are more effective for specific types of seizures and the goal for neurologists is to achieve a seizure-free status for their patients without adverse effects. Treatment of epilepsy involves reducing the number of seizures by administering various antiepileptic drugs (AEDs) and about 60% of patients require treatment with anticonvulsants. Unfortunately, more than one-third of people who experience seizures continue to have issues despite the medication given. Many patients do not have all the treatments available to them because their seizures are not adequately controlled, or because they experience severe adverse effects. 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 December 31, 2017

New Horizons in the Treatment and Management of Multiple Sclerosis: Exploring Novel Mechanisms of Action in the Treatment of 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. As part of a multi-part webinar program this session will focus on novel mechanisms of action. It is critical that HCPs who will be in attendance for the live webinar, or participate in any of the enduring materials, learn about these emerging agents and how to incorporate them into their respective management strategies.
Physician, Nursing and CMCN credits valid to December 31, 2018

Evolving Treatment Options and Strategies in Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic progressive disease and is the most common neurological cause of disability among young adults, with a prevalence of approximately 400,000 cases throughout the United States. Although there is still no cure for MS, many advances in MS treatment 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. Over the past decade, there have been numerous revisions to MS diagnostic criteria and the development of multiple new and emerging therapies. While the explosion of these emerging therapies have shown the ability to improve outcomes and quality of life in patient’s relapsing MS, it makes staying current with best practices a challenge that must be overcome through education. These new options must be compared and contrasted with current treatments, including immunomodulatory agents, to ultimately form an individualized treatment strategy for each MS patient.
Physician, Nursing and CMCN credits valid to December 31, 2017

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Pain Management

Management Strategies of Chronic Pain: Let’s Talk about Opioids

Chronic pain is defined as pain that has lasted for over three months, is persistent and causes a loss of quality of life, often due to depression, loss of job productivity, and loss of socialization. It may have started out as acute pain, caused by some injury or other problem and the most common types of chronic pain are associated with back pain, headaches, arthritis, nerves, muscles, and pain caused by cancer. Close to half of patients with chronic pain are left untreated and even with those untreated the economic cost is staggering with an estimated $100 billion in lost income, lost productivity, and increased healthcare expenses. It’s important the chronic pain treatment include several types such as pharmaceutical, physical, and lifestyle changes. This multi-dimensional approach has a higher probability for pain relief or management, and the potential to avoid addiction and dependence to pain relievers. Options include over the counter (OTC) pain relievers, prescription NSAIDs, or opioids, physical therapy, diet, exercise, massage, and possibly meditation and acupuncture. Currently, the FDA has put out the REMS program for ER/LA opioids because these types of pain medicines have clearly emerged as those with the highest potential for harm from misuse, abuse, and unintentional overdose. When all other forms of pain medication and treatment have been ineffective at controlling the pain, opioid analgesics may be required, if so therapy management will need to be strictly implemented in order to prevent addiction, abuse or other adverse effects.
Physician, Nursing and CMCN credits valid to December 31, 2017

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Pulmonary

What’s New in CFTR Modulator Therapy in the Management of Cystic Fibrosis

Cystic fibrosis (CF), also known as mucoviscidosis, is a genetic disorder that affects mostly the lungs but also the pancreas, liver, kidneys and intestine. Long-term issues include difficulty breathing and coughing up sputum as a result of frequent lung infections. 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. CF is an autosomal recessive disorder caused by the presence of mutations in both copies of the gene for the protein cystic fibrosis transmembrane conductance regulator (CFTR). The condition is diagnosed by a sweat test and genetic testing however screening of infants at birth takes place in some areas of the world. 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, enabling patients to breath more easily and stay out of the hospital, improving outcomes and quality of life. This option is a breakthrough in CF management, because it is the first therapy that specifically targets an important genetic mutation.
Physician, Nursing and CMCN credits valid to August 1, 2018

New Horizons in the Diagnosis & Management of Idiopathic Pulmonary Fibrosis (IPF)

Idiopathic pulmonary fibrosis (IPF) is a lung disease that results from the formation of scar tissue deep inside the lungs. It is the most common of the idiopathic interstitial pneumonias, and is a devastating disease associated with irreversible destruction of the lung. 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 idiopathic pulmonary fibrosis present with a gradual onset, which makes it difficult to diagnosis early. Strong awareness of guidelines and the current criteria still makes the diagnostic process difficult to obtain as well as incomplete. 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. Treatment strategies for IPF aim at managing the symptoms and slowing disease progression to best maintain a patient’s quality of life. Guideline recommendations for treatments include nintedanib, which is a tyrosine kinase inhibitor that targets multiple tyrosine kinases, and pirfenidone. Along with these treatments, the standard of care for IPF includes oxygen supplementation, management of co-morbidities, and lung transplants.
Physician, Nursing and CMCN credits valid to August 1, 2018

Effective Strategies and Clinical Updates in Pulmonary Arterial Hypertension

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, while those with untreated PAH have an average survival expectancy of approximately three years following diagnosis – and even with aggressive management, PAH has a 15% annual mortality rate. Associated treatment costs have risen with the expansion of treatment options, ranging from $18,000 to $244,000 annually per patient. Additionally, PAH often leads to the onset of 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 costs. Emerging treatments, including prostanoids, are changing the way patients are being treated and clinicians need to understand how to apply treatment algorithms accordingly for pharmacologic decisions.
Physician, Nursing and CMCN credits valid to August 1, 2018

Preventing Acute Exacerbations through Novel Insights in Treatment Strategies for COPD

Chronic Obstructive Pulmonary Disease (COPD) is an incurable and progressive disease so early diagnosis is very important to decrease lung damage, improve patient quality of life, and reduce costs. Unfortunately, COPD is substantially under-diagnosed, undertreated, and is devalued as a major health issue. A major advance in COPD management is the recognition that COPD exacerbations can be prevented, and that individuals at risk for first or recurrent exacerbations can be identified sooner than later. The guidelines also recommend all healthcare professionals who treat COPD patients choose an appropriate treatment regimen that may include pharmacologic and non-pharmacologic therapies based on personalized and individual assessment results according to their diagnosis. Pharmacologic agents most commonly used to manage the disease include bronchodilators (beta agonists and anticholinergics), phosphodiesterase-4 inhibitors, antibiotics, and corticosteroids (inhaled and oral). Symptom relief can be achieved through first line therapy with short-acting beta agonists or for long time control with long-acting beta agonists and short- and long-acting anticholinergics. There are also combined therapies that will help manage COPD. Inhaled corticosteroids are recommended as an adjunct therapy to long-acting bronchodilators as well in patients with severe COPD and with a history of repeat exacerbations. Novel treatment options, including biologic and combination therapies, have shown promise in helping to reduce exacerbations.
Physician, Nursing and CMCN credits valid to August 1, 2018

Controlling Severe Asthma through Advanced Diagnosis and Treatment Strategies

There is no cure for asthma, but it is possible to manage the disease successfully through a number of behavioral changes and therapies. Pharmacologic management can include using 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. The National Asthma Education and Prevention Program (NAEPP) and the Expert Panel Report 3 (EPR-3) emphasizes the assessment process from initial diagnosis to long-term management and the creation of a personalized treatment plan as the key components to patient adherence. The guidelines also state that healthcare professionals should take an initial assessment to determine the severity of asthma and to initiate treatment, and then at each follow-up visit, an additional assessment should be performed detailing information of symptom characteristics and information on patient treatment adherence, including all medications and behavioral modifications. Based upon these follow-up assessments, a written action plan should be developed by the physician and patient in order to create an individualized treatment regimen.
Physician, Nursing and CMCN credits valid to August 1, 2018

Updates in the Management of Pulmonary Arterial Hypertension (PAH)

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, while those with untreated PAH have an average survival expectancy of approximately three years following diagnosis – and even with aggressive management, PAH has a 15% annual mortality rate. Associated treatment costs have risen with the expansion of treatment options, ranging from $18,000 to $244,000 annually per patient. Additionally, PAH often leads to the onset of 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 costs, as incorrect classification can lead to inappropriate treatment decisions and unnecessary costs to the health care system. Emerging treatments including prostanoids are changing the way patients are being treated and clinicians need to understand how to apply treatment algorithms accordingly for pharmacologic decisions.
Physician, Nursing and CMCN credits valid to January 31, 2018

Advances in the Management of Cystic Fibrosis: A Closer Look at the Roles of CFTR Modulation Therapy

According to the Cystic Fibrosis (CF) 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. CF is an autosomal recessive disorder, caused by the presence of mutations in both copies of the gene for the protein cystic fibrosis transmembrane conductance regulator (CFTR). 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, enabling patients to breathe 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.
Physician, Nursing and CMCN credits valid to January 31, 2018

Strategies for Updated Treatment Options for IPF

Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias, and is a devastating disease associated with irreversible destruction of the lung. There are more than 80,000 adults in the US that have IPF and more than 30,000 cases are diagnosed each year, being more common in men than in women. IPF typically has a poor prognosis with a median survival of 3 years, thus it is imperative that clinicians diagnosis the disease early in order to implement appropriate management options to control symptoms and slowing of the disease progression to best maintain patient quality of life. Although there is no cure for IPF, there are numerous treatment options that have become available in the past several years. These options include corticosteroids, proton pump inhibitors, antioxidants and immune suppressants. There have also been advances in the pharmacological management which include nintedanib and pirfenidone. These effective therapies have shown improvement in a patient’s quality of life by slowing the progression of the lung tissue damage. Recent clinical trials have identified new treatments for this disease which lead to the approval of new therapeutic options by the FDA. The education of healthcare professionals will help with the appropriate use of current and newly approved medications as well as giving effective management strategies.
Physician, Nursing and CMCN credits valid to December 31, 2017

Key Advances in the Treatment and Management of Asthma

As progress is made in the scientific understanding of airway inflammation and narrowing, the prevalence of asthma continues to rise, and there is a clear need for improved diagnosis and more aggressive and effective treatment. Consequently, many studies show insufficient patient adherence to prescribed and behavioral treatment regimens, leading to a major cause of poor clinical outcomes. Patients with asthma often do not have their asthma well controlled due to many different barriers including: age, socioeconomic status, complexity of the treatment plan and lack of education. For improved asthma management, these factors must be addressed and solutions sought, so that adherence can be more accurately targeted and treated through increased assessment.

While there is no cure for asthma, it is possible to manage the disease successfully through a number of behavioral changes and therapies, such as decreasing exposure to allergens and by using an inhaled corticosteroids (ICS) and/or long-acting beta-2 agonists. There are also several new therapies emerging in clinical trials which aim to help control and treat asthma. These treatments have shown to improve lung function and decrease rescue bronchodilator use. The treatment goals for most asthmatic patients are to reduce the frequency and intensity of symptoms and reduce the risk of future asthma attacks, as these attacks lead to the decline in lung function.
Physician, Nursing and CMCN credits valid to December 31, 2017

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For more information contact Jeremy Williams at 804-527-1905 or jwilliams@namcp.org.
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