Using Real-World Patient Scenarios and Simulations to Overcome Barriers to Appropriate Use of Oral Anticoagulants-Unprovoked VTE

Pulmonary Disease
Curriculum:
Unprovoked VTE
Credits:
.50 AMA PRA Category 1 Credit(s)™ .50 ANCC Contact Hours 0.50 ACPE
Launch Date:
June 27, 2019
Expiration Date:
June 27, 2020

Primary Audience:

Physicians, vascular medicine and surgery, pulmonology, hematology, emergency medicine specialists, PCPs, RNs, and PharmDs

Relevant Terms:

Venous thromboembolism, Anti-coagulation, Direct oral anticoagulants

Jeffrey Weitz, MD, FRCP(C), FACP (Course Director)

Professor of Medicine and Biochemistry, McMaster University
Heart and Stroke Foundation/JF Mustard Chair in Cardiovascular Research
Canada Research Chair (Tier 1) in Thrombosis
Executive Director, Thrombosis and Atherosclerosis Research Institute
Hamilton, Ontario, Canada

Dr Weitz is a Professor of Medicine and Biochemistry and Biomedical Sciences at McMaster University and is also the Executive Director of the Thrombosis and Atherosclerosis Research Institute in Ontario, Canada. He is Board certified in internal medicine, hematology, and medical oncology and focuses his clinical practice on patients with thrombotic disorders. His research spans the spectrum from basic studies in the biochemistry of blood coagulation and fibrinolysis, to animal models of thrombosis, as well as clinical trials of antithrombotic therapy. His extensive work has been published in over 500 journals including the Journal of Clinical Investigation, the Journal of Biological Chemistry, Biochemistry, Circulation, Blood, the Annals of Internal Medicine, the New England Journal of Medicine, and Lancet, as well as 60 book chapters. Dr Weitz is also a fellow of the American Heart Association, the Royal Society of Canada, and the Canadian Academy of Health Sciences. Dr Weitz is involved in clinical trials that examine optimal methods for the prevention, diagnosis, and treatment of clotting disorders, and is an active participant in the education of medical students, residents, and postdoctoral fellows. Dr Weitz also coordinates a graduate course in medical sciences, and his laboratory is a fertile training ground for graduate students and postdoctoral fellows in the medical sciences and bioengineering.

Marc Carrier, MD, MSc, FRCPC

Professor, Department of Medicine
University of Ottawa
Senior Scientist, Clinical Epidemiology Program
Ottawa Hospital Research Institute
Ottawa, Canada

Dr Marc Carrier is the current Vice Chair of Research for the Department of Medicine, an Associate Professor in the Faculty of Medicine, Department of Medicine, and Senior Scientist in the Clinical Epidemiology Program of The Ottawa Hospital Research Institute in Ottawa, Canada. Dr Carrier holds a Tier 2 Research Chair in Venous Thromboembolism (VTE) and Cancer from the University of Ottawa and received a New Investigator Award from the Heart and Stroke Foundation of Canada. In 2015, Dr Carrier was the recipient of the prestigious Dr Michel Chrétien Researcher of the Year Award for his study published in the New England Journal of Medicine that improves care for VTE patients around the world.

Dr Carrier’s clinical research is focused on VTE disease and cancer, specifically cancer screening, prevention, and management. He is currently the Principal Investigator of 4 peer-reviewed clinical trials (Heart and Stroke Foundation [2] and Canadian Institutes of Health Research [2]) and numerous industry-sponsored trials. He has published important systematic reviews and has had multiple international speaking invitations to speak on the topics of cancer and thrombosis.

1. IMPLEMENT risk stratification of patients to determine who would benefit from extended oral anticoagulant therapy following an unprovoked VTE.
2. IDENTIFY the risk factors for recurrence in patients with unprovoked VTE.
3. REVIEW the evidence for the different types of OAC therapy and their duration following an unprovoked VTE.
4. DEVELOP strategies to engage patients to overcome barriers to optimal adherence to OACs.

Supported by an educational grant from the Bristol-Myers Squibb and Pfizer Alliance.
 
Provided by ASiM CE, LLC.
 
OVERVIEW
For longer-term anticoagulation treatment, choosing among the different options frequently depends upon clinician experience and drug availability, risks of bleeding, patient comorbidities, patient preferences, cost, and convenience. Both direct oral anticoagulants (DOACs) and warfarin have advantages and disadvantages. In the setting of an unprovoked venous thromboembolism (VTE), many patients will require long-term secondary prevention. As with many preventive treatments for any chronic disease, adherence is often suboptimal, but the efficacy and safety of the OACs depends on adherence. Using a case-based format, this activity will review risk stratification, treatment options, and duration of therapy for patients with an unprovoked VTE, as well as common barriers to adherence with OAC therapy and strategies to engage patients to overcome those barriers.
 
GOAL
The goal of this program is to provide both specialists (in vascular medicine and surgery, pulmonology, and hematology), primary providers (community-based cardiologists, primary care physicians, pharmacists, nurse practitioners, physician assistants, and nurses), and emergency department providers with the evidence-based knowledge and skills to treat patients with unprovoked VTE with the appropriate duration and choice of OAC. This activity will also address patient barriers to adherence to long-term anticoagulant therapy for secondary prevention.

 

CME/CE Credit provided by AKH Inc., Advancing Knowledge in Healthcare
Physicians
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of AKH Inc., Advancing Knowledge in Healthcare and ASiM CE, LLC. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.

AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
AKH, Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is awarded 0.5 Contact Hour.

Pharmacists 
AKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

AKH Inc., Advancing Knowledge in Healthcare approves this knowledge‐based activity for 0.5 contact hour (0.05 CEU). UAN: 0077-9999-19-012-H04-P. Initial Release date: June 19, 2019.

Activity is jointly-provided by AKH Inc., Advancing Knowledge in Healthcare and ASiM CE, LLC.

Criteria for Success
Statements of credit will be awarded based on the participant reviewing each presentation, scoring a 70% on the post test, and completing and submitting an activity evaluation. A statement of credit will be available upon completion of an online evaluation/claimed credit form. You must participate in the entire activity to receive credit. There is no fee to participant in this activity. If you have questions about this CE activity, please contact AKH Inc. at tbrignoni@akhcme.com.

FACULTY DISCLOSURES
Dr Weitz as disclosed the following relevant financial relationships:
Consultant - Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Ionis, Janssen, Merck, Novartis, Pfizer, Portola.

Dr Carrier as disclosed the following relevant financial relationships:
Advisory Board/Consultative Meetings - Aspen, Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, Sanofi, Servier
Contracted Research - Bayer, Bristol-Myers Squibb, LEO Pharma, Octapharma
Speakers Bureau - Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, LEO Pharma, Pfizer, Sanofi, Servier
 

STAFF/REVIEWERS   
Trish Brignoni, Director of Operations, discloses no financial relationships with pharmaceutical or medical product manufacturers.
Dorothy Caputo, MA, BSN, RN, Lead Nurse Planner, discloses no financial relationships with pharmaceutical or medical product manufacturers.
ASiM CE, LLC and AKH Inc, planners and reviewers have disclosed no financial relationships with pharmaceutical or medical product manufacturers.

Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.

Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclosure Declaration
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Faculty Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other faculty for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.  AKH planners and reviewers have no relevant financial relationships to disclose.

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