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2019 Management of Ulcerative Colitis: Where, When, Who, and What Now?
Ulcerative colitis (UC) is a progressive disease whose clinical, functional, and psychosocial impact can be comparable to that of Crohn's disease (CD). While the management of UC has for some time focused on simple control of symptoms, strategies for managing UC have progressed, with treatment goals shifting from resolution of symptoms to full control of the disease, with a final aim of halting ...
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A Change of Plans: Adjusting Treatment and Prescribing Methods to Address the Opioid Epidemic
Nurses, physician assistants, and nurse practitioners are at the forefront of primary care, orthopedic surgery, and oral surgery patient care. Clinicians practicing in the primary care setting are well suited to manage chronic pain as they are adept at managing chronic disease and associated comorbidities, coordinating care, and applying a biopsychosocial approach to multimodal pain management. ...
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A Change of Plans: Adjusting Treatment and Prescribing Protocols to Address the Opioid Epidemic
Nurses, physician assistants, and nurse practitioners are at the forefront of primary care, orthopedic surgery, and oral surgery patient care. Clinicians practicing in the primary care setting are well suited to manage chronic pain as they are adept at managing chronic disease and associated comorbidities, coordinating care, and applying a biopsychosocial approach to multimodal pain management. ...
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Biomarkers for Diagnosis and Prognosis of MS
It is an exciting period for the clinical management of multiple sclerosis (MS), with an expanding treatment landscape and recent approval of new disease-modifying therapies (DMTs) for both relapsing and progressive MS. The Consortium of Multiple Sclerosis Centers (CMSC) 2019 Annual Meeting, the largest MS meeting in North America, features the latest information on cutting-edge research finding...
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Case Simulations in the Detection and Management of Narcolepsy: Patients That Keep You Up At Night
Residual ES in patients undergoing treatment for narcolepsy and OSA has a profound negative impact on patients' health-related quality of life (HRQoL). In order to properly treat this disorder, it is imperative that the rate of detection increases and that clinicians are educated on the efficacy of current and emerging treatment strategies that minimize the incidence of residual ES. Clinical too...
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Case Simulations in the Detection of OSA: Patients That Keep You Up At Night
Sleep is necessary for optimal functioning and health, and many patients diagnosed with obstructive sleep apnea (OSA) and narcolepsy experience residual excessive sleepiness (ES) despite treatment. In order to avoid the negative impact on health-related quality of life (HRQoL) and high medical costs associated with patients who suffer from residual ES, it is imperative that the rate of detection...
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Case Simulations in the Management of Persistent Excessive Sleepiness in OSA: Patients That Keep You Up At Night
The impact of residual excessive sleepiness (ES) in patients undergoing treatment for narcolepsy and OSA is profound, which highlights treatment challenges in their management. Optimal management of residual ES involves clinicians understanding the efficacy of current and emerging treatment strategies and the importance of shared decision-making tools and strategies.
In this CME Outfitters d...
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Clinical Insights on Recent Advances in Spinal Muscular Atrophy
Spinal muscular atrophy (SMA) is a leading, fatal, autosomal recessive disorder that affects approximately one in 10,000 live births. Nusinersen was approved as the first targeted therapy for SMA, and since its groundbreaking approval data has been published that demonstrates its efficacy for both infantile- and later-onset SMA populations. Additionally, recent guidelines were published that pro...
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Current and Emerging Therapies for Schizophrenia: How MOA Affects Clinical Outcomes
Clinical trial data that addresses the safety and efficacy of antipsychotics is continuously emerging, with a focus on optimizing the management of schizophrenia. These data include the identification of strategies with novel mechanisms of action (MOAs) to effectively resolve symptoms and promote recovery while minimizing metabolic effects.
The second episode of this schizophrenia CMEOcast p...
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Don’t Snooze on the Latest Evidence on Excessive Daytime Sleepiness in OSA and Narcolepsy: An Expert-Guided Tour of the Sleep 2019 Annual Meeting
Residual excessive daytime sleepiness (EDS) associated with obstructive sleep apnea (OSA) and narcolepsy is a common, debilitating condition that compromises patients' overall health, wellness, and safety. The field of sleep medicine is rapidly evolving to address the unmet needs of EDS as novel treatment options become available.
In this CME Outfitters dynamic, interactive infographic, expe...
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Fatal Attraction: Why are Opioids so Addicting?
Early in the opioid crisis, physicians were the principle source of opioid use and abuse due to overprescribing, often leading to patients storing leftover prescriptions at home and friends or family members finding and using these leftovers. Unfortunately, simply restricting opioid prescriptions is not an effective strategy in a culture that has wildly available and accessible drugs of abuse av...
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Honing in on the Appeal Process to Improve Access to Anti-VEGF Therapy for Patients with AMD
Step therapy requirements have limited patient access to FDA-approved, anti–vascular endothelial growth factor (VEGF) agents for the treatment of AMD. Prior authorization requests for these therapies are commonly denied. Hence, it is important that clinicians be aware of the approaches to overcome these barriers and implement systematic and clinically supported appeals that ensure uninterrupte...
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How PAs are Improving Skill Sets to Approach Opioid Use
A 2017 survey of physician assistants (PAs), data showed PAs are prescribing opioids and managing patients with pain in their practice; they’ve also expressed a need for education on both prescribing opioids and managing their patients with opioid use disorders – particularly in underserved populations.
In this free CME Snack, Dr. Gold and Ms. Catherine Judd share insights on best ways t...
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It Starts with a Signal: Understanding Pain, Addiction, and Treatment
The number of opioid related deaths in the US is on the rise and health care providers often struggle finding a balance between prescribing guidelines and the individual needs of patients with acute and/or chronic pain. It's imperative that clinicians seeing patients with pain are knowledgeable about acute and chronic pain pathways and underlying mechanisms so that they may appropriately assess ...
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Keeping the Patient in the Center in AMD Care
Age-related macular degeneration (AMD) is the leading cause of legal blindness in adults over age 50, but the development of agents that target vascular endothelial growth factor (VEGF) has revolutionized its treatment. There are currently two FDA-approved agents (ranibizumab and aflibercept) and one off-label anti-VEGF agent (bevacizumab) being used to treat patients with AMD, and data from eme...
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Long-Acting Injectables for Schizophrenia: An Effective, Yet Often Underutilized Tool for Rapid Symptom Reduction and Restoration of Function
Schizophrenia is a serious and debilitating disorder that often poses a considerable challenge to clinicians. While long-acting injectables (LAIs) have emerged as a viable means to address patient nonadherence – often a component of schizophrenia management – clinicians often fail to implement the use of LAIs. Many times this is due to clinicians not being aware of updates such as the introd...
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Management of Sickle Cell Disease in the Emergency Department: A Case-Based Discussion
Sickle cell disease (SCD) is a painful disease with many life-threatening complications including acute chest syndrome, infections, severe anemia, and venous thromboembolism. Patients with SCD often present to the ED and hence, it is critical for clinicians in the emergency department (ED) to be educated so that they can promptly assess and treat acute sickle cell pain and evaluate and treat ass...
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Managing the Complexity of Chronic Pain in the Primary Care Setting
Primary care physicians (PCPs) have the opportunity to make a difference in the opioid epidemic, as they are responsible for approximately 50% of opioid prescriptions. PCPs are well suited to manage chronic pain as they are adept at managing chronic disease and associated comorbidities, coordinating care, and applying a biopsychosocial approach to multimodal pain management. Incorporating best p...
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Minimizing the Burden of Prior Authorization in AMD Through Actionable Strategies and Improved Communication
The development of anti–vascular endothelial growth factor (VEGF) agents has revolutionized the treatment of age-related macular degeneration (AMD). Nevertheless, optimal management of AMD is impeded by challenges in access to FDA-approved therapies. Step therapy, a type of prior authorization (PA) instituted by the payer, mandates that more cost-effective therapies be used before more expensi...
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Navigating Through the Latest Advances in Monoclonal Antibodies: Translating Evidence to the Care of Patients with Psoriasis
Recent years have seen an increase in the number of therapeutic monoclonal antibodies (mAbs) that are available to treat a variety of conditions caused by immune-mediated chronic inflammation such as psoriasis. Health care professionals are often presented with complex and conflicting information surrounding concepts of mAb production and immunogenicity; therefore, there is a significant need fo...
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New Perspectives and Approaches from Orthopedic Surgeons for the Management of Acute Pain
To meet the pain needs of patients and minimize opioid prescribing, the Orthopedic Trauma Association has released new acute pain guidelines that emphasize precise prescribing within multimodal treatment plans that integrate non-opioid medications, cognitive strategies, and physical strategies such as immobilization, ice, elevation, and physical therapy.
Not meant to be a one-size-fits-all s...
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Opioid Use Disorder in Special Populations: Making Recovery a Goal
The opioid epidemic is ravaging many parts of the United States, resulting in drug overdose deaths emerging as the leading cause of injury death. The 2015 statistics from Health and Human Services on human and economic costs were staggering, reporting that 12.5 million people misused prescription opioids that year, resulting in $78.5 billion in economic costs. Yet the National Institute on Alcoh...
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Providing the Right Expectations: Understanding the Pathophysiology of Pain
It can be difficult and daunting to evaluate patients with chronic pain, as the nervous system is complex and knowing which type of pain the patient is experiencing – neuropathic, nociceptive, or nociplastic – is the best guide for where clinicians should focus their treatment choices; the fact that there is no clinical way to diagnose sensitization only adds to the difficulty. It’s import...
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Putting Pressure on Opioid Prescribing: Novel Approaches to Pain Management
Opioids continue to impact all corners of the United States and its communities, a burden that continues to grow at a rapid pace. The current opioid crisis is incredibly challenging for both patients and health care providers (HCPs). There has been a 30% increase in overdoses among men and a 24% increase among women, with all ages affected. While changing these current trends is important, it ca...
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Recent Clinical Trial Data on the Safety and Efficacy of Current and Emerging Therapies to Optimize Schizophrenia Management
Safe and effective treatments for schizophrenia are imperative to optimizing personalized therapy, which helps in reducing relapse and promoting functional recovery in patients with schizophrenia. Emerging data on reducing symptoms, maintaining effective therapy over long-term periods, and minimizing treatment-related metabolic side effects can guide clinicians in choosing the best therapies for...
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Shifting Perspectives on Pain Management in Oral Surgery
In a survey of 1,015,116 opioid naïve patients undergoing surgery, total duration of opioid use was the strongest predictor of misuse and the greatest risk for individuals in the 15-24 age group. Young people aged 15-24 often get their first exposure to opioids with dental surgery. In a survey of randomly selected oral surgeons conducted by Dr. Abubaker and colleagues, the average number of opi...
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Streamlining Preventive Health for Patients with IBD Through Effective Care Models, Evidence-based Guidelines, and Patient Engagement
The Cleveland Clinic estimates that less than 20% of patients with IBD seen in their Digestive Disease & Surgery Institute have received appropriate immunization and preventative services that align with national guidelines and recommendations. Education is an important component for creating a roadmap and gaining buy-in among clinicians to implement change in practice. Educational interventions...
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The Role that Gender Plays in Pain Perception, Treatment, and Addiction
Studies have shown that gender plays an important role in pain, pain perception, and opioid use. Women are more likely to gain access to opioids through their medical treatment. Not only are women prescribed opioids more often than men (53% vs. 46%), but this number increases with age. Often there is a lack of attention to underlying causes of opioid use disorder (OUD), particularly past sexual ...
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Time to Listen: What the Experts Have to Say About Safe Opioid Prescribing and Addiction Treatment
The data and trends illustrating the impact of opioids on the United States are staggering. From July 2016 through September 2017, the Centers for Disease Control and Prevention (CDC) reported a 30% increase in overdoses among men and a 24% increase among women.
In December 2018, the Opioid Healthcare Provider/Advocacy Working Group convened for a two-day advisory board meeting with represent...
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Understanding the Big Picture of Pain and Pain Assessment
Statement of Need
The number of opioid related deaths in the US is on the rise and health care providers (HCPs) often struggle finding a balance between prescribing guidelines and the individual needs of patients with acute and/or chronic pain. It’s imperative that clinicians seeing patients with pain are knowledgeable about acute and chronic pain pathways and underlying mechanisms so that ...
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Zooming in on the Education and Empowerment of Patients in AMD Care
FDA-approved agents that target vascular endothelial growth factor (VEGF) constitute important elements of optimal management of AMD. Prior authorization (PA) requirements limit patient access to these therapies. Navigating the PA process can be frustrating for patients, and may result in treatment abandonment leading to suboptimal outcomes. Hence, there is a need for patients to become advocate...
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