Clearing the Air

Faculty

Fernando J. Martinez, MD, MS
Executive Vice Chair of Medicine
Gladys and Roland Harriman Professor of Medicine
Joan and Sanford I. Weill Department of Medicine
Weill Cornell Medical College
New York-Presbyterian Hospital/Weill Cornell Medical Center
New York, New York

Barbara P. Yawn, MD, MSc, FAAFP
Adjunct Professor in Family and Community Health
University of Minnesota
Director of Research
Olmsted Medical Center
Rochester, Minnesota

Target Audience

This educational activity is targeted to an audience of NPs and PAs, who are integral to the diagnosis and ongoing management of chronic obstructive pulmonary disease (COPD).

Statement of Need

Characterized by incompletely reversible pulmonary airflow obstruction, COPD is a common and treatable group of clinical respiratory conditions that include emphysema, chronic bronchitis, and combinations of these disorders.^1,2 The disease has been diagnosed in 15 million Americans, and may be undiagnosed or misdiagnosed in almost as many people.^3,4 Not surprisingly, it has significant medical and socioeconomic burdens. COPD is the fourth leading cause of death for patients 45 to 65 years of age, and the third leading cause of death among people older than 65 years.³ In the United States, direct and indirect costs (eg, lost productivity) approach $50 billion annually.⁵ Particularly problematic are COPD exacerbations, which are markedly symptomatic disease episodes characterized by rapidly reduced lung function, noticeably impaired quality of life, and significantly elevated mortality risks.^6,7 A number of barriers to good patient outcomes have been identified, including suboptimal use of spirometry, common complicating comorbidities in affected individuals, low referral rates for pulmonary rehabilitation, and a frequent failure to individualize multimodal maintenance regimens based on symptom severity, tests of lung function, and exacerbation risks.^8-11 During this eCourse activity, two expert faculty discuss practical approaches to COPD diagnosis, evidence-based options for therapy, and patient education strategies that encourage shared decision-making and improve treatment adherence.

References

1. Eisner MD, et al. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2010;182(5):693-718.
2. Vestbo J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):347-365.
3. Kosacz NM, et al. Chronic obstructive pulmonary disease among adults—United States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61:938-943.
4. Mannino DM, et al. Chronic obstructive pulmonary disease surveillance--United States, 1971-2000. Respir Care. 2002;47(10):1184-1199.
5. Global Initiative for Chronic Obstructive Lung Disease Scientific Committee. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2016 Revision.
6. Hurst JR, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363(12):1128-1138.
7. Mackay AJ, Hurst JR. COPD exacerbations: causes, prevention, and treatment. Immunol Allergy Clin North Am. 2013;33(1):95-115.
8. Belletti D, et al. Results of the CAPPS: COPD--assessment of practice in primary care study. Curr Med Res Opin. 2013;29(8):957-966.
9. Mularski RA, et al. The quality of obstructive lung disease care for adults in the United States as measured by adherence to recommended processes. Chest. 2006;130(6):1844-1850.
10. Noteboom B, et al. Comorbidities and medication burden in patients with chronic obstructive pulmonary disease attending pulmonary rehabilitation. J Cardiopulm Rehabil Prev. 2014;34(1):75-79.
11. Hayton C, et al. Barriers to pulmonary rehabilitation: characteristics that predict patient attendance and adherence. Respir Med. 2013;107(3):401-407.

Learning Objectives

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

• Diagnose COPD based on a comprehensive assessment of symptoms, risk factors, and spirometry results
• Implement individualized multimodal management plans for patients with COPD to reflect disease severity, guideline recommendations, and the clinical profiles of available medications
• Tailor maintenance therapy to minimize COPD symptoms, reduce exacerbations, and improve patient function and quality of life
• Educate patients with COPD about their disease, therapeutic options, appropriate use of prescribed medications, and treatment adherence

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. Global is accredited by the ACCME to provide continuing medical education for physicians.

Global Education Group designates this enduring material 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.

Nursing Continuing Education

Global Education Group is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s COA.

This educational activity for 1.0 contact hour is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Instructions to Receive Credit

In order to receive credit, participants must complete the preactivity questionnaire, posttest, and program evaluation. Participants must also score at least 70% on the posttest. Certificates will be distributed online at the conclusion of the activity.

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

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:

Fernando Martinez, MD, MS: Consultant/Independent Contractor to AstraZeneca plc, Bayer AG, Boehringer Ingelheim GmbH, Genentech Inc., GlaxoSmithKline plc, Ikaria, Inc/Bellerophon Therapeutics, Kadmon Corporation, LLC, Novartis Pharmaceuticals, Pearl Therapeutics, Skyepharma PLC, Veracyte, Inc.; Grant/Research Support from Afferent Pharmaceuticals, Inc., Bayer AG, Boehringer Ingelheim GmbH, Forest Laboratories, Inc., Gilead Sciences, Inc., GlaxoSmithKline plc, Takeda Pharmaceuticals USA, Inc.; Honoraria from Biogen, GlaxoSmithKline plc (DSMBs); Speakers Bureau to AstraZeneca plc and Takeda Pharmaceuticals USA, Inc. (European Respiratory Society)

Barbara P. Yawn, MD, MSc, FAAFP: Consultant/Independent Contractor to AstraZeneca plc, Boehringer Ingelheim GmbH, Merck & Co., Inc., and Novartis Pharmaceuticals; Grant/Research Support from Boehringer Ingelheim GmbH.

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:

Ashley Marostica, RN, MSN Nothing to disclose
Amanda Glazar, PhD Nothing to disclose
Andrea Funk Nothing to disclose
Laura Gilsdorf
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. ­­­