CME Hours / Accreditation Information
This activity is being sponsored by Boston University School of Medicine.
Boston University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Boston University School of Medicine designates this educational activity for a maximum of 10 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Each module will require about 2 hours per week for up to 5 weeks of participation. Participation includes reading and listening to online presentations, taking part in online group discussions, reading and responding to in-depth case studies, applying knowledge and practice to patients, and completing a final self-evaluation.
Term of Approval
Date of Release: July, 2008
Expiration Date: July, 2011
Course Director
John M. Wiecha, MD, MPH,
Associate Professor
Director, Distance Education for Health
Director of Predoctoral Education
Department of Family Medicine
Boston University School of Medicine
Faculty Member has nothing to disclose with regards to commercial interests.
Course Faculty
Jeremy Golding, MD
Clinical Associate Professor
Family Medicine and Community Health
UMass Medical School
Faculty member is a stockholder of the Stryker Foundation.
Disclosure Policy
Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve apparent conflicts of interest. In addition, faculty members are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices occurs.
Target Audience
Primary care physicians.
Educational Needs Addressed
Care of patients with CHF has become significantly more complex in the last decade, with rapid advancement in state of the art care. Gaps between primary care and specialty care in quality of care have grown as PCPs struggle to digest these data. It is also clear that adherence to guidelines can improve CHF outcomes.(1) There is also evidence that adoption of research findings on new medical therapies, without careful physician education and training in how to tailor therapy to appropriate patients, has produced paradoxical reduced quality of care and increased morbidity and mortality from CHF drug side effects.(2) This course will review current standards of care, review recent evidence underlying clinical guidelines for heart failure, and review up-to-date guidelines on the diagnosis and management of congestive heart failure.
_______________________
1 Stromer, H. and M. Camerer, Adherence to guidelines is a predictor of outcome in chronic heart failure: the Mahler survey. Eur Heart J, 2006. 27(2): p. 247-8.
2 Juurlink, D.N., et al., Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med, 2004. 351(6): p. 543-51.
Program Learning Objectives
At the conclusion of this course, participants will be able to:
1) When seeing a patient with new onset heart failure, will perform workup in accordance with AHA Guidelines for diagnosis and evaluation.
2) When seeing a patient with known heart failure will:
a) prescribe an ACE-I (preferred) or ARB (or ensure patient is already on), assuming no contraindication
b) prescribe a beta blocker, titrating according to guidelines
c) prescribe spironolactone in appropriate NYHA class 4 and class 3 patients
d) recognize patients for whom digoxin is appropriate, and prescribe in low dose, according to guidelines
e) identify patients who are candidates for nitrates and hydralazine vasodilator therapy
f) prescribe antiplatelet and anticoagulation therapy when appropriate
g) understand the importance of establishing a 'dry weight' for each patient, and note in chart
h) know how to educate patients about dry weight, and establish a plan for fluid weight gain
i) recognize those patients who may benefit from device therapy, specifically biventricular pacing, and defibrillator therapy, making referrals as appropriate
3) Considering a patient with acutely decompensated heart failure, will state an approach to diagnosis and therapy including management of oxygenation, fluid overload, and blood pressure.
4) State similarities and differences between systolic dysfunction and diastolic dysfunction heart failure.
Disclaimer
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. NEITHER TRUSTEES OF BOSTON UNIVERSITY NOR THE DEVELOPERS OF THE MATERIALS MAKE ANY WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL THE TRUSTEES OF BOSTON UNIVERSITY OR THE DEVELOPERS OF THESE MATERIALS BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.
Funding
This project was made possible through a grant from the Physicians' Foundation for Health Systems Excellence and is supported in part by unrestricted educational grants from Pfizer, GlaxoSmithKline, The Olympus Medical Charitable Foundation, and Beckman Coulter.
|
