Treatment Patterns in Family Medicine: The Role of the Primary Care Clinician in Patient-Centered Management of IBD: Module 2: Escalating Therapy, Addressing Treatment Risks, and Co-Managing with Specialists
Released: September 30, 2016
Expires: October 14, 2017
• CE for this activity will not be available after this date.
• A participation code will be provided at the end of the CE activity. See below for details.
This activity, the second in a 3-part series, addresses diagnosis and initial treatment options for IBD, as well as collaboration between primary care clinicians and specialists.
Some patients with inflammatory bowel disease (IBD) present with moderate or severe symptoms that warrant initial treatment with stronger therapies than aminosalicylates or steroids (which are discussed at length in Module 1, “Diagnosis and Initial Treatment Options”). In other cases, patients with mild ulcerative colitis (UC) or Crohn’s disease (CD) who have responded to initial therapy for a year or 2 may eventually require more aggressive therapy. And steroids, which are effective at inducing remission in the short term, are not appropriate for extended use due to their long-term side effects.
A stepwise approach is generally recommended for treating IBD. Initial therapy for cases considered “mild” usually entails a steroid, commonly budesonide, combined with 5-aminosalicylic acid (5-ASA). The second step, for patients with “moderate” disease, includes steroids combined with biologics, immunosuppressives, or both. The third step may involve cyclosporine, surgery, or experimental therapies in the context of clinical trials, and is normally reserved for patients with “severe” disease.
After completion of this activity participants will be better able to:
• Review criteria for clinical situations in which the intensity of IBD therapy should be increased and strategies for making these changes.
• Discuss strategies to address medication-related side effects and treatment risks associated with IBD therapies.
• Describe conditions that indicate the need for consultation with/referral to gastroenterology and surgery.
Bret A. Lashner, MD
Elliot B. Davidson, MD, FAAFP
This activity was planned in accordance with AANP Accreditation Standards and Policies. Developed by the New Jersey Academy of Family Physicians (NJAFP), the American Association of Nurse Practitioners (AANP), and the American Academy of PAs (AAPA) in cooperation with MCM Education, this CE activity is supported by educational grants from Shire; AbbVie, Inc.; and Salix Pharmaceuticals, a division of Valeant Pharmaceuticals North America, LLC.
Bret A. Lashner, MD, has no conflicts of interest to disclose.
Elliot B. Davidson, MD, FAAFP, has no conflicts of interest to disclose.
Lauren Carruth, MD, has no conflicts of interest to disclose.
Alana R. Wichmann, APN, has disclosed the following: Speaker’s Bureau with AbbVie, Inc
Eric Peterson, EdM, FACEHP, CHCP, has no conflicts of interest to disclose.
To complete the CE for this activity, review all the content, successfully complete on the online post-test and submit the online program evaluation. At the end of the program, you will receive the participation code to complete the posttest/evaluation for the activity and claim credit. In the AANP CE Center for this program, click Get Certificate and choose Participation Codes. Enter the code provided and the posttest/evaluation will be available to you.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.
Post Impact Survey:
Between 30 to 90 days after this activity is completed, AANP will send out an invitation to participate in a Post Impact Outcomes Survey (PI Survey) . Participation in the survey is optional and does not affect the credit earned. The PI surveys help measure the overall impact of the education content, see how the material impacts practice behaviors and what changes are being made. This anonymous information is crucial in helping the Education department improve current activities as well as guiding AANP in planning future CE activities.
For questions or more information concerning the AANP CE Center, or this online CE opportunity, please contact the AANP CE Center Manager at CECenter@aanp.org.