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Overview
Atherothrombosis is the leading cause of death worldwide and the underlying process in the etiology of acute coronary syndrome (ACS), stroke and vascular death. Cardiovascular risk factors such as obesity, the metabolic syndrome, diabetes mellitus, hypertension, smoking and other "lifestyle" risks contribute to this pandemic of atherothrombotic disease. Patients with ACS, stroke/TIA and PAD (peripheral arterial disease), present major challenges to the primary care clinician in terms of managing CV risk factors and prevention of a second event. This lecture will overview current studies and treatment guidelines for PAD, ACS and Stroke and explore the role of primary care in long-term treatment of these patients.
Objectives
Describe 3 clinical conditions in which dual antiplatelet therapy is recommended
Name 5 treatment recommendations for reduction of global CV risk
Faculty
Kelly Anne Spratt, DO, FACC
Clinical Assistant Professor of Medicine
Cardiovascular Risk Intervention Program
University of Pennsylvania School of Medicine
Philadelphia, PA
F. Wilford Germino, MD, FAHA
Overview
Evidence clearly indicates that gastroesophageal reflux disease (GERD) adversely affects the quality of life for a significant proportion of the adult population, especially those who are overweight or obese. Because of its high prevalence in adults and increased risk in the overweight patient, primary care providers need increased awareness and knowledge of GERD as a disease spectrum. This will provide a rational basis for improvements in screening, diagnosis, and treatment strategies in those overweight individuals suffering mild to moderate reflux and who are at elevated risk for disease progression, if left untreated. Participants will gain enhanced understanding of GERD symptom presentation and risks in overweight and obese patients, greater insight into effective screening and diagnostic strategies in this patient population, and have an opportunity to evaluate a patient-centered, symptom-based approach to treatment and management that can improve practice and optimize patient outcomes.
Objectives
Recognize and evaluate symptoms (typical and atypical) of GERD using a time-efficient approach in the overweight and obese patient in the primary care setting
Demonstrate the ability to apply evidence-based approaches to GERD treatment and management in overweight and obese patients including both lifestyle modifications and effective pharmacotherapeutic strategies
Faculty
Karen Luken, MS, ARNP
Nurse Practitioner
Gastrointestinal Associates
Overview
Patients with refractory chronic low back pain represent a clinical challenge to primary care practitioners. Worsening persistent pain, an array of comorbid conditions, and loss of function coupled with a lack of evidence for treatment can create a clinical conundrum. Learn how to improve the longitudinal management of patients presenting to your practice with this ubiquitous and demanding condition.
Objectives
Select validated tools for use in comprehensive assessment and risk-stratification of patients with refractory chronic low back pain treated with opioids
Devise a treatment plan specific to the needs of chronic low back pain patients that demonstrate an understanding of recommended guidelines published jointly by the ACP/APS
Faculty
Steve P. Stanos, DO
Penny Tenzer, MD
Associate Professor
Vice Chair and Director, Residency Program
Department of Family Medicine & Community Health
Chief of Service for Family Medicine, University of Miami Hospital
University of Miami Miller School of Medicine
Miami, FL
Overview
Insomnia, defined as complaints of disturbed sleep in the presence of adequate opportunity and circumstance for sleep, is the most common adult sleep pathology. Besides cognition, other pathologic processes have been deleteriously associated with insomnia, including cardiovascular morbidity and glycemic control. The latest evidence about sleep pathology will be presented, including spectral analysis that indicates sleep patterns, including slow wave sleep, are important, rather than just total sleep time. Nonpharmacologic approaches, as well as current and developing pharmacotherapies used to address these sleep pathologies will be described.
Objectives
Identify the underlying causes and comorbid conditions of insomnia for increased confidence in treatment
Assess the current and developing nonpharmacologic and pharmacologic approaches to the management of primary and comorbid insomnia
Faculty
David Neubauer, MD
Associate Professor
Department of Psychiatry
Johns Hopkins University School of Medicine
Associate Director
Johns Hopkins Sleep Disorders Center
Baltimore, MD
Paul P. Doghramji, MD, FAAFP
Family Physician
Collegeville Family Practice
Medical Director of Health Services, Ursinus College
Collegeville, PA
Overview
Is hyperuricemia another door to the metabolic syndrome? This activity will focus on hyperuricemia and gout and will examine the latest guidance around treating patients in the primary care practice. The program will include a focus on the latest guidelines as well as applying the learning into everyday practice dynamics.
Objectives
List the key components of a differential diagnosis for gout based on clinical history and physical examination elements
Develop a treatment plan, which includes behavioral modification and pharmacologic strategies
Faculty
N. Lawrence Edwards, MD, FACP, FACR
Professor of Medicine
Division of Rheumatology and Clinical Immunology
Program Director and Vice Chairman
Department of Medicine
University of Florida
Gainesville, FL
Paul P. Doghramji, MD, FAAFP
Family Physician
Collegeville Family Practice
Medical Director of Health Services, Ursinus College
Collegeville, PA
Overview
This presentation will address early and aggressive LDL-C management and the clinical challenges of goal attainment. Clinicians will be provided with pathways and knowledge to help them improve their patient outcomes by goal attainment of the healthy lipid profile.
Discussion will be applicable to clinicians' practice including lifestyle changes of diet and exercise, along with pharmacologic treatment options available for lipid management in order to give the appropriate tools to get patients to their true LDL goals.
Objectives
Understand the key tenets of assessing and managing dyslipidemia in clinical practice and the current evidence regarding the safety and efficacy of available LDL-C lowering therapies
Identify at least 2 lipid lowering strategies to initiate and tailor comprehensive management treatment plans for patients with high LDL-C in order to reach and maintain targeted goals
Faculty
Emma Meagher, MD
Associate Professor
University of Pennsylvania, School of Medicine
Philadelphia, PA
Ronald A. Codario, MD, FACP
Clinical Instructor in Medicine
Thomas Jefferson University Hospital
University of Pennsylvania Health System
Philadelphia, PA
Overview
This program will underscore the importance of osteoporosis screening, risk-benefit analysis, treatment selection, and long-term patient adherence. Evidence-based data on available and emerging pharmacotherapies will be presented to assist with treatment initiation, efficacy issues, and long-term safety assessment. Clinical challenges such as use and interpretation of BMD testing, patient adherence, and treatment failure will also be addressed.
Objectives
Assess for risk factors of osteoporosis to identify which patients require additional screening
Relate the application of available and emerging treatments for osteoporosis
Faculty
Bess Dawson Hughes, MD
Overview
For some, alleviating a headache is as simple as taking two aspirin. But for the approximate 28 million Americans who suffer from migraine, this is not the case. In light of new research that has brought about this understanding, clinicians have also been able to implement new and individualized treatment strategies tailored specifically the needs and characteristics of the patient. This educational activity will provide an in-depth look at how primary care clinicians can obtain the best outcomes for their patients with migraine.
Objectives
Recognize migraine by using symptom-based criteria and headache calendars to recognize physiological and environmental triggers
Identify specific strategies that address the management of clinically identified migraine types
Faculty
Brian Koffman, MDCM
Clinical Professor, Department of Family Medicine
Keck School of Medicine, USC Family Practice
St. Jude Heritage Medical Group
Diamond Bar, CA
Norman Gordon, MD
President, Eastside Neurology Inc.
Chief of the Division of Neurology, Miriam Hospital
Clinical Associate Professor of Neurology, Brown University
Medical Director, CNS Research Inc.
Providence, RI