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Confronting the Challenges of Severe Asthma Improving Patient Outcomes via Coordinated Multidisciplinary Care

Michael E. Wechsler, MD; Steven F. Weinstein, MD; Barbara P. Yawn, MD, MSc, FAAFP

This activity is jointly provided by Global Education Group and Integritas Communications.

This activity is supported by an educational grant from AstraZeneca.

Faculty

Michael E. Wechsler, MD, MMSc
Professor, Department of Medicine
Co-Director, The Cohen Family Asthma Institute
Division of Pulmonary, Critical Care, and Sleep Medicine
Director, Asthma Program
National Jewish Health
Denver, Colorado

Steven F. Weinstein, MD
Director
Allergy and Asthma Specialists Medical Group and Research Center
Huntington Beach, California

Barbara P. Yawn, MD, MSc, FAAFP
Adjunct Professor, Department of Family and Community Health
University of Minnesota
Minneapolis, Minnesota

Target Audience

The educational design of this activity addresses the needs of internal medicine physicians and other primary care providers who treat patients with severe asthma.

Educational Objectives

After completing this activity, the participant should be better able to:

  • Diagnose severe asthma using criteria from evidence-based clinical practice guidelines and ongoing evaluations of symptoms and treatment responses
  • Discuss the mechanisms of action and clinical profiles of cytokine-targeting biologic medications in the treatment of severe asthma
  • Coordinate with specialists to tailor therapy for patients with severe asthma to address the degree of disease control, exacerbation risks, and history of asthma-related hospitalizations
  • Educate patients with severe asthma and their caregivers about treatment options, asthma action plans, and adherence

Statement of Need/Program Overview

Between 5% and 15% of the more than 25 million Americans with asthma have a severe form of the disease.1 Even with multimodal therapy, many patients with severe asthma continue to suffer from uncontrolled symptoms, increased mortality risks, significant health-related consequences from disease exacerbations, and markedly negative effects on daily functioning and quality of life.1,2 Evolving insights into the pathophysiologic underpinnings of various asthma phenotypes have paved the way for new targeted therapies that are changing best-practice recommendations for the management of severe disease.3 This Interactive Exchange™ program will open with a brief 3D animated video highlighting mechanistic insights into asthma development and progression. Faculty experts with experience in clinical immunology, pulmonology, and primary care will discuss practical strategies to identify patients with severe asthma, review the clinical profiles of current and emerging biologic treatment options, and provide recommendations for coordinating multidisciplinary care.

References

  1. Levy ML. The national review of asthma deaths: what did we learn and what needs to change? Breathe (Sheff). 2015;11(1):14-24.
  2. Chung KF, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343-373.
  3. Walsh GM. Biologics targeting IL-5, IL-4 or IL-13 for the treatment of asthma—an update. Expert Rev Clin Immunol. 2017;13(2):143-149.

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

This CME/CE activity complies with all requirements of the federal Physician Payment Sunshine Act. If a reportable event is associated with this activity, the accredited provider managing the program will provide the appropriate physician data to the Open Payments database.

Physician Credit Designation

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.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must score 70% on the posttest and complete the program evaluation

System Requirements

PC
Microsoft Windows 2000 SE or above.
Flash Player Plugin (v7.0.1.9 or greater)
Internet Explorer (v5.5 or greater), or Firefox
Adobe Acrobat Reader*

MAC
MAC OS 10.2.8
Flash Player Plugin (v7.0.1.9 or greater)
Safari
Adobe Acrobat Reader*
Internet Explorer is not supported on the Macintosh.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouses/life partners 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.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Michael E. Wechsler, MD, MMSc: Honoraria: Ambit Bioscience Corporation; AstraZeneca plc;Boston Scientific Corporation; Genentech, Inc.; GliaCure Inc.;Meda Pharmaceuticals Inc.; Mylan N.V.; Neurotronic, Inc.;Novartis Pharmaceuticals Corporation; Regeneron Pharmaceuticals, Inc.; sanofi-aventis U.S. LLC; SentienBiotechnologies, Inc.; Sunovion Pharmaceuticals Inc.; TevaPharmaceutical Industries Ltd.; Theravance Biopharma US, Inc.; Tunitas Therapeutics, Inc.; Vectura Group plc.

Steven F. Weinstein, MD: Consultant/Independent Contractor: Teva Pharmaceutical Industries Ltd. Grant/Research Support: AstraZeneca plc; GlaxoSmithKlineplc; Merck & Co., Inc.; Teva Pharmaceutical Industries Ltd.

Barbara P. Yawn, MD, MSc, FAAFP: Consultant/Independent Contractor: AstraZeneca plc;GlaxoSmithKline plc; Merck & Co., Inc.; Teva Pharmaceutical Industries Ltd. Grant/Research Support: Agency for Healthcare Research and Quality (AHRQ); National Institutes of Health (NIH);Patient-Centered Outcomes Research Institute (PCORI)

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Karen Kaufman Nothing to disclose
Andrea Funk  Nothing to disclose
Laura Gilsdorf  Nothing to disclose
Ashley Marostica, RN, MSN  Nothing to disclose
Rose O’Connor, PhD  Nothing to disclose
Jim Kappler, PhD   Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Integritas do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Click "Begin Activity" to acknowledge that you have reviewed the preamble information for this activity.

Begin Activity

expiration 06/07/2018

type Webcast


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SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
3 0.002555 0.000852 0.000290 0.001957
SELECT * FROM `activities` `t` WHERE `t`.`id`=60 LIMIT 1
5 0.001626 0.000325 0.000283 0.000468
SHOW COLUMNS FROM `activities`
1 0.001594 0.001594 0.001594 0.001594
SHOW COLUMNS FROM `events`
1 0.001452 0.001452 0.001452 0.001452
SHOW COLUMNS FROM `users`
1 0.001224 0.001224 0.001224 0.001224
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
2 0.001203 0.000602 0.000292 0.000911
SHOW COLUMNS FROM `resources`
1 0.001100 0.001100 0.001100 0.001100
SHOW COLUMNS FROM `view_log`
1 0.001086 0.001086 0.001086 0.001086
SHOW COLUMNS FROM `questionnaires`
1 0.001012 0.001012 0.001012 0.001012
SHOW COLUMNS FROM `user_activitiesstatus`
1 0.001002 0.001002 0.001002 0.001002
SHOW COLUMNS FROM `interactions`
1 0.000969 0.000969 0.000969 0.000969
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
2 0.000962 0.000481 0.000459 0.000503
SELECT `t`.`id` AS `t0_c0`, `t`.`group_id` AS `t0_c1`, `t`.`resource_id` AS `t0_c2`, `t`.`title` AS `t0_c3`, `t`.`type` AS `t0_c4`, `t`.`facultyNames` AS `t0_c5`, `t`.`shortDescription` AS `t0_c6`, `t`.`fullDescription` AS `t0_c7`, `t`.`creditAmount` AS `t0_c8`, `t`.`shortAddress` AS `t0_c9`, `t`.`creditType` AS `t0_c10`, `t`.`startDate` AS `t0_c11`, `t`.`finishDate` AS `t0_c12`, `t`.`sponsors` AS `t0_c13`, `t`.`status` AS `t0_c14`, `t`.`createDate` AS `t0_c15`, `t`.`image` AS `t0_c16`, `t`.`image_featured` AS `t0_c17`, `t`.`archived` AS `t0_c18`, `t`.`managers_list` AS `t0_c19`, `t`.`is_send_pp_email` AS `t0_c20`, `t`.`muvi_sync_date` AS `t0_c21`, `t`.`expert_questions` AS `t0_c22`, `interaction`.`id` AS `t1_c0`, `interaction`.`activity_id` AS `t1_c1`, `interaction`.`title` AS `t1_c2`, `interaction`.`link` AS `t1_c3`, `interaction`.`type` AS `t1_c4`, `interaction`.`status` AS `t1_c5`, `interaction`.`createDate` AS `t1_c6` FROM `activities` `t` LEFT OUTER JOIN `interactions` `interaction` ON (`interaction`.`activity_id`=`t`.`id`) WHERE (`t`.`id`=60)
1 0.000623 0.000623 0.000623 0.000623
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=60) GROUP BY `activity_id`
1 0.000524 0.000524 0.000524 0.000524
SELECT `resource`.`id` AS `t1_c0`, `resource`.`shortAddress` AS `t1_c1`, `resource`.`status` AS `t1_c2`, `resource`.`title` AS `t1_c3`, `resource`.`type` AS `t1_c4`, `resource`.`image` AS `t1_c5`, `resource`.`slides` AS `t1_c6`, `resource`.`linkedResources` AS `t1_c7`, `resource`.`reading` AS `t1_c8`, `resource`.`shortDescription` AS `t1_c9`, `resource`.`fullDescription` AS `t1_c10`, `resource`.`link` AS `t1_c11`, `resource`.`createDate` AS `t1_c12`, `resource`.`archived` AS `t1_c13` FROM `resources` `resource` WHERE (`resource`.`id`=:ypl0)
1 0.000473 0.000473 0.000473 0.000473
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
1 0.000420 0.000420 0.000420 0.000420
SHOW CREATE TABLE `activities`
1 0.000347 0.000347 0.000347 0.000347
SHOW CREATE TABLE `events`
1 0.000344 0.000344 0.000344 0.000344
SHOW CREATE TABLE `users`
1 0.000329 0.000329 0.000329 0.000329
SHOW CREATE TABLE `view_log`
1 0.000312 0.000312 0.000312 0.000312
SHOW CREATE TABLE `questionnaires`
1 0.000311 0.000311 0.000311 0.000311
SHOW CREATE TABLE `user_activitiesstatus`
1 0.000281 0.000281 0.000281 0.000281
SHOW CREATE TABLE `resources`
1 0.000278 0.000278 0.000278 0.000278
SHOW CREATE TABLE `interactions`
1 0.000272 0.000272 0.000272 0.000272
# Query Time (s)
0
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000911
1
SHOW COLUMNS FROM `activities`
0.001594
2
SHOW CREATE TABLE `activities`
0.000347
3
SHOW COLUMNS FROM `users`
0.001224
4
SHOW CREATE TABLE `users`
0.000329
5
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000503
6
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
0.003771
7
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000459
8
UPDATE `users` SET `lastLogin`=:yp0 WHERE `users`.`id`=2491922
0.003352
9
SELECT * FROM `activities` `t` WHERE `t`.`id`=60 LIMIT 1
0.000468
10
SHOW COLUMNS FROM `events`
0.001452
11
SHOW CREATE TABLE `events`
0.000344
12
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.001957
13
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000292
14
SELECT * FROM `activities` `t` WHERE `t`.`id`=60 LIMIT 1
0.000291
15
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.000290
16
SELECT * FROM `activities` `t` WHERE `t`.`id`=60 LIMIT 1
0.000296
17
UPDATE activities SET archived=1 WHERE finishDate<now();
0.005956
18
SHOW COLUMNS FROM `view_log`
0.001086
19
SHOW CREATE TABLE `view_log`
0.000312
20
INSERT INTO `view_log` (`source`, `unique_id`, `resource_id`, `type`) VALUES (:yp0, :yp1, :yp2, :yp3)
0.003338
21
SHOW COLUMNS FROM `user_activitiesstatus`
0.001002
22
SHOW CREATE TABLE `user_activitiesstatus`
0.000281
23
SHOW COLUMNS FROM `interactions`
0.000969
24
SHOW CREATE TABLE `interactions`
0.000272
25
SELECT `t`.`id` AS `t0_c0`, `t`.`group_id` AS `t0_c1`, `t`.`resource_id` AS `t0_c2`, `t`.`title` AS `t0_c3`, `t`.`type` AS `t0_c4`, `t`.`facultyNames` AS `t0_c5`, `t`.`shortDescription` AS `t0_c6`, `t`.`fullDescription` AS `t0_c7`, `t`.`creditAmount` AS `t0_c8`, `t`.`shortAddress` AS `t0_c9`, `t`.`creditType` AS `t0_c10`, `t`.`startDate` AS `t0_c11`, `t`.`finishDate` AS `t0_c12`, `t`.`sponsors` AS `t0_c13`, `t`.`status` AS `t0_c14`, `t`.`createDate` AS `t0_c15`, `t`.`image` AS `t0_c16`, `t`.`image_featured` AS `t0_c17`, `t`.`archived` AS `t0_c18`, `t`.`managers_list` AS `t0_c19`, `t`.`is_send_pp_email` AS `t0_c20`, `t`.`muvi_sync_date` AS `t0_c21`, `t`.`expert_questions` AS `t0_c22`, `interaction`.`id` AS `t1_c0`, `interaction`.`activity_id` AS `t1_c1`, `interaction`.`title` AS `t1_c2`, `interaction`.`link` AS `t1_c3`, `interaction`.`type` AS `t1_c4`, `interaction`.`status` AS `t1_c5`, `interaction`.`createDate` AS `t1_c6` FROM `activities` `t` LEFT OUTER JOIN `interactions` `interaction` ON (`interaction`.`activity_id`=`t`.`id`) WHERE (`t`.`id`=60)
0.000623
26
SELECT `activity_id` AS `c`, COUNT(*) AS `s` FROM `user_activitiesstatus` `t` WHERE (user_id=:user AND isFinished=1) AND (`t`.`activity_id`=60) GROUP BY `activity_id`
0.000524
27
SELECT `event`.`id` AS `t1_c0`, `event`.`group_id` AS `t1_c1`, `event`.`shortAddress` AS `t1_c2`, `event`.`resource_id` AS `t1_c3`, `event`.`type` AS `t1_c4`, `event`.`addType` AS `t1_c5`, `event`.`title` AS `t1_c6`, `event`.`shortDescription` AS `t1_c7`, `event`.`facultyNames` AS `t1_c8`, `event`.`faculty` AS `t1_c9`, `event`.`calendarDate` AS `t1_c10`, `event`.`creditAmount` AS `t1_c11`, `event`.`creditType` AS `t1_c12`, `event`.`shortWhen` AS `t1_c13`, `event`.`fullWhen` AS `t1_c14`, `event`.`venue` AS `t1_c15`, `event`.`shortWhere` AS `t1_c16`, `event`.`fullWhere` AS `t1_c17`, `event`.`createDate` AS `t1_c18`, `event`.`status` AS `t1_c19`, `event`.`description` AS `t1_c20`, `event`.`image` AS `t1_c21`, `event`.`linkout` AS `t1_c22`, `event`.`registrationEnabled` AS `t1_c23`, `event`.`activity_id` AS `t1_c24`, `event`.`adobe_connect_sco` AS `t1_c25`, `event`.`adobe_connect_datetime` AS `t1_c26`, `event`.`users_limit` AS `t1_c27`, `event`.`adobe_connect_duration` AS `t1_c28`, `event`.`calendar_description` AS `t1_c29` FROM `events` `event` WHERE (`event`.`activity_id`=:ypl0)
0.000308
28
SELECT * FROM `activities` `t` WHERE `t`.`id`=60 LIMIT 1
0.000288
29
SELECT * FROM `activities` `t` WHERE `t`.`id`=60 LIMIT 1
0.000283
30
SHOW COLUMNS FROM `questionnaires`
0.001012
31
SHOW CREATE TABLE `questionnaires`
0.000311
32
SELECT * FROM `questionnaires` `t` WHERE t.activity_id=:id AND t.type=:type LIMIT 1
0.000420
33
SHOW COLUMNS FROM `resources`
0.001100
34
SHOW CREATE TABLE `resources`
0.000278
35
SELECT `resource`.`id` AS `t1_c0`, `resource`.`shortAddress` AS `t1_c1`, `resource`.`status` AS `t1_c2`, `resource`.`title` AS `t1_c3`, `resource`.`type` AS `t1_c4`, `resource`.`image` AS `t1_c5`, `resource`.`slides` AS `t1_c6`, `resource`.`linkedResources` AS `t1_c7`, `resource`.`reading` AS `t1_c8`, `resource`.`shortDescription` AS `t1_c9`, `resource`.`fullDescription` AS `t1_c10`, `resource`.`link` AS `t1_c11`, `resource`.`createDate` AS `t1_c12`, `resource`.`archived` AS `t1_c13` FROM `resources` `resource` WHERE (`resource`.`id`=:ypl0)
0.000473
Log Messages
Message (details) Level Category Time