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| Title: “Identifying and Treating Resistant Hypertension – Part Two of a Two-Part Series”
| | | AAPA Release Date: October 20, 2009 | | | AAPA Expiration Date: October 31, 2010 | | Note: CME credit cannot be awarded after this date | | | Presented by: The American Academy of Physician Assistants | | | Funding: Supported through educational grants from Boehringer-Ingelheim and Merck | |
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Faculty
| Lawrence Herman, MPA, RPA-C, DFAAPA
Moderator
Physician Assistant
Senior Clinical Coordinator
Assistant Professor
Department of Physician Assistant Studies
New York Institute of Technology
Old Westbury, NY
Director, Medical Education
Island Medical Physicians, PC
Hauppauge, NY
Mr. Herman is an Assistant Professor (with tenure) and Senior Clinical Coordinator in the Department of Physician Assistant Studies at New York Institute of Technology, New York College of Osteopathic Medicine affiliation in Old Westbury. He is also Vice President of Medical Education and Senior PA at Island Medical Physicians PC, in Hauppauge, New York, where he sees patients and is responsible for setting all of the practice guidelines for a large, multi-office family practice group.
He received a master of public administration in health administration and health system finance from Long Island University in Brookville, New York. He was certified by the National Commission on Certification of Physician Assistants, with special distinction in both surgery and primary care and remains certified in primary care.As a Distinguished Fellow of the American Academy of Physician Assistants, Mr. Herman has served and chaired numerous AAPA committees as well as being a Past-President of the New York State Society of Physician Assistants. He has contributed numerous book chapters to the literature and has published over 30 peer-reviewed articles. He has participated in several clinical pharmaceutical trials and continues to be an invited speaker at international and national meetings. He is the 2009 recipient of the New York Institute of Technology Annual Scholars Award for significant publication scholarship activities, the 2008 Standard of Excellence Award for providing the highest level of research and scholarship, and the 2007 and 2008 Educator of the Year award. | Randall M. Zusman, MD
Associate Professor of Medicine
Harvard Medical School
Director
Division of Hypertension and Vascular Medicine
Massachusetts General Hospital
Boston, MA
Dr. Zusman is the Director of the Division of Hypertension and Vascular Medicine at the Massachusetts General Hospital, and Consultant in Cardiology at the Massachusetts Institute of Technology, in Boston, Massachusetts. He is also an Associate Professor of Medicine at Harvard Medical School. Dr. Zusman has recently been designated a Specialist in Clinical Hypertension by the American Society of Hypertension.A Fellow in the American College of Cardiology, Dr. Zusman is a member of many professional societies including the American Heart Association, the American Society of Hypertension, and the American Society of Nephrology. He has also served in several positions at the American Federation for Clinical Research, including Chairman of the Public Policy Committee. Dr. Zusman has contributed to the publication of over 100 papers, abstracts, clinical studies, and book chapters, including reports in leading scientific medical journals such as the New England Journal of Medicine, American Journal of Cardiology, American Journal of Hypertension, Lancet, and Circulation. He is currently on the Editorial Advisory Board of Reviews in Contemporary Pharmacotherapy. Dr. Zusman also has served as an Associate Editor of Hypertension, and on the Editorial Board of the Journal of Hypertension and the Journal of Clinical Hypertension. Dr. Zusman received his medical degree from Yale University School of Medicine in New Haven, Connecticut, in 1973, where he was awarded the Louis B. Nahum Prize for Cardiovascular Research and was elected to Alpha Omega Alpha. Dr. Zusman completed his internship, junior and senior residencies and chief residency in the Department of Medicine at the Massachusetts General Hospital. He completed fellowships in the Hypertension-Endocrine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, and in the Cardiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Dr. Zusman received his undergraduate degree from University of Michigan in Ann Arbor, Michigan, graduating Phi Beta Kappa, in 1969. | John G. McGinnity, MS, PA-C
Clinical Associate Professor
Eugene Applebaum College of Pharmacy and Health Sciences
Wayne State University
Detroit, MI
Physician Assistant
Downriver Cardiology Consultants
Trenton, MI
Mr. McGinnity is a Clinical Associate Professor at the Eugene Applebaum College of Pharmacy and Health Sciences at Wayne State University in Detroit, Michigan, where he is a course coordinator and lecturer in Physician Assistant Studies and the Physical Therapy Program. He is also a Physician Assistant at Downriver Cardiology Consultants in Trenton, Michigan. Mr. McGinnity has received the Innovations in Health Care Award from the American Academy of Physician Assistants and the Physician Assistant Foundation and the Eugene Applebaum College of Pharmacy and Health Sciences Excellence in Teaching Award. He is the Immediate Past President of the Michigan Academy of Physician Assistants and the Chairman of the Conference Education Planning Committee for the American Academy of Physician Assistants. Mr. McGinnity has also served as a member of the National Institutes of Health, National Heart Attack Alert Program, Coordinating Committee.Among his editorial and peer-reviewer responsibilities, Mr. McGinnity serves on the editorial board of Advance for Physician Assistants and has authored or co-authored numerous articles in such journals as the American Journal of Cardiology, Circulation, and Advance for Physician Assistants. Mr. McGinnity is a frequent speaker at regional and national professional meetings. | |
© 2009 American Academy of Physician Assistants. All rights reserved.
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| | Title: “Identifying and Treating Resistant Hypertension – Part Two of a Two-Part Series” | | AAPA Release Date: October 20, 2009 | | | | AAPA Expiration Date: October 31, 2010 | | Note: CME credit cannot be awarded after this date | | | Presented by: The American Academy of Physician Assistants | | | Funding: Supported through educational grants from Boehringer-Ingelheim and Merck | | | Program Overview | Hypertension is the most common primary diagnosis in America (over 35 million annual office visits) and it is the leading cause of mortality worldwide. Current BP control rates (systolic <140 mmHg and diastolic <90 mmHg), though improved, are still far below the Healthy People 2010 goal of 50 percent of treated patients achieving BP control. 30 percent of those affected are still unaware they have hypertension. In the majority of patients, controlling systolic hypertension, a more important CVD risk factor than diastolic pressure except in patients younger than age 50, has been considerably more difficult than controlling diastolic hypertension.[1-4]Recent clinical trials have demonstrated that effective BP control can be achieved in most patients who are hypertensive, but the majority will require two or more antihypertensive drugs. When clinicians fail to prescribe lifestyle modifications, adequate antihypertensive drug doses, or appropriate drug combinations, inadequate BP control may result [1-3]. In addition to the personal cost to the individual patient, uncontrolled hypertension creates huge, avoidable, economic burdens. The impact of uncontrolled hypertension on direct costs such as medical care and rehabilitation for patients suffering avoidable strokes, myocardial infarction and renal disease is enormous. In addition, the effects of hypertension contribute to significant indirect economic stresses, including increased disability benefits, demands on social care, lost income and productivity.[4]Resistant hypertension is defined as blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes. Ideally, one of the three agents should be a diuretic and all agents should be prescribed at maximal effective doses. Resistant hypertension is thus defined in order to identify patients who are at high risk of having reversible causes of hypertension and/or patients who, because of persistently high blood pressure levels, may benefit from special diagnostic and therapeutic considerations.[5]Resistant hypertension is a common clinical problem faced by both primary care clinicians and specialists. While the exact prevalence of resistant hypertension is unknown, clinical trials suggest that it is not rare, involving perhaps 20% to 30% of study participants. As older age and obesity are two of the strongest risk factors for uncontrolled hypertension, the incidence of resistant hypertension will likely increase as the population becomes more elderly and heavier. The specific prognostic differences between hypertension and resistant hypertension are unknown, but cardiovascular risk is undoubtedly increased as patients often have a history of long-standing, severe hypertension complicated by multiple other cardiovascular risk factors such as obesity, sleep apnea, diabetes, and chronic kidney disease.[5]Effective management of patients with hypertension involves two steps: 1) recognizing the abnormal BP elevation and 2) initiating and intensifying treatment until therapeutic goals are reached. Although physician assistants diagnose and treat many patients with HBP, most patients are treated inadequately. In the United States, the diagnosis is established for only 69% of patients with hypertension. Moreover, pharmacologic therapy is used for approximately 53% of patients with HBP. To compound matters further, blood pressure control is adequate in only about 45% of those patients treated for hypertension [6]. Simply stated, hypertension is perhaps the single most important health problem primary care providers don’t manage well.[7]For many patients, blood pressure levels remain above goal because providers do not initiate or intensify therapy when clinically indicated. We have characterized this problem as “clinical inertia”. To overcome clinical inertia, physician assistants must understand its causes. Clinical inertia is not linked to patient sex or race, but it has been associated with a history of medication nonadherence, providers claiming satisfaction with blood pressure control, and the number of comorbid diseases. Such observations suggest that clinical inertia may reflect uncertainty about the level of blood pressure that merits intensification and preoccupation with the patient’s other problems.[7] | | References | - Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206-1252.
- American Heart Association. Heart Disease and Stroke Statistics — 2009 Update. Dallas, Texas: American Heart Association; 2009.
- American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics 2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009;119:e21-e181.
- Redon J, Brunner HR, Ferri C, et al. Practical solutions to the challenges of uncontrolled hypertension: a white paper. J Hypertension 2008;26(Suppl 4):S1-S14.
- Calhoun DA, Jones D, Textor S, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension 2008;51:1403-19.
- Phillips LS. Clinical inertia. Ann Int Med 2001;135:825-834.
- Phillips LS, Twomby JG. It’s time to overcome clinical inertia. Ann Int Med 2008;148:783-785.
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Faculty
| | Lawrence Herman, MPA, RPA-C, DFAAPA Moderator Physician Assistant Senior Clinical Coordinator Assistant Professor Department of Physician Assistant Studies New York Institute of Technology Old Westbury, NY Director, Medical Education Island Medical Physicians, PC Hauppauge, NY | | | Randall M. Zusman, MD Associate Professor of Medicine Harvard Medical School Director Division of Hypertension and Vascular Medicine Massachusetts General Hospital Boston, MA | | | John G. McGinnity, MS, PA-C
Clinical Associate Professor
Eugene Applebaum College of Pharmacy and Health Sciences
Wayne State University Detroit, MI Physician Assistant Downriver Cardiology Consultants Trenton, MI | | | Intended Audience | | Physician Assistants | | |
Clinical Dialogue Program Description
| | Clinical Dialogues are 15-20 minute video-based moderated discussions featuring leading experts and are designed to engage the users and deliver the most up-to-date educationally relevant program possible. The interactive ‘give-and-take’ format of these programs provides for lively discussions that distill topics into clinically-pertinent ‘need to know’ information which users may immediately apply to clinical practice. This Internet-based CME activity includes an optional pre-and post-survey, a CME post-test and program evaluation (feedback). CME credit will be awarded to those achieving a grade of 70% or higher on the post-test. | | |
eCase Challenge Program Description
| | eCase Challenges are 20 minute text-based case programs where PAs are presented with challenging case scenarios and are asked to make patient management decisions. At the conclusion of each case, there is a Clinical Pearl video that the participant can view which highlights the key take away messages from each program. This Internet-based CME activity includes an optional pre-and post-survey, a CME post-test and program evaluation (feedback). CME credit will be awarded to those achieving a grade of 70% or higher on the post-test. | | | Educational Objectives | |
At the conclusion of this activity, the physician assistant should be better able to:
| - Identify clinical manifestations and risk factors for the development of pre-hypertension, hypertension, poorly controlled or uncontrolled hypertension, and resistant hypertension;
- Recognize the clinical pathophysiology that contributes to co-morbid events (especially acute coronary syndromes, stroke, CHF, and kidney disease) in individuals with hypertension;
- Identify goals for blood pressure control within patient population sub-groups;
- Describe resistant hypertension and medication choices for resistant hypertension based upon evidence-based guidelines;
- Recognize the importance of the management of hypertension including aggressive lifestyle changes and medications to reduce morbidity and mortality, and improve patient outcomes.
| | | Accreditation Statements |  | | Each program in this initiative has been reviewed and is approved for a maximum of 0.5 hour of AAPA Category 1 CME credit by the Physician Assistant Review Panel. Physician assistants should claim only those hours actually spent participating in the CME activity. This program was planned in accordance with the AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. Approval is valid for one year from the issue date of October 20, 2009. Participants may submit the self-assessment at any time during that period. | | |
Responsibility Statement
| | The American Academy of Physician Assistants takes responsibility for the content, quality, and scientific integrity of this CME activity. | | | Faculty Disclosures | | It is the policy of the American Academy of Physician Assistants to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following: | | LAWRENCE HERMAN, RPA-C, reports that he has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | Randall M. Zusman, MDreports receiving honoraria, consultant fees, grants/research support and on Speaker's bureau from AstraZeneca, Bristol-Myers Squibb, Daiichi-Sankyo, Eli Lilly, Forest, GlaxoSmithKline, Novartis, Pfizer, and Sanofi-aventis.
| | John G. McGinnity, MS, PA-Creports receiving honoraria from Forest and Pfizer and has been on the Speaker's Bureau for Novartis.
| | | Off-Label Discussion | | There are no references to unlabelled/unapproved uses of products in this program. | | Disclaimer | | The opinions and comments expressed by faculty and other experts, whose input is included in this program, are their own. This enduring material is produced for educational purposes only. Please review complete prescribing information of specific drugs mentioned in this program including indications, contraindications, warnings, and adverse effects and dosage before administering to patients. | | |
Archived Presentation
| | The Clinical Dialogue and eCase Challenge will be archived for clinicians. CME credits will be provided by the AAPA from October 20, 2009 through October 31, 2010 for physician assistants at www.AAPA.org. | | | Obtaining CME Credits | | Upon completion of your participation in the program, physician assistants will be directed to www.AAPA.org to complete a post-test and receive your certificates. | | | Successful completion of the self-assessment by physician assistants is required to earn Category 1.0 CME credit. Successful completion is defined as a cumulative score of at least 70% correct. Upon successful completion of the post-test, the AAPA will issue a certificate of completion for your records. | | |
Technical Requirements
| | Processor Speed: 1.4 GHz P3 | | Memory: 256 MB RAM (20MB available) | | Operating Systems Supported: Windows 2000/XP, MAC | | Browsers Supported: Internet Explorer 5.5 or greater, Mozilla Firefox and Safari 3.525 or greater | |
Additional Requirements: Flash player 8.0 or greater, 800x600 Resolution or higher with 32-bit color
| | Connection Speed: 128 Kbps or better | | Adobe Acrobat 6.0 or greater | | | Sponsored by the American Academy of Physician Assistants | 
| Supported through educational grants from Boehringer-Ingelheim and Merck
| | Produced by: |  | | |
© 2009 American Academy of Physician Assistants. All rights reserved.
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| “Identifying and Treating Resistant Hypertension – Part Two of a Two-Part Series” | | |
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| | Title: “Identifying and Treating Resistant Hypertension – Part Two of a Two-Part Series” | | AAPA Release Date: October 20, 2009 | | | | AAPA Expiration Date: October 31, 2010 | | Note: CME credit cannot be awarded after this date | | | Presented by: The American Academy of Physician Assistants | | | Funding: Supported through educational grants from Boehringer-Ingelheim and Merck | | | Program Overview | Hypertension is the most common primary diagnosis in America (over 35 million annual office visits) and it is the leading cause of mortality worldwide. Current BP control rates (systolic <140 mmHg and diastolic <90 mmHg), though improved, are still far below the Healthy People 2010 goal of 50 percent of treated patients achieving BP control. 30 percent of those affected are still unaware they have hypertension. In the majority of patients, controlling systolic hypertension, a more important CVD risk factor than diastolic pressure except in patients younger than age 50, has been considerably more difficult than controlling diastolic hypertension.[1-4]Recent clinical trials have demonstrated that effective BP control can be achieved in most patients who are hypertensive, but the majority will require two or more antihypertensive drugs. When clinicians fail to prescribe lifestyle modifications, adequate antihypertensive drug doses, or appropriate drug combinations, inadequate BP control may result [1-3]. In addition to the personal cost to the individual patient, uncontrolled hypertension creates huge, avoidable, economic burdens. The impact of uncontrolled hypertension on direct costs such as medical care and rehabilitation for patients suffering avoidable strokes, myocardial infarction and renal disease is enormous. In addition, the effects of hypertension contribute to significant indirect economic stresses, including increased disability benefits, demands on social care, lost income and productivity.[4]Resistant hypertension is defined as blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes. Ideally, one of the three agents should be a diuretic and all agents should be prescribed at maximal effective doses. Resistant hypertension is thus defined in order to identify patients who are at high risk of having reversible causes of hypertension and/or patients who, because of persistently high blood pressure levels, may benefit from special diagnostic and therapeutic considerations.[5]Resistant hypertension is a common clinical problem faced by both primary care clinicians and specialists. While the exact prevalence of resistant hypertension is unknown, clinical trials suggest that it is not rare, involving perhaps 20% to 30% of study participants. As older age and obesity are two of the strongest risk factors for uncontrolled hypertension, the incidence of resistant hypertension will likely increase as the population becomes more elderly and heavier. The specific prognostic differences between hypertension and resistant hypertension are unknown, but cardiovascular risk is undoubtedly increased as patients often have a history of long-standing, severe hypertension complicated by multiple other cardiovascular risk factors such as obesity, sleep apnea, diabetes, and chronic kidney disease.[5]Effective management of patients with hypertension involves two steps: 1) recognizing the abnormal BP elevation and 2) initiating and intensifying treatment until therapeutic goals are reached. Although physician assistants diagnose and treat many patients with HBP, most patients are treated inadequately. In the United States, the diagnosis is established for only 69% of patients with hypertension. Moreover, pharmacologic therapy is used for approximately 53% of patients with HBP. To compound matters further, blood pressure control is adequate in only about 45% of those patients treated for hypertension [6]. Simply stated, hypertension is perhaps the single most important health problem primary care providers don’t manage well.[7]For many patients, blood pressure levels remain above goal because providers do not initiate or intensify therapy when clinically indicated. We have characterized this problem as “clinical inertia”. To overcome clinical inertia, physician assistants must understand its causes. Clinical inertia is not linked to patient sex or race, but it has been associated with a history of medication nonadherence, providers claiming satisfaction with blood pressure control, and the number of comorbid diseases. Such observations suggest that clinical inertia may reflect uncertainty about the level of blood pressure that merits intensification and preoccupation with the patient’s other problems.[7] | | References | - Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206-1252.
- American Heart Association. Heart Disease and Stroke Statistics — 2009 Update. Dallas, Texas: American Heart Association; 2009.
- American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics 2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009;119:e21-e181.
- Redon J, Brunner HR, Ferri C, et al. Practical solutions to the challenges of uncontrolled hypertension: a white paper. J Hypertension 2008;26(Suppl 4):S1-S14.
- Calhoun DA, Jones D, Textor S, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension 2008;51:1403-19.
- Phillips LS. Clinical inertia. Ann Int Med 2001;135:825-834.
- Phillips LS, Twomby JG. It’s time to overcome clinical inertia. Ann Int Med 2008;148:783-785.
| | |
Faculty
| | Lawrence Herman, MPA, RPA-C, DFAAPA Moderator Physician Assistant Senior Clinical Coordinator Assistant Professor Department of Physician Assistant Studies New York Institute of Technology Old Westbury, NY Director, Medical Education Island Medical Physicians, PC Hauppauge, NY | | | Randall M. Zusman, MD Associate Professor of Medicine Harvard Medical School Director Division of Hypertension and Vascular Medicine Massachusetts General Hospital Boston, MA | | | John G. McGinnity, MS, PA-C
Clinical Associate Professor
Eugene Applebaum College of Pharmacy and Health Sciences
Wayne State University Detroit, MI Physician Assistant Downriver Cardiology Consultants Trenton, MI | | | Intended Audience | | Physician Assistants | | |
Clinical Dialogue Program Description
| | Clinical Dialogues are 15-20 minute video-based moderated discussions featuring leading experts and are designed to engage the users and deliver the most up-to-date educationally relevant program possible. The interactive ‘give-and-take’ format of these programs provides for lively discussions that distill topics into clinically-pertinent ‘need to know’ information which users may immediately apply to clinical practice. This Internet-based CME activity includes an optional pre-and post-survey, a CME post-test and program evaluation (feedback). CME credit will be awarded to those achieving a grade of 70% or higher on the post-test. | | |
eCase Challenge Program Description
| | eCase Challenges are 20 minute text-based case programs where PAs are presented with challenging case scenarios and are asked to make patient management decisions. At the conclusion of each case, there is a Clinical Pearl video that the participant can view which highlights the key take away messages from each program. This Internet-based CME activity includes an optional pre-and post-survey, a CME post-test and program evaluation (feedback). CME credit will be awarded to those achieving a grade of 70% or higher on the post-test. | | | Educational Objectives | |
At the conclusion of this activity, the physician assistant should be better able to:
| - Identify clinical manifestations and risk factors for the development of pre-hypertension, hypertension, poorly controlled or uncontrolled hypertension, and resistant hypertension;
- Recognize the clinical pathophysiology that contributes to co-morbid events (especially acute coronary syndromes, stroke, CHF, and kidney disease) in individuals with hypertension;
- Identify goals for blood pressure control within patient population sub-groups;
- Describe resistant hypertension and medication choices for resistant hypertension based upon evidence-based guidelines;
- Recognize the importance of the management of hypertension including aggressive lifestyle changes and medications to reduce morbidity and mortality, and improve patient outcomes.
| | | Accreditation Statements |  | | Each program in this initiative has been reviewed and is approved for a maximum of 0.5 hour of AAPA Category 1 CME credit by the Physician Assistant Review Panel. Physician assistants should claim only those hours actually spent participating in the CME activity. This program was planned in accordance with the AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. Approval is valid for one year from the issue date of October 20, 2009. Participants may submit the self-assessment at any time during that period. | | |
Responsibility Statement
| | The American Academy of Physician Assistants takes responsibility for the content, quality, and scientific integrity of this CME activity. | | | Faculty Disclosures | | It is the policy of the American Academy of Physician Assistants to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following: | | LAWRENCE HERMAN, RPA-C, reports that he has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | Randall M. Zusman, MDreports receiving honoraria, consultant fees, grants/research support and on Speaker's bureau from AstraZeneca, Bristol-Myers Squibb, Daiichi-Sankyo, Eli Lilly, Forest, GlaxoSmithKline, Novartis, Pfizer, and Sanofi-aventis.
| | John G. McGinnity, MS, PA-Creports receiving honoraria from Forest and Pfizer and has been on the Speaker's Bureau for Novartis.
| | | Off-Label Discussion | | There are no references to unlabelled/unapproved uses of products in this program. | | Disclaimer | | The opinions and comments expressed by faculty and other experts, whose input is included in this program, are their own. This enduring material is produced for educational purposes only. Please review complete prescribing information of specific drugs mentioned in this program including indications, contraindications, warnings, and adverse effects and dosage before administering to patients. | | |
Archived Presentation
| | The Clinical Dialogue and eCase Challenge will be archived for clinicians. CME credits will be provided by the AAPA from October 20, 2009 through October 31, 2010 for physician assistants at www.AAPA.org. | | | Obtaining CME Credits | | Upon completion of your participation in the program, physician assistants will be directed to www.AAPA.org to complete a post-test and receive your certificates. | | | Successful completion of the self-assessment by physician assistants is required to earn Category 1.0 CME credit. Successful completion is defined as a cumulative score of at least 70% correct. Upon successful completion of the post-test, the AAPA will issue a certificate of completion for your records. | | |
Technical Requirements
| | Processor Speed: 1.4 GHz P3 | | Memory: 256 MB RAM (20MB available) | | Operating Systems Supported: Windows 2000/XP, MAC | | Browsers Supported: Internet Explorer 5.5 or greater, Mozilla Firefox and Safari 3.525 or greater | |
Additional Requirements: Flash player 8.0 or greater, 800x600 Resolution or higher with 32-bit color
| | Connection Speed: 128 Kbps or better | | Adobe Acrobat 6.0 or greater | | | Sponsored by the American Academy of Physician Assistants |  | | | Supported through educational grants from Boehringer-Ingelheim and Merck | | | Produced by: |  | | |
© 2009 American Academy of Physician Assistants. All rights reserved.
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