The Whole Patient-The Integrated Management of Chronic Disorders (Isabel)
- Credit Type
- Credit Amount
- Release Date
- Expiration Date
- Activity Type
Jointly sponsored by Global Education Group and Asante Communications, LLC.
This activity is supported by an educational grant from Kowa Pharmaceuticals American, Inc., and
Lilly USA, LLC. For further information concerning Lilly grant funding visit www.lillygrantoffice.com
Primary care physicians (PCPs) are charged with integrating the full spectrum of scientific and medical advances across heterogeneous and frequently interconnected disease states, a daunting hurdle in today’s time-constrained primary care settings. This educational platform will feature a case-based Interactive Multimedia CME Experience, exploring best practices in managing select chronic disorders. Participants in the live activity will receive a pre-programmed iPod touch to guide them through the CME program, directing them to various preconfigured sections of the meeting area.
At the conclusion of this educational activity, participants should be better prepared to:
• Conduct assessment strategies of patients with mixed dyslipidemia
• Develop patient-specific treatment goals based in part on lipid measures, comorbidities, current and prior medications, and commitment to multimodal therapy and lifestyle modifications
• Formulate individualized treatment plans for patients with dyslipidemia, incorporating appropriate pharmacotherapy, diet, increased physical activity, and other lifestyle modifications
• Modify monotherapy and combination treatment regimens as needed to ensure optimal effectiveness, safety, and minimal drug-drug interactions
For Major Depressive Disorder (MDD):
• Select and initiate antidepressant treatment regimens based in part on the patient’s depressive symptomatology, physical exam, psychosocial history, functional status, and prior and current medications
• Employ validated screening measures and clinical interviews to identify functional deficits, residual symptoms, and related barriers to achieving full remission
• Describe how to monitor treatment response and adjust antidepressant medications as needed for patients with MDD
• Explain how to combine antidepressant medications and psychosocial therapies to help achieve and maintain remission
• Identify how to cultivate a therapeutic alliance with patients, fostering dialogue about patient-related barriers to optimal adherence, treatment needs, and goals
Needs Assessment & Learner’s Gap
Primary care populations are unparalleled in their scope and diversity. Most patients present with chronic disorders that vary considerably in their clinical presentation, morbidity, and mortality. Further, patients rarely present with a single disorder, unaffected by other clinical challenges; the signs and symptoms of one disorder may cause, overlap, mask, or aggravate those of another. PCPs are increasingly cognizant of the interrelationships among human disease, psychology, and patient-specific considerations that influence clinical presentation and, by extension, assessment and treatment. Yet validated screening instruments and similar resources, no matter how comprehensive, fail to capture the singular complexity of the human being. PCPs must therefore examine, listen, and treat each patient individually as an N-of-1 trial.
Primary care patients typically present with a chronic medical or psychiatric pathology, each with complex sequelae that require therapeutic management. Among the more common conditions are elevated triglycerides (75.3 million adults), elevated LDL-C (57.8 million adults), diabetes (25.8 million adults), and depression (21 million adults) (CDC, 2010; Dandona and Rosenberg, 2010; NIH, 2011; Roger et al, 2011; US Census Bureau, 2009). A common underlying etiology for these conditions is excessive body weight—in particular, central adiposity—which adversely affects multiple metabolic pathways and mood (Mokdad et al, 2003; Roger et al, 2011; USPSTF, 2002). Additionally, hypogonadism (5.6 million adults) frequently underlies cardiometabolic and affective disturbances. To elucidate causal relationships and establish a clear differential diagnosis, obtaining a comprehensive history and conducting clinical interviews are essential; each provides in-depth commentary and biopsychosocial context. Yet evidence-based recommendations for whole patient assessment and treatment are limited, presenting a timely opportunity for discussion. Especially important are best practice strategies for individualizing treatment goals and structuring rational multimodal regimens.
- Centers for Disease Control and Prevention (CDC). Current depression among adults—United States, 2006 and 2008. MMWR Morb Mortal Wkly Rep. 2010;59:1229-1235.
- Dandona P, Rosenberg RT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract. 2010;64:682-696.
- Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289:76-79.
- Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation. 2011;123:e18-e209.
- US Census Bureau. Projections of the population by selected age groups and sex for the United States: 2010 to 2050. http://www.census.gov/population/www/projections/files/nation/summary/np2008-t2.xls. Published August 14, 2008. Accessed October 11, 2011.
- US Department of Health and Human Services, National Institutes of Health (NIH). National diabetes statistics, 2011. http://diabetes.niddk.nih.gov/dm/pubs/statistics/DM_Statistics.pdf. Publishsed February 2011. Accessed October 11, 2011.
- U.S. Preventive Services Task Force (USPSTF). Screening for depression: recommendations and rationale. Ann Intern Med. 2002;136:760-764.
This educational platform is designed to meet the educational needs of PCPs and other clinicians who assess, diagnose, and manage chronic disease states, which often occur with other medical and/or psychiatric pathologies.
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Global Education Group (Global) and Asante Communications, LLC. Global is accredited by the ACCME to provide continuing medical education for physicians.
Global Education Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Method of Participation
In order to receive credit for this activity, the participant must take a pre-test, participate in the activity, and turn in a completed post-test and evaluation. There is no fee to participate in this activity
Conflict of Interest Statement
Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.
Faculty & Planning Committee Disclosures
Jackie Dawson, RN
Nothing to disclose
Amanda Glazar, PhD
Nothing to disclose
Philip R. Muskin, MD
Bristol-Myers Squibb Company (Speakers Bureau)
James A. Underberg, MD, MS, FACPM, FACP, FASH, FNLA
Abbott Laboratories (Speakers Bureau); Daiichi Sankyo, Inc. (Speakers Bureau); Forest Laboratories, Inc. (Speakers Bureau); GlaxoSmithKline (Speakers Bureau); Kowa Pharmaceuticals American, Inc. (Speakers Bureau); Lilly USA, LLC (Speakers Bureau); LipoScience (Speakers Bureau, Consultant); Merck & Co., Inc. (Speakers Bureau); National Lipid Association (Honoraria)
Alan G. Morrice, PhD
Nothing to disclose
Christopher S. Ontiveros, PhD
Nothing to disclose