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| Title: “Discourse on Approaches to Treat Depression in Primary Care”
| | | AAPA Release Date: October 28, 2010 | | AAPA Expiration Date: October 31, 2011 | | Note: CME credit cannot be awarded after this date | | | Estimated time to complete each part of this activity: 30 minutes for each of the three activities. Each part of this activity has been approved for a maximum of 0.50 AAPA Category I Credit. | | | | Presented by: The American Academy of Physician Assistants | | | Acknowledgement of Commercial Support: Supported by educational grants from AstraZeneca, LP, Lilly USA, LLC, and Pfizer, Inc. | |
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Faculty
| Lawrence Herman, MPA, RPA-C, DFAAPA
Moderator
Physician Assistant
Academic Coordinator
Assistant Professor
Department of Physician Assistant Studies
New York Institute of Technology
Old Westbury, NY
Vice President, Medical Education
Island Medical Physicians, PC
Hauppauge, NY
Mr. Herman is an Assistant Professor (with tenure) and Academic 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 State Society of Physician Assistants Educator of the Year, the 2009 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 2006 and 2008 Department of Physician Assistant Studies Educator of the Year award. | Christopher M. Eten, MPAS, RPA-C
Physician Assistant
Internal/Family Medicine Practice
Riverhead, NY
Mr. Eten completed his Physician Assistant studies at Alderson-Broaddus College in Philippi, West Virginia in 2001. Upon graduation, he was board certified by the National Commission on Certification of Physician Assistants in both Primary Care and Surgery and remains so in Primary Care. He received his Masters Degree in 2006 from Alderson-Broaddus as well. Since 2001, Mr. Eten has worked clinically in Primary Care, Emergency Medicine, and Neurosurgery. He is currently practicing clinically at Island Urgent Medical Care in Riverhead, NY, a division of Island Medical Physicians. He is a member of the American Academy of Physician Assistants as well as the New York State Society of Physician Assistants. | Timothy F. Quigley, MPH, PA-C, DFAAPA
Physician Assistant
Faculty
MEDEX Northwest Physician Assistant Program
University of Washington School of Medicine
Seattle, WA
Professor Quigley is currently on the faculty of the University of Washington School of Medicine’s MEDEX PA Program.Before MEDEX, Professor Quigley was on the faculty of the Wichita State University PA Department from 1995–2010. He taught Behavioral Medicine/Clinical Psychiatry, Clinical Preventive Medicine, Epidemiology, Urology, Nephrology and Neurology topics in the PA curriculum. In addition, Mr. Quigley has a clinical practice as a psychiatric PA in a rural community mental health center. He has over 12 years experience in psychiatry in the outpatient and inpatient settings.Mr. Quigley completed the first PA program of study through the Indiana University School of Medicine in 1974, and received his Master of Public Health degree through a joint program of the University of Kansas School of Medicine and Wichita State University in 1999.Professor Quigley has held leadership positions in the American Academy of Physician Assistants where he was recently named a Distinguished Fellow. He received the highest teaching award at Wichita State University in 2008. | |
© 2010 American Academy of Physician Assistants. All rights reserved.
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| | Title: “Discourse on Approaches to Treat Depression in Primary Care” | | AAPA Release Date: October 28, 2010 | | | | AAPA Expiration Date: October 31, 2011 | | Note: CME credit cannot be awarded after this date | | Estimated time to complete each part of this activity: 30 minutes for each of the three activities. Each part of this activity has been approved for a maximum of 0.50 AAPA Category I Credit. | | | Presented by: The American Academy of Physician Assistants | | | Acknowledgement of Commercial Support: Supported by educational grants from AstraZeneca, LP, Lilly USA, LLC, and Pfizer, Inc. | | | Program Overview | Depression is a major public health problem and a leading predictor of functional disability and mortality. In community-dwelling US adults, major depression as defined by DSM-IV criteria has a point prevalence of approximately 3 to 5 percent in males and 8 to 10 percent in females and lifetime prevalence about twice the point prevalence. Depression is more common in populations with a greater burden of medical illness, including residents of assisted living or skilled nursing facilities, recipients of home health care, and patients suffering from a wide range of acute and chronic medical conditions. Less severe depression affects many more people than major depression, and cumulatively accounts for greater functional morbidity.Depression is a strong risk for all-cause mortality. Findings are mixed as to whether the mortality risk is independent of medical disease burden or related factors. For some conditions however, such as coronary artery disease, it is clear that the mortality risk associated with depression is not fully explained by the medical severity of the disease. Additional mortality is due to suicide. Most of the older persons who die by suicide suffer from inadequately treated major depression. Younger and middle-aged adults who die by suicide also have high rates of depression, often comorbid with other psychiatric disorders such as alcohol dependence. Depressed patients may find any or all of their day-to-day role functions adversely affected. Depression may reduce efficiency at work or decrease socialization, which may be endured only with extra effort. Severe depression may lead to patients becoming house- or bed-bound and, in the most ill patients, failing to perform basic activities of living including personal hygiene, toileting, and feeding.This program will review the etiology, incidence, pathophysiology and burden of depression; the differential diagnosis; appropriate screening tools; the nonpharmacologic and pharmacologic choices for treatment; the role of behavioral therapy; and how to manage referrals appropriately in patients diagnosed with depression. | | References | - Altshuler LL, Hendrich V, Cohen LS. Course of mood and anxiety disorders during pregnancy and the postpartum period. J Clin Psychiatry 1998;59:29.
- Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2006;67(2):247-257.
- Cassano P, Fava M. Depression and public health, an overview. J Psychosom Res 2002;53:849-857.
- Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. J Psychosom Res 2002;53:859-863.
- Conwell Y. Suicide in later life: a review and recommendations for prevention. Suicide Life Threat Behav 2001;31(Suppl.):32-47.
- Lebowitz BD, Pearson JL, Schneider LS, et al. Diagnosis and treatment of depression in late life: consensus statement update. JAMA 1997;278(14):1186-1190.
- Little JT, Reynolds CF III, Dew MA, et al. How common is resistance to treatment in recurrent, nonpsychotic geriatric depression? Am J Psychiatry 1998;155(8):1035-1038.
| | |
Faculty
| | Lawrence Herman, MPA, RPA-C, DFAAPA Moderator Physician Assistant Academic Coordinator Assistant Professor Department of Physician Assistant Studies New York Institute of Technology Old Westbury, NY Vice President, Medical Education Island Medical Physicians, PC Hauppauge, NY | | | Christopher M. Eten, MPAS, RPA-C
Physician Assistant
Internal/Family Medicine Practice Riverhead, NY | | | Timothy F. Quigley, MPH, PA-C, DFAAPA Physician Assistant Faculty MEDEX Northwest Physician Assistant Program University of Washington School of Medicine Seattle, WA | | | Intended Audience | | Physician Assistants | | |
Clinical Dialogue Program Description
| | Clinical Dialogues are 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 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:
| - Describe the etiology, incidence, pathophysiology and burden of depression
- Discuss the differential diagnosis of depression
- Utilize appropriate screening tools when evaluating patients for depression
- Describe the pharmacologic choices in the treatment of depression
- Outline the role of behavioral therapy for patients with depression
- Manage referrals appropriately
| | | Accreditation Statements |  | | Each program in this initiative has been reviewed and is approved for a maximum of 0.5 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 28, 2010. 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, MPA, RPA-C, DFAAPA has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | Christopher M. Eten, MPAS, RPA-C has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | Timothy F. Quigley, MPH, PA-C, DFAAPA has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | | 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 28, 2010 through October 31, 2011 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 | PC
| - 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
| | MAC
| - Processor Speed: G4 processor or higher
- Memory: 256 MB RAM
- Operating Systems Supported: OSX
- Browsers Supported: IE for Mac, 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: 128Kbps or better
- Adobe Acrobat Reader 6.0 or greater
| | | Sponsored by the American Academy of Physician Assistants |
| Supported by educational grants from AstraZeneca, LP, Lilly USA, LLC, and Pfizer, Inc.
| | Produced by: |  | | |
© 2010 American Academy of Physician Assistants. All rights reserved.
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“Discourse on Approaches to Treat Depression in Primary Care” | | |
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Technical Requirements
| | PC
| 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
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MAC
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Processor Speed: G4 processor or higher
Memory: 256 MB RAM
Operating Systems Supported: OSX
Browsers Supported: IE for Mac, 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: 128Kbps or better
Adobe Acrobat Reader 6.0 or greater
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IN ACCORDANCE WITH AAPA POLICY, PRIOR TO PARTICIPATING IN THIS ACTIVITY PLEASE REVIEW THE INFORMATION BELOW. YOU MAY LAUNCH THIS PROGRAM AT THE BOTTOM OF THIS PAGE.
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| | Title: “Discourse on Approaches to Treat Depression in Primary Care” | | AAPA Release Date: October 28, 2010 | | | | AAPA Expiration Date: October 31, 2011 | | Note: CME credit cannot be awarded after this date | | Estimated time to complete each part of this activity: 30 minutes for each of the three activities. Each part of this activity has been approved for a maximum of 0.50 AAPA Category I Credit. | | | Presented by: The American Academy of Physician Assistants | | | Acknowledgement of Commercial Support: Supported by educational grants from AstraZeneca, LP, Lilly USA, LLC, and Pfizer, Inc. | | | Program Overview | Depression is a major public health problem and a leading predictor of functional disability and mortality. In community-dwelling US adults, major depression as defined by DSM-IV criteria has a point prevalence of approximately 3 to 5 percent in males and 8 to 10 percent in females and lifetime prevalence about twice the point prevalence. Depression is more common in populations with a greater burden of medical illness, including residents of assisted living or skilled nursing facilities, recipients of home health care, and patients suffering from a wide range of acute and chronic medical conditions. Less severe depression affects many more people than major depression, and cumulatively accounts for greater functional morbidity.Depression is a strong risk for all-cause mortality. Findings are mixed as to whether the mortality risk is independent of medical disease burden or related factors. For some conditions however, such as coronary artery disease, it is clear that the mortality risk associated with depression is not fully explained by the medical severity of the disease. Additional mortality is due to suicide. Most of the older persons who die by suicide suffer from inadequately treated major depression. Younger and middle-aged adults who die by suicide also have high rates of depression, often comorbid with other psychiatric disorders such as alcohol dependence. Depressed patients may find any or all of their day-to-day role functions adversely affected. Depression may reduce efficiency at work or decrease socialization, which may be endured only with extra effort. Severe depression may lead to patients becoming house- or bed-bound and, in the most ill patients, failing to perform basic activities of living including personal hygiene, toileting, and feeding.This program will review the etiology, incidence, pathophysiology and burden of depression; the differential diagnosis; appropriate screening tools; the nonpharmacologic and pharmacologic choices for treatment; the role of behavioral therapy; and how to manage referrals appropriately in patients diagnosed with depression. | | References | - Altshuler LL, Hendrich V, Cohen LS. Course of mood and anxiety disorders during pregnancy and the postpartum period. J Clin Psychiatry 1998;59:29.
- Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2006;67(2):247-257.
- Cassano P, Fava M. Depression and public health, an overview. J Psychosom Res 2002;53:849-857.
- Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. J Psychosom Res 2002;53:859-863.
- Conwell Y. Suicide in later life: a review and recommendations for prevention. Suicide Life Threat Behav 2001;31(Suppl.):32-47.
- Lebowitz BD, Pearson JL, Schneider LS, et al. Diagnosis and treatment of depression in late life: consensus statement update. JAMA 1997;278(14):1186-1190.
- Little JT, Reynolds CF III, Dew MA, et al. How common is resistance to treatment in recurrent, nonpsychotic geriatric depression? Am J Psychiatry 1998;155(8):1035-1038.
| | |
Faculty
| | Lawrence Herman, MPA, RPA-C, DFAAPA Moderator Physician Assistant Academic Coordinator Assistant Professor Department of Physician Assistant Studies New York Institute of Technology Old Westbury, NY Vice President, Medical Education Island Medical Physicians, PC Hauppauge, NY | | | Christopher M. Eten, MPAS, RPA-C
Physician Assistant
Internal/Family Medicine Practice Riverhead, NY | | | Timothy F. Quigley, MPH, PA-C, DFAAPA Physician Assistant Faculty MEDEX Northwest Physician Assistant Program University of Washington School of Medicine Seattle, WA | | | Intended Audience | | Physician Assistants | | |
Clinical Dialogue Program Description
| | Clinical Dialogues are 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 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:
| - Describe the etiology, incidence, pathophysiology and burden of depression
- Discuss the differential diagnosis of depression
- Utilize appropriate screening tools when evaluating patients for depression
- Describe the pharmacologic choices in the treatment of depression
- Outline the role of behavioral therapy for patients with depression
- Manage referrals appropriately
| | | Accreditation Statements | | | Each program in this initiative has been reviewed and is approved for a maximum of 0.5 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 28, 2010. 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, MPA, RPA-C, DFAAPA has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | Christopher M. Eten, MPAS, RPA-C has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | Timothy F. Quigley, MPH, PA-C, DFAAPA has no relationship with any commercial interests whose products or services may be mentioned during this presentation.
| | | 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 28, 2010 through October 31, 2011 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 | PC
| - 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
| | MAC
| - Processor Speed: G4 processor or higher
- Memory: 256 MB RAM
- Operating Systems Supported: OSX
- Browsers Supported: IE for Mac, 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: 128Kbps or better
- Adobe Acrobat Reader 6.0 or greater
| | | Sponsored by the American Academy of Physician Assistants | | | | Supported by educational grants from AstraZeneca, LP, Lilly USA, LLC, and Pfizer, Inc. | | | Produced by: | | | |
© 2010 American Academy of Physician Assistants. All rights reserved.
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