Participating Faculty: Improving Outcomes in Chronic Kidney Disease: Optimizing Management of Cardiovascular Diseases

Improving Outcomes in Chronic Kidney Disease: Optimizing Management of Cardiovascular Diseases

In today’s healthcare environment, prompt diagnosis and comprehensive management of highly prevalent and multifaceted disease states, such as chronic kidney disease (CKD), are critical to ensuring optimal clinical and economic outcomes. This supplement to The American Journal of Managed Care aims to address current educational gaps in this area by informing managed care professionals about the prevalence of CKD and its important association with cardiovascular disease (CVD), the role of pharmacotherapy in reducing CVD-related morbidity and mortality, and the managed care aspects of identifying and managing the CKD population.

Faculty

David Calabrese, RPh, MHP

Assistant Clinical Professor

Northeastern University Bouvé College of Pharmacy and Allied

Health Sciences

Vice President, Clinical Operations

MedMetrics Health Partners, an SXC company

Worcester, Massachusetts

Joel C. Marrs, PharmD, BCPS, CLS

Assistant Professor

University of Colorado, Anschutz Medical Campus

School of Pharmacy

Aurora, Colorado

Matthew R. Weir, MD

Professor and Director

Division of Nephrology

University of Maryland, School of Medicine

Baltimore, Maryland

Faculty Disclosures

These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

David Calabrese, RPh, MHP, has no relevant financial relationships to disclose that are related to this activity.

Joel C. Marrs, PharmD, BCPS, CLS, has no relevant financial relationships to disclose that are related to this activity.

Matthew R. Weir, MD

Consultant/Advisory Board:

Amgen, Daiichi Sankyo, Merck Sharp & Dohme Idea, Inc, Novartis, sanofi-aventis

Grants:

National Institute of Diabetes and Digestive and Kidney Diseases

The planning staff from Physicians’ Education Resource, LLC,

and the Pharmacy Times Office of Continuing Professional Education have no relevant financial relationships with commercial interests to disclose related to this activity.

The American Journal of Managed Care,

The contents of this supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

Improving Outcomes in Chronic Kidney Disease: Optimizing Management of Cardiovascular Diseases

Release date: November 30, 2011

Expiration date: November 30, 2012

Estimated time to complete activity: 2.5 hours

Type of activity: Knowledge

This activity is supported by an educational grant from Merck & Co, Inc.

Intended Audience

The audience for this supplement consists of medical directors, pharmacy directors, and other managed care professionals who oversee the care of patients with chronic kidney disease and cardiovascular disease.

Statement of Educational Need

Chronic kidney disease (CKD), characterized by progressively worsening kidney damage and decreased renal function, affects 26 million American adults and is rising in incidence. Recent statistics indicate that the prevalence of CKD (stages 1 to 4) increased from 10% in 1988 to 1994 to 13.1% in 1999 to 2004. Beyond the direct complications of CKD, cardiovascular disease (CVD), along with traditional CVD risk factors (eg, hypertension, dyslipidemia, diabetes), is increasingly recognized to occur at significantly higher rates in patients with CKD compared with the general population.

Due to the common coexistence of CKD and CVD, optimal antihypertensive and lipid-lowering therapy is warranted to reduce the risk of future cardiovascular events. Numerous published trials, as well as national guidelines, support the role of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and statins in early- and late-stage CKD, with recommended blood pressure and low-density lipoprotein cholesterol targets of less than 130/80 mm Hg and less than 100 mg/dL, respectively.

Despite the relatively common prevalence of CKD and associated cardiovascular complications, it remains underrecognized and poses an economic burden. Care of CKD accounts for a substantial portion of US Medicare spending, with major costs primarily associated with hospitalization and drug therapy. While various strategies aimed at improving identification of CKD have shown to be cost-effective in patients at greatest risk of complications (eg, those with diabetes), selecting the most appropriate way to identify these individuals remains a challenge. Individualized care centers, which manage numerous comorbidities (eg, hypertension, diabetes, albuminuria, dyslipidemia) in a given patient, appear promising since they may prevent the downstream consequences of worsening CVD.

Overall Educational Objectives

Upon completion of this educational activity, the participant should be able to:

• Identify the prevalence trends of chronic kidney disease (CKD) and evaluate the relationships between CKD and cardiovascular disease
• Evaluate evidence for various therapies in helping to improve cardiovascular outcomes in patients with CKD
• Review cost factors and cost-effectiveness of strategies used to improve outcomes in patients with CKD

How to Obtain Credit

To receive a statement of credit (pharmacists) or CME certificate (physicians), all participants must read the entire supplement, complete the online posttest with a score of 70% or better, and complete the online evaluation form.

Activity Fee

Physicians: Participants can complete the posttest and activity evaluation free of charge online at http://www.ajmc.com/publications/supplement/2011/ACE002_11Nov.

Pharmacists: Participants can complete the posttest and activity evaluation free of charge online at www.pharmacytimes.com.

Disclosure Policy

According to the disclosure policies of Physicians’ Education Resource and Pharmacy Times Office of Continuing Professional Education, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with relevant commercial interests.

If a conflict of interest is identified, it is the responsibility of Physicians’ Education Resource, LLC and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Physician Credit

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Physicians’ Education Resource and the Pharmacy Times Office of Continuing Professional Education. Physicians’ Education Resource is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Physicians’ Education Resource designates this journal-based CME activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Credit

Accreditation Statement

Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (0.25 CEUs) under the ACPE universal activity number 0290-9999-11-060-H01-P. The activity is available for CE credit through November 30, 2012.

The contents of this supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

System Requirements

PC-based attendees Required:

Windows^® 7, Vista, XP, 2003 Server or 2000

Macintosh^®-based attendees Required:

Mac OS^® X 10.4.11 (Tiger^®) or newer

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