Hosted by: CardioCareLive On-Demand Presentations thru May 14, 2011

Program Description:

Attention: Primary care & family physicians, cardiologists, endocrinologists, nurses, cardiac imaging specialists, diabetes educators, physician assistants, pharmacists.

Current Cardioprotective Strategies: Dealing with Dyslipidemia
featuring Dr. Peter Kwiterovich, MD
Chief, Director and Professor of Medicine - the Johns Hopkins University

The Premier Virtual Congress on Cardiovascular Care

Earn Up To 15 Credits at No Cost!

On-Demand Presentations Available May 14, 2010 - May 14, 2011

20+ Cardiology Experts: Drs. Blumenthal, Libby, Nesto, Cannon. Weir & Others

100% ONLINE - REGISTER NOW!

Hosted by: CardioCareLive On-Demand Presentations thru May 14, 2011

Program Description:

Attention: Primary care & family physicians, cardiologists, endocrinologists, nurses, cardiac imaging specialists, diabetes educators, physician assistants, pharmacists.

Medical Management of Atherosclerotic Vascular Disease:
The biological basis of contemporary management featuring Dr. Peter Libby, MD
Chief of Cardiovascular Medicine - Brigham & Women's Hospital; Harvard Medical School

The Premier Virtual Congress on Cardiovascular Care

Earn Up To 15 Credits at No Cost!

On-Demand Presentations Available May 14, 2010 - May 14, 2011

20+ Cardiology Experts: Drs. Blumenthal, Libby, Nesto, Cannon. Weir & Others

100% ONLINE - REGISTER NOW!

Hosted by: CardioCareLive On-Demand Presentations thru May 14, 2011

Program Description:

Attention: Primary care & family physicians, cardiologists, endocrinologists, nurses, cardiac imaging specialists, diabetes educators, physician assistants, pharmacists.

Hypertension Management: Optimizing Therapy and Maximizing Patient Compliance featuring Dr. Matthew R Weir, MD, Physician, Director, and Professor of Medicine - University of Maryland School Of Medicine.

The Premier Virtual Congress on Cardiovascular Care

Earn Up To 15 Credits at No Cost!

On-Demand Presentations Available May 14, 2010 - May 14, 2011

20+ Cardiology Experts: Drs. Blumenthal, Libby, Nesto, Cannon. Weir & Others

100% ONLINE - REGISTER NOW!

Hosted by: Mark Chyna, MD

Program Description:

How confident are you in differentiating COPD from other chronic respiratory conditions? In this segment entitled The Lung in COPD: What's Left, hear Dr Stokes Peebles speak on improving diagnosis and symptom management in patients with COPD.

Hosted by: Alan S. Brown, MD

Program Description:

Welcome to CME on ReachMD XM 160. This radio broadcast/podcast is the first in a series that will discuss a selection of virtual patients, Howard and Joseph, which are fully presented online on the website of the National Lipid Association www.lipid.org. These segments will highlight some of the key assessment, workup and management issues that you would face if these patients were presented in your practice on a visit-by-visit basis.

After the completion of this activity, please continue to follow virtual patients, Howard and Joseph, on the National Lipid Association website:

• To follow Howard, please click here: Visit 2.
• To follow Joseph, please click here: Visit 2.

Hosted by: Lee Freedman, MD

Program Description:

Patient knowledge about gout and its treatment is poor and often hinders effective management. Patient education, including improved physician-patient communication, disease education, and long-term goals of treatment, can help improve adherence and overcome barriers widely impacting quality of gout care.

Hosted by: Lee Freedman, MD

Program Description:

Patient knowledge about gout and its treatment is poor and often hinders effective management. Patient education, including improved physician-patient communication, disease education, and long-term goals of treatment, can help improve adherence and overcome barriers widely impacting quality of gout care.

Hosted by: Elliott Vichinsky, MD

Program Description:

Iron overload is a disorder characterized by the accumulation of excess iron in bodily tissues. It can be caused by hemochromatosis or may be a complication of frequent, regular blood transfusions used to treat severe anemia in patients with sickle cell disease, thalassemia, and other hematologic malignancies. If left untreated, iron accumulation in organs such as the liver, heart, and pancreas can cause organ failure and early death. Identifying a therapeutic strategy that is safely compatible with coexisting medical conditions and provides effective management of iron burden is an important aspect of treatment for iron overload, as it may be necessary to initiate therapy in patients as young as 2 years of age. One strategy that can be used to decrease and manage body iron levels in pediatric patients is iron chelation therapy. Ongoing development of new agents for iron chelation therapy and techniques for the detection of body iron stores is continuing to increase survival and improve quality of life for pediatric patients experiencing iron overload. At the end of this activity, participants will be able to describe the etiology, risk factors, and consequences of iron overload, evaluate the safety and efficacy of iron chelation therapy, and summarize the efficacies of available techniques for monitoring iron overload in pediatric patients.

Hosted by: Lee Freedman, MD

Program Description:

Gout is associated with a number of risk factors and comorbid conditions such as hypertension, chronic kidney disease, or obesity. Considering these comorbidities when developing a treatment plan is necessary for the comprehensive long-term management of gout.

Hosted by: Lee Freedman, MD

Program Description:

Gout is associated with a number of risk factors and comorbid conditions such as hypertension, chronic kidney disease, or obesity. Considering these comorbidities when developing a treatment plan is necessary for the comprehensive long-term management of gout.

Hosted by: Lee Freedman, MD

Program Description:

Gout treatment is often limited to treating typical signs, such as acute monoarthritic flares which affect 90% of initial cases. Clinicians can often ignore the flare as a warning sign of the underlying metabolic disease: hyperuricemia. To optimally treat gout patients who will likely suffer from the chronic nature of gout, a step-by-step, practical approach to reduce hyperuricemia and combat long-term gout can overcome this common culprit.

Hosted by: Lee Freedman, MD

Program Description:

Gout treatment is often limited to treating typical signs, such as acute monoarthritic flares which affect 90% of initial cases. Clinicians can often ignore the flare as a warning sign of the underlying metabolic disease: hyperuricemia. To optimally treat gout patients who will likely suffer from the chronic nature of gout, a step-by-step, practical approach to reduce hyperuricemia and combat long-term gout can overcome this common culprit.

Hosted by: Lee Freedman, MD

Program Description:

It is estimated that prostate cancer accounted for more than 27,300 deaths in the United States during 2009, which makes this malignancy the second leading cause of cancer death among men. Most cases of prostate cancer are identified while the disease is still in the localized stage and is potentially curable with local radiotherapy or surgery; however, 5% of cases are identified at the advanced stage, which remains incurable despite recent advances in first- and second-line therapies. Patients with advanced disease are treated with surgery and/or hormonal therapy to deplete androgen levels in the body. While androgen deprivation can be very successful at slowing the progression of prostate cancer, eventually the cancer will become refractory to hormone therapy, necessitating the development of effective second-line treatments. Median survival in patients with castration-resistant prostate cancer (CRPC) can be extended to 18 months with first-line treatment using docetaxel-based chemotherapy. The recent development of new cancer vaccines, cell-based immunotherapies, and targeted agents for advanced prostate cancer could provide additional, more effective treatment options for this disease. This program will update healthcare professionals on the latest research regarding the safety and efficacy of these novel cancer immunotherapies and targeted agents for the treatment of CRPC and describe emerging data on treatment strategies for patients with advanced prostate cancer as presented at the American Society of Clinical Oncology 2010 Genitourinary Cancers Symposium.

Hosted by: Lee Freedman, MD

Program Description:

Gout is a common and increasingly prevalent cause of acute and chronic arthritis and is the most common inflammatory arthritis in men. Nevertheless, gout has not been widely recognized and managed as a chronic disease. A general change in recognizing the long-term nature of gout is necessary to successfully manage patients with a chronic care approach.

Hosted by: Lee Freedman, MD

Program Description:

Gout is a common and increasingly prevalent cause of acute and chronic arthritis and is the most common inflammatory arthritis in men. Nevertheless, gout has not been widely recognized and managed as a chronic disease. A general change in recognizing the long-term nature of gout is necessary to successfully manage patients with a chronic care approach.

Hosted by: Lee Freedman, MD

Program Description:

There are many obstacles to timely diagnosis and effective management of hereditary angioedema (HAE). Because the symptoms of HAE can resemble other conditions (such as allergic reactions and gastrointestinal tract obstructions), and diagnosis is dependent on an array of laboratory findings and patient and family history, a definitive diagnosis is often delayed by 10 years or more from first onset of symptoms.[1,2] Long-term prophylaxis using 17α-alkylated anabolic androgens and antifibrinolytic agents can be moderately successful, but these agents are associated with significant side effects.[1,3] Newer therapeutic strategies, such as C1 inhibitor replacement, kallikrein inhibition, and bradykinin antagonism, show promise for improving patient outcomes. To overcome the many obstacles in HAE, allergists and other healthcare professionals who encounter patients with angioedema must be aware of the most up-to-date clinical data regarding diagnosis and treatment.

Sources/Citations:
1 Zuraw BL. N Engl J Med. 2008;359:1027-1036.
2 Roche O, et al. Ann Allergy Asthma Immunol. 2005;94:498-503.
3 Gompels MM, et al. Clin Exp Immunol. 2005;139:379-394.

Hosted by: Matt Sorrentino, MD

Program Description:

"What the scalpel is to the surgeon, words are to the clinician ... the conversation between doctor and the patient is the heart of the practice of medicine." Tumulty P. What is a clinician and what does he do? NEJM 1979; 283:2024.

This activity will provide you information you need to assess your practice's ability to serve patients in a linguistic and culturally proficient manner. This assessment will help you improve not only patient satisfaction, but also staff satisfaction and health outcomes.

Communication is the absolute heart of medical practice. Studies have shown that up to 70% of final diagnoses are based on the history alone. Anything that compromises the quality of the communication between patients and physicians represents a threat to the quality of care provided. Clear communication is hard enough, even with English-speaking patients. When the patient does not speak English, communication becomes that much more difficult. In a 2003 study conducted by the California Academy of Family Physicians, almost half the physicians surveyed were personally familiar with incidents in which quality of care was compromised by language barriers.

In addition to the impact that language barriers can have on quality of care, there are also financial implications to unclear communication in health care, and legal implications when unaddressed language barriers lead to a poor health outcome or to unequal access to care. When communication is unclear, we often resort to ordering expensive diagnostic tests; these additional costs hurt individual physicians, individual payors, public systems of reimbursement, and the system as a whole. Clear communication can control costs. In addition, federal Civil Rights law and a series of California regulations and contractual agreements require language access in health care.

Hosted by: Lee Freedman, MD

Program Description:

Patient-Centered Medical Home concept is not new. It has been around for 40+ years originating in 1967 by the American Academy of Pediatrics (AAP) to enhance the care of children with special needs. The concept has expanded with organizations such as the Future of Family Medicine, AAFP, ACP, AAP & AOA. In 2007 the AAFP, ACP, AAP & AOA drafted joint principles of the Patient-Centered Medical Home which the AMA adopted in 2008.

Hosted by: John J. Cush, MD

Program Description:

Note: The remainder of the activities in this free CME series will be available for participation at www.cmeoutfitters.com/RMD beginning in January 2010.

ACTIVITY OVERVIEW:
Regularly scheduled, standardized, quantitative measurement of disease status is widely recognized as essential to improving chronic disease management and outcomes. Optimal therapeutic decisions depend on and are driven by such measurement.[Ref. 1] The management of inflammatory arthritis is a complex matrix of managing symptoms with risk not only associated with disease progression, but also with complications that arise from drug therapy and various comorbidities. Patients can present with hypertension, diabetes, osteoporosis, cancer, and an increased susceptibility for infection. The epidemiology and natural history of rheumatoid arthritis (RA) support early, aggressive treatment to reduce joint damage and functional decline.[Ref. 2] However, early treatment of RA requires timely referrals and improved communication between rheumatology and primary care. Patient education has become an integral part of the therapeutic approach to helping patients with RA to self-manage their arthritis. A variety of evidence indicates that educational attainment is associated with better disease outcomes in RA.[Ref. 3] In this series of interviews and case vignettes, the faculty will address the issues facing rheumatologists and their patients in achieving improved outcomes in the management of RA.

References:
1. Harrington JT. Performance measures and improvement in rheumatic diseases: alternatives for disease activity measurement for rheumatoid arthritis management in rheumatology practice. Curr Opin Rheumatol 2008;20:153-158.
2. Walker D, Adebajo A, Heslop P, et al. Patient education in rheumatoid arthritis: the effectiveness of the ARC booklet and the mind map. Rheumatology 2007;46:1593-1596.
3. O'Dell JR. Treating rheumatoid arthritis early: a window of opportunity? Arthritis Rheum 2002;46:283-285.

Hosted by: John J. Cush, MD

Program Description:

Note: The remainder of the activities in this free CME series will be available for participation at www.cmeoutfitters.com/RMD beginning in January 2010.

ACTIVITY OVERVIEW:
Regularly scheduled, standardized, quantitative measurement of disease status is widely recognized as essential to improving chronic disease management and outcomes. Optimal therapeutic decisions depend on and are driven by such measurement.[Ref. 1] The management of inflammatory arthritis is a complex matrix of managing symptoms with risk not only associated with disease progression, but also with complications that arise from drug therapy and various comorbidities. Patients can present with hypertension, diabetes, osteoporosis, cancer, and an increased susceptibility for infection. The epidemiology and natural history of rheumatoid arthritis (RA) support early, aggressive treatment to reduce joint damage and functional decline.[Ref. 2] However, early treatment of RA requires timely referrals and improved communication between rheumatology and primary care. Patient education has become an integral part of the therapeutic approach to helping patients with RA to self-manage their arthritis. A variety of evidence indicates that educational attainment is associated with better disease outcomes in RA.[Ref. 3] In this series of interviews and case vignettes, the faculty will address the issues facing rheumatologists and their patients in achieving improved outcomes in the management of RA.

References:
1. Harrington JT. Performance measures and improvement in rheumatic diseases: alternatives for disease activity measurement for rheumatoid arthritis management in rheumatology practice. Curr Opin Rheumatol 2008;20:153-158.
2. Walker D, Adebajo A, Heslop P, et al. Patient education in rheumatoid arthritis: the effectiveness of the ARC booklet and the mind map. Rheumatology 2007;46:1593-1596.
3. O'Dell JR. Treating rheumatoid arthritis early: a window of opportunity? Arthritis Rheum 2002;46:283-285.

Hosted by: Larry Kaskel, MD

Program Description:

Statement of Need
Chronic myeloid leukemia (CML) accounts for approximately 20% of adult leukemias diagnosed in the United States. CML is characterized by the presence of the Philadelphia chromosome, which is generated through a translocation between chromosomes 9 and 22 and creates the BCR-ABL oncogene. The resultant BCR-ABL protein has constitutive tyrosine kinase activity and affects the transformation, growth, and survival of hematopoietic cells.

Imatinib was the first tyrosine kinase inhibitor (TKI) of the BCR-ABL protein to be developed and is now considered the standard of care for first-line treatment of CML. Despite high response rates to imatinib, the development of resistance to therapy, particularly for those with advanced CML, has emerged as a major problem. The second-generation BCR-ABL TKIs, dasatinib and nilotinib, were subsequently developed to combat imatinib-resistant disease. However, not all imatinib-resistant clones respond to treatment and some clones develop resistance to second-line TKIs. Thus, new agents and combination strategies are being developed to further improve the outcomes of patients with CML. At the end of this program, participants will be able to describe the optimal use of TKI therapies in the first- and second-line settings, and the importance of prompt recognition and classification of imatinib resistance.

Hosted by: Anthony Alessi, MD

Program Description:

Are you underestimating the effect of migraines on your patients? A recent study suggests you might be. In this program, we'll explore how you can improve communication with your patients with migraine so you can improve their quality of care.

Hosted by: Alan S. Brown, MD

Program Description:

The pharmacological armamentarium available to mitigate cardiovascular (CV) risk continues to grow, as do the options for assessing the impact of pharmacological interventions. Dr. Alan Brown leads a discussion on select research presented at the 2009 American Heart Association Scientific Sessions that advance our knowledge regarding the clinical utility of various therapeutic strategies to improve lipid profiles, slow the progression of atherosclerosis, and mitigate global CV risk. Joining him are Drs. Christie Ballantyne and Michael Davidson.

This activity is sponsored by the National Lipid Association. For more information, please visit www.lipid.org.

Hosted by: Lee Freedman, MD

Program Description:

To download the Resource Guide for this program, click here.

ACTIVITY PURPOSE:
More than 900,000 venous thromboembolism (VTE) events occur annually in the United States and the incidence of VTE has not changed significantly in the past 25 years, despite medical advances.[1,2] Moreover, an estimated 30% of patients who have a VTE event die within 30 days and the same percentage will experience a recurrent VTE within 10 years.[3] These data indicate a need to build appreciation of the clinical impact of VTE and the need for appropriate VTE management practices and led to a recent call to action by the US Surgeon General for a plan to reduce the US incidence of deep vein thrombosis (DVT) and pulmonary embolism.[4]
The Agency for Healthcare Research and Quality states that implementing an appropriate VTE risk stratification and prevention plan is the number one way for US hospitals to promote patient safety and reduce costs; however, despite recommendations, fewer than 50% of hospitalized patients diagnosed with DVT receive prophylaxis.[3-5] Evidence-based guidelines, including the recently updated 8th edition American College of Chest Physicians guidelines, also emphasize the importance of VTE risk stratification and appropriate methods of prophylaxis, yet data indicate an ongoing lack of adherence to evidence-based recommendations.[6-8] Not only can prophylaxis prevent costly and clinically significant VTE events, but data show VTE prophylaxis can be cost-saving with an average savings of $1000 per discharge.[9] Furthermore, research stresses the importance of healthcare education on VTE prevention, with hospital-targeted education directly linked to significant improvements in quantity and quality of VTE prophylaxis.[5,10,11] With the increased complexity of VTE patient care in special populations and the need for close monitoring, hospital-based clinicians can greatly benefit from education to ensure appropriate medication direction and selection, based on current guidelines and evidence.

REFERENCES
1. Heit J, Petterson T, Farmer S, Bailey K, Melton L. Trends in incidence of deep vein thrombosis and pulmonary embolism: a 35-year population-based study. Blood. 2006;108:430A.
2. Heit J, Cohen A, Anderson FJ. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. Blood. 2005;106:267A.
3. Michota FA. Bridging the gap between evidence and practice in venous thromboembolism prophylaxis: the quality improvement process. J Gen Intern Med. 2007;22:1762-1770.
4. US Department of Health and Human Services. The surgeon general's call to action to prevent deep vein thrombosis and pulmonary embolism. http://www.surgeongeneral.gov/topics/deepvein/calltoaction/call-to-action-on-dvt-2008.pdf. Accessed August 24, 2009.
5. Diagnosis and Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Agency for Healthcare Research and Quality Web site. http://www.ahrq.gov/downloads/pub/evidence/pdf/dvt/dvt.pdf. Accessed August 24, 2009.
6. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):454S-545S.
7. Yu HT, Dylan ML, Lin J, Dubois RW. Hospitals' compliance with prophylaxis guidelines for venous thromboembolism. Am J Health Syst Pharm. 2007;64(1):69-76.
8. Nutescu EA. Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. Am J Health Syst Pharm. 2007;64(11 Suppl 7):S5-S13.
9. Medical News: Venous Thrombosis. Medpage Today Website. http://www.medpagetoday.com/Cardiology/VenousThrombosis/15600. Accessed August 24, 2009.
10. Cohn SL, Adekile A, Mahabir V. Improved use of thromboprophylaxis for deep vein thrombosis following an educational intervention. J Hosp Med. 2006;1:331-338.
11. Dobesh PP, Stacy ZA. Effect of a clinical pharmacy education program on improvement in the quantity and quality of venous thromboembolism prophylaxis for medically ill patients. J Manag Care Pharm. 2005;11(9):755-762.

Hosted by: Lee Freedman, MD

Program Description:

To download the Resource Guide for this program, click here.

ACTIVITY PURPOSE
More than 900,000 venous thromboembolism (VTE) events occur annually in the United States and the incidence of VTE has not changed significantly in the past 25 years, despite medical advances.[1,2] Moreover, an estimated 30% of patients who have a VTE event die within 30 days and the same percentage will experience a recurrent VTE within 10 years.[3] These data indicate a need to build appreciation of the clinical impact of VTE and the need for appropriate VTE management practices and led to a recent call to action by the US Surgeon General for a plan to reduce the US incidence of deep vein thrombosis (DVT) and pulmonary embolism.[4]
The Agency for Healthcare Research and Quality states that implementing an appropriate VTE risk stratification and prevention plan is the number one way for US hospitals to promote patient safety and reduce costs; however, despite recommendations, fewer than 50% of hospitalized patients diagnosed with DVT receive prophylaxis.[3-5] Evidence-based guidelines, including the recently updated 8th edition American College of Chest Physicians guidelines, also emphasize the importance of VTE risk stratification and appropriate methods of prophylaxis, yet data indicate an ongoing lack of adherence to evidence-based recommendations.[6-8] Not only can prophylaxis prevent costly and clinically significant VTE events, but data show VTE prophylaxis can be cost-saving with an average savings of $1000 per discharge.[9] Furthermore, research stresses the importance of healthcare education on VTE prevention, with hospital-targeted education directly linked to significant improvements in quantity and quality of VTE prophylaxis.[5,10,11] With the increased complexity of VTE patient care in special populations and the need for close monitoring, hospital-based clinicians can greatly benefit from education to ensure appropriate medication direction and selection, based on current guidelines and evidence.

REFERENCES
1. Heit J, Petterson T, Farmer S, Bailey K, Melton L. Trends in incidence of deep vein thrombosis and pulmonary embolism: a 35-year population-based study. Blood. 2006;108:430A.
2. Heit J, Cohen A, Anderson FJ. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. Blood. 2005;106:267A.
3. Michota FA. Bridging the gap between evidence and practice in venous thromboembolism prophylaxis: the quality improvement process. J Gen Intern Med. 2007;22:1762-1770.
4. US Department of Health and Human Services. The surgeon general's call to action to prevent deep vein thrombosis and pulmonary embolism. http://www.surgeongeneral.gov/topics/deepvein/calltoaction/call-to-action-on-dvt-2008.pdf. Accessed August 24, 2009.
5. Diagnosis and Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Agency for Healthcare Research and Quality Web site. http://www.ahrq.gov/downloads/pub/evidence/pdf/dvt/dvt.pdf. Accessed August 24, 2009.
6. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):454S-545S.
7. Yu HT, Dylan ML, Lin J, Dubois RW. Hospitals' compliance with prophylaxis guidelines for venous thromboembolism. Am J Health Syst Pharm. 2007;64(1):69-76.
8. Nutescu EA. Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. Am J Health Syst Pharm. 2007;64(11 Suppl 7):S5-S13.
9. Medical News: Venous Thrombosis. Medpage Today Website. http://www.medpagetoday.com/Cardiology/VenousThrombosis/15600. Accessed August 24, 2009.
10. Cohn SL, Adekile A, Mahabir V. Improved use of thromboprophylaxis for deep vein thrombosis following an educational intervention. J Hosp Med. 2006;1:331-338.
11. Dobesh PP, Stacy ZA. Effect of a clinical pharmacy education program on improvement in the quantity and quality of venous thromboembolism prophylaxis for medically ill patients. J Manag Care Pharm. 2005;11(9):755-762.

Hosted by: Matt Sorrentino, MD

Program Description:

To download the Resource Guide for this activity, click here.

ACTIVITY PURPOSE
More than 900,000 venous thromboembolism (VTE) events occur annually in the United States and the incidence of VTE has not changed significantly in the past 25 years, despite medical advances.[1,2] Moreover, an estimated 30% of patients who have a VTE event die within 30 days and the same percentage will experience a recurrent VTE within 10 years.[3] These data indicate a need to build appreciation of the clinical impact of VTE and the need for appropriate VTE management practices and led to a recent call to action by the US Surgeon General for a plan to reduce the US incidence of deep vein thrombosis (DVT) and pulmonary embolism.[4]
The Agency for Healthcare Research and Quality states that implementing an appropriate VTE risk stratification and prevention plan is the number one way for US hospitals to promote patient safety and reduce costs; however, despite recommendations, fewer than 50% of hospitalized patients diagnosed with DVT receive prophylaxis.[3-5] Evidence-based guidelines, including the recently updated 8th edition American College of Chest Physicians guidelines, also emphasize the importance of VTE risk stratification and appropriate methods of prophylaxis, yet data indicate an ongoing lack of adherence to evidence-based recommendations.[6-8] Not only can prophylaxis prevent costly and clinically significant VTE events, but data show VTE prophylaxis can be cost-saving with an average savings of $1000 per discharge.[9] Furthermore, research stresses the importance of healthcare education on VTE prevention, with hospital-targeted education directly linked to significant improvements in quantity and quality of VTE prophylaxis.[5,10,11] With the increased complexity of VTE patient care in special populations and the need for close monitoring, hospital-based clinicians can greatly benefit from education to ensure appropriate medication direction and selection, based on current guidelines and evidence.

REFERENCES
1. Heit J, Petterson T, Farmer S, Bailey K, Melton L. Trends in incidence of deep vein thrombosis and pulmonary embolism: a 35-year population-based study. Blood. 2006;108:430A.
2. Heit J, Cohen A, Anderson FJ. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. Blood. 2005;106:267A.
3. Michota FA. Bridging the gap between evidence and practice in venous thromboembolism prophylaxis: the quality improvement process. J Gen Intern Med. 2007;22:1762-1770.
4. US Department of Health and Human Services. The surgeon general's call to action to prevent deep vein thrombosis and pulmonary embolism. http://www.surgeongeneral.gov/topics/deepvein/calltoaction/call-to-action-on-dvt-2008.pdf. Accessed August 24, 2009.
5. Diagnosis and Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Agency for Healthcare Research and Quality Web site. http://www.ahrq.gov/downloads/pub/evidence/pdf/dvt/dvt.pdf. Accessed August 24, 2009.
6. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):454S-545S.
7. Yu HT, Dylan ML, Lin J, Dubois RW. Hospitals' compliance with prophylaxis guidelines for venous thromboembolism. Am J Health Syst Pharm. 2007;64(1):69-76.
8. Nutescu EA. Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. Am J Health Syst Pharm. 2007;64(11 Suppl 7):S5-S13.
9. Medical News: Venous Thrombosis. Medpage Today Website. http://www.medpagetoday.com/Cardiology/VenousThrombosis/15600. Accessed August 24, 2009.
10. Cohn SL, Adekile A, Mahabir V. Improved use of thromboprophylaxis for deep vein thrombosis following an educational intervention. J Hosp Med. 2006;1:331-338.
11. Dobesh PP, Stacy ZA. Effect of a clinical pharmacy education program on improvement in the quantity and quality of venous thromboembolism prophylaxis for medically ill patients. J Manag Care Pharm. 2005;11(9):755-762.

Hosted by: Matt Sorrentino, MD

Program Description:

To download the Resource Guide for this program, click here.

ACTIVITY PURPOSE:
More than 900,000 venous thromboembolism (VTE) events occur annually in the United States and the incidence of VTE has not changed significantly in the past 25 years, despite medical advances.[1,2] Moreover, an estimated 30% of patients who have a VTE event die within 30 days and the same percentage will experience a recurrent VTE within 10 years.[3] These data indicate a need to build appreciation of the clinical impact of VTE and the need for appropriate VTE management practices and led to a recent call to action by the US Surgeon General for a plan to reduce the US incidence of deep vein thrombosis (DVT) and pulmonary embolism.[4]
The Agency for Healthcare Research and Quality states that implementing an appropriate VTE risk stratification and prevention plan is the number one way for US hospitals to promote patient safety and reduce costs; however, despite recommendations, fewer than 50% of hospitalized patients diagnosed with DVT receive prophylaxis.[3-5] Evidence-based guidelines, including the recently updated 8th edition American College of Chest Physicians guidelines, also emphasize the importance of VTE risk stratification and appropriate methods of prophylaxis, yet data indicate an ongoing lack of adherence to evidence-based recommendations.[6-8] Not only can prophylaxis prevent costly and clinically significant VTE events, but data show VTE prophylaxis can be cost-saving with an average savings of $1000 per discharge.[9] Furthermore, research stresses the importance of healthcare education on VTE prevention, with hospital-targeted education directly linked to significant improvements in quantity and quality of VTE prophylaxis.[5,10,11] With the increased complexity of VTE patient care in special populations and the need for close monitoring, hospital-based clinicians can greatly benefit from education to ensure appropriate medication direction and selection, based on current guidelines and evidence.

REFERENCES
1. Heit J, Petterson T, Farmer S, Bailey K, Melton L. Trends in incidence of deep vein thrombosis and pulmonary embolism: a 35-year population-based study. Blood. 2006;108:430A.
2. Heit J, Cohen A, Anderson FJ. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. Blood. 2005;106:267A.
3. Michota FA. Bridging the gap between evidence and practice in venous thromboembolism prophylaxis: the quality improvement process. J Gen Intern Med. 2007;22:1762-1770.
4. US Department of Health and Human Services. The surgeon general's call to action to prevent deep vein thrombosis and pulmonary embolism. http://www.surgeongeneral.gov/topics/deepvein/calltoaction/call-to-action-on-dvt-2008.pdf. Accessed August 24, 2009.
5. Diagnosis and Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Agency for Healthcare Research and Quality Web site. http://www.ahrq.gov/downloads/pub/evidence/pdf/dvt/dvt.pdf. Accessed August 24, 2009.
6. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):454S-545S.
7. Yu HT, Dylan ML, Lin J, Dubois RW. Hospitals' compliance with prophylaxis guidelines for venous thromboembolism. Am J Health Syst Pharm. 2007;64(1):69-76.
8. Nutescu EA. Assessing, preventing, and treating venous thromboembolism: evidence-based approaches. Am J Health Syst Pharm. 2007;64(11 Suppl 7):S5-S13.
9. Medical News: Venous Thrombosis. Medpage Today Website. http://www.medpagetoday.com/Cardiology/VenousThrombosis/15600. Accessed August 24, 2009.
10. Cohn SL, Adekile A, Mahabir V. Improved use of thromboprophylaxis for deep vein thrombosis following an educational intervention. J Hosp Med. 2006;1:331-338.
11. Dobesh PP, Stacy ZA. Effect of a clinical pharmacy education program on improvement in the quantity and quality of venous thromboembolism prophylaxis for medically ill patients. J Manag Care Pharm. 2005;11(9):755-762.

Hosted by: Larry Kaskel, MD

Program Description:

This expert interview is designed to dispel misconceptions that many physicians and practice managers have about vaccine-preventable diseases in order to close clinical practice gaps related to the prevention of vaccine-preventable diseases in adult patients.

Hosted by: CE Medicus

Program Description:

Primary care providers are on the front line of recognition, diagnosis, and treatment of depression in the U.S. This activity is designed for family physicians and primary care physicians - Learn how you can better identify and diagnose patients with depression with particular attention to patient somatic symptoms.

To participate in this program, click here.

CME Credits:

1.0 AMA PRA Category 1 Credit
1.0 Prescribed AAFP Credit
1 Category 2-B AOA Credit

Faculty:

David Baron, MSEd, DO
Professor and Chair
Department of Psychiatry
Temple University School of Medicine
Philadelphia, PA

Thomas C. Bent, MD
Medical Director/COO
Laguna Beach Community Clinic
Laguna Beach, CA

Lesley A. Schroeder, MD
Associate Clinical Professor
Department of Psychiatry & Behavioral Sciences
University of California - Davis
Davis, CA

Hosted by: Larry Kaskel, MD

Program Description:

In the United States each year, over 1.4 million people will be hospitalized for unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI). Multiple antiplatelet agents have been developed to interfere with or inhibit the specific pathways of platelet activation and aggregation that lead to the development of UA and non-ST-segment elevation acute coronary syndrome (NSTE ACS). The American College of Cardiology and the American Heart Association Task Force on Practice Guidelines developed guidelines in 2007 for the management of UA and NSTEMI which cover the use of antiplatelet agents. Since then, multiple studies have been designed to determine the utility of new antiplatelet agents and to clarify the timing and dosage of the currently available antiplatelet agents.

Hosted by: CE Medicus

Program Description:

This unique continuing medical education (CME) initiative allows you to critically assess the progress of treatment for patients with colorectal cancer (CRC) through means of a CRC curriculum and will also help you prepare for certification and board exams. At the end of the curriculum, you will be able to receive CME credit, and also be eligible to receive a certificate of completion for a CRC specialty study.

To participate in this activity, please click here.

CME Credits:

1.0 AMA PRA Category 1 Credits™

Faculty:

Johanna Bendell, SB, MD
Director of GI Cancer Research
Associate Director, Drug Development
Sarah Cannon Research Institute

Axel Grothey, MD
Senior Associate Consultant
Division of Medical Oncology
Mayo Clinic

John Marshall, MD
Associate Professor of Hematology/Oncology
Georgetown University

Alan P. Venook, MD
Professor of Clinical Medicine
Division of Medical Oncology
University of California, San Francisco

Hosted by: Mark Chyna, MD

Program Description:

The European Association for the Study of Diabetes (EASD) recently reported findings from four studies that suggest a link between use of insulin glargine and increased cancer risk. The American Diabetes Association cautions that the results of these studies are conflicting and inconclusive, and advises against over-reaction until more information is available.

Hosted by: Lee Freedman, MD

Program Description:

The health of smokers impact physicians everyday through illness, co-morbidities, and premature death. The 2008 U.S. Public Health Service release of the Clinical Practice Guideline: Treating Tobacco Use and Dependence provides evidence based recommendations that help patients quit smoking.

Hosted by: Larry Kaskel, MD

Program Description:

Epilepsy continues to pose significant challenges to health care practitioners and represents one of the more difficult neurological disorders to effectively treat. However, areas such as bioequivalence, generic substitution, and neuroprotection are constantly evolving as areas for helping to improve this debilitating disorder. Dr. Welty is here to speak on epilepsy from the pharmacist standpoint, and address ways in which the disorder can be more effectively managed.

Hosted by: David S. Ettinger, MD

Program Description:

Presented by The Johns Hopkins University School of Medicine.

This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit, www.lillygrantoffice.com.

STATEMENT OF NEED
New treatments and methods for improving the care of patients with non-small-cell lung cancer (NSCLC) are continually being investigated. This includes studies of the potential benefits of using histologic markers to target treatment, updating chemotherapy regimens, and the role of novel therapeutic agents. As the field rapidly evolves, guidelines are also being updated almost every year, providing a wealth of new information for oncology clinicians.

The following segment focuses on the importance of targeted therapy in NSCLC, as well as discusses recent studies presented at the 2009 ASCO Annual Meeting. This discussion is hosted by David S. Ettinger, MD, FACP, FCCP, Alex Grass Professor of Oncology, Professor of Medicine, and Professor of Radiation Oncology and Molecular Radiation Sciences at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Dr Ettinger will speak with Edward S. Kim, MD, Assistant Professor in the Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center.

Hosted by: David S. Ettinger, MD

Program Description:

Presented by The Johns Hopkins University School of Medicine.

This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit, www.lillygrantoffice.com.

STATEMENT OF NEED
New treatments and methods for improving the care of patients with non-small-cell lung cancer (NSCLC) are continually being investigated. This includes studies of the potential benefits of using histologic markers to target treatment, updating chemotherapy regimens, and the role of novel therapeutic agents. As the field rapidly evolves, guidelines are also being updated almost every year, providing a wealth of new information for oncology clinicians.

The following segment focuses on the importance of personalized medicine in the treatment of NSCLC. This discussion is hosted by David S. Ettinger, MD, FACP, FCCP, Alex Grass Professor of Oncology, Professor of Medicine, and Professor of Radiation Oncology and Molecular Radiation Sciences at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Dr Ettinger will speak with Edward S. Kim, MD, Assistant Professor in the Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center.

Hosted by: Larry Kaskel, MD

Program Description:

At this year's American College of Cardiology Scientific Sessions annual meeting, a variety of new data were presented on the role of statins for lowering cardiovascular risk and preventing future events. Dr. Stein will address the results, limitations, and clinical implications of some of these trials in order to provide clinicians with the latest advances in mitigating cardiovascular disease.

Hosted by: Anthony Alessi, MD

Program Description:

Alzheimer’s disease is a debilitating problem for both patients and families, and with increasing elderly populations in the United States it will continue to grow.  Practitioners need to be armed with the latest diagnosis, screening, and management tools, as well as be aware of the importance of clinical research in this area.  As an expert in the area, Dr. Cummings will discuss Alzheimer’s disease and ways to improve management in primary care.

Hosted by: David S. Ettinger, MD

Program Description:

Presented by The Johns Hopkins University School of Medicine.

This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit, www.lillygrantoffice.com.

STATEMENT OF NEED
New treatments and methods for improving the care of patients with non-small-cell lung cancer (NSCLC) are continually being investigated. This includes studies of the potential benefits of using histologic markers to target treatment, updating chemotherapy regimens, and the role of novel therapeutic agents. As the field rapidly evolves, guidelines are also being updated almost every year, providing a wealth of new information for oncology clinicians.

The following segment focuses on the importance of histologic subtyping of NSCLC and the choice of first-line chemotherapy. This discussion is hosted by David S. Ettinger, MD, FACP, FCCP, Alex Grass Professor of Oncology, Professor of Medicine, and Professor of Radiation Oncology and Molecular Radiation Sciences at The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Dr Ettinger will speak with Mark A. Socinski, MD, Professor of Medicine and Director of the Multidisciplinary Thoracic Oncology Program at the University of North Carolina School of Medicine in Chapel Hill.

Hosted by: Lee Freedman, MD

Program Description:

Asthma affects more than 22 million people in the United States. The number of deaths due to asthma has declined in recent years; however, hospitalization rates have remained relatively stable over the last decade, and the burden of avoidable hospitalizations remains substantial. This program will focus on the use of practice guidelines in patient management, including individualizing therapy and methods to improve patient self-management, adherence, and ultimately, treatment effectiveness.