Target Audience
This complimentary educational activity has been designed to meet the educational needs of LPNs, RNs, MSNs, NPs, and other ancillary care providers in home health care, managed care, and physician office settings.

Purpose Statement
The purpose of this activity is to provide insight into the unique challenges that IBD patients present to the clinician and their staff in regards to selecting the most appropriate therapeutic selection as well as how to alter a patient's treatment regimen to respond to changing manifestations of the disease. In addition, the activity will insure that nurses understand the attributes, challenges, roles in the therapeutic selection process, administration needs, and issues associated with these newer therapies and drug classes being approved for IBD and how they impact overall patient care - acutely and longer term.

Statement of Need/Program Overview
Inflammatory Bowel Disease (IBD) affects approximately 1,000,000 people in the United States - just about evenly split between the two primary forms of IBD: ulcerative colitis and Crohn's Disease - both of which cause major disruptions to a patient's quality of life. The exact cause of IBD remains unknown, but there is agreement that the cause of the chronic inflammation seen with the disease is affected and stimulated by the patient's own immune system. There are theories on external stimulants that cause the immune system to go into "hyper drive," but regardless of the theories, evidence shows once the immune system is overly activated, it does not know how to down regulate itself back to baseline. Since everyone's immune system is different, finding the right therapeutic combination for effective patient management remains elusive.

Historically, there were not a lot of good therapeutic options for IBD management and in the past few years newer agents targeting specific elements of the immune system have become available. Physicians typically cycle through a number of different agents at varying stages of disease activity to find the optimal combination for individual patients. The expanding therapeutic options in IBD have resulted in better outcomes and care for patients while presenting clinicians with more flexibility, thereby resulting in achievement of goals that had not routinely been possible - true disease management - reducing inflammation and symptoms, ultimately resulting in the promotion of mucosal healing. Although these advances in treatment options are bringing remission and control to many IBD patients not previously managed, their cost and possible complications are resulting in many different access and use restrictions imposed by insurance carriers or health plans. A recent knowledge gap analysis indicates that not only is a strong understanding of the clinical elements of these emerging options critical, but becoming equally critical is a strong understanding of the processes necessary to gain quick and timely access to these agents. Since nurses often act as the conduit between the patient, physician, and the health plan, their background and understanding of these emerging therapeutic options and the access issues associated are vital to positive patient outcomes.

This activity is intended to enhance the nurses' understanding of the emerging therapeutic options for the treatment and management of IBD and how to utilize that knowledge to help patients gain quicker access to these agents, which can lead to improved clinical outcomes. It will provide insight into the unique challenges that IBD patients present to the clinician and their staff in regards to selecting the most appropriate therapeutic selection as well as how to alter a patient's treatment regimen to respond to changing manifestations of the disease. In addition, the activity will insure that nurses understand the attributes, challenges, roles in the therapeutic selection process, administration needs, and issues associated with these newer therapies and drug classes being approved for IBD and how they impact overall patient care - acutely and longer term. At the conclusion of the activity, the audience will have a greater understanding of the IBD disease state, its primary causes and manifestations, diagnostic procedures, patient challenges, and the emerging therapeutic options available for use.

Educational Objectives
After completing this activity, the participant should be better able to:

• Describe the forms of Inflammatory Bowel Disease (IBD), its associated differential diagnosis, and disease progression
• Review emerging therapeutic options for the treatment and management of IBD
• Explain challenges facing clinicians and ancillary care providers that impact appropriate therapeutic selection for patients with IBD
• Describe how overall patient outcomes for IBD can be improved by overcoming administration barriers facing ancillary care providers

Agenda
Pre-Activity Survey

Challenges and Changes in the Diagnosis and Progression of Inflammatory Bowel Disease
Miguel Regueiro, MD

The Evolving Role of the Nurse in the Management of IBD
Beth Rothert, RN, BSN

Emerging Advancements and Treatment Options in the Management of IBD
David A. Schwartz, MD

Post-Activity Survey and Evaluation Completion

Faculty
Miguel Regueiro, MD Associate Professor of Medicine University of Pittsburgh School of Medicine Pittsburgh, PA Click here for bio
Beth Rothert, RN, BSN IBD Coordinator University of Pittsburgh Pittsburgh, PA Click here for bio
David A. Schwartz, MD Director, Inflammatory Bowel Disease Center Associate Professor of Medicine Vanderbilt University Medical Center Nashville, TN Click here for bio

Physician 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 (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Impact Education, LLC. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nursing Accreditation Statement

This educational activity for 1.5 contact hours is provided by Postgraduate Institute for Medicine (PIM).

Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

A statement of credit will be issued only upon receipt of a completed activity evaluation form. If you submit an evaluation online, you will receive your certificate electronically. If you submit an evaluation via fax, your certificate will be mailed to you within 3 weeks.

Fee Information
There is no fee for this educational activity.

Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Method of Participation
There are no fees for participating and receiving CME credit for this activity. During the period March, 2009 through September, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the posttest online or record the best answer to each question in the answer key on the evaluation form ; 4) complete the evaluation form; and 5) submit the form electronically or fax the evaluation form with answer key to Postgraduate Institute for Medicine.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better. If you submit an evaluation online, you will receive your certificate electronically. If you submit an evaluation via fax, your certificate will be mailed to you within 3 weeks.

Media
Internet

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Impact Education, LLC and UCB, Inc. do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Impact Education, and UCB, Inc.. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

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