25-30 of 316 Activities
Anticoagulation for renally-impaired individuals with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE) often entails balancing the risk of vascular events (e.g., stroke, pulmonary embolism) with the dangers of excess bleeding. In this CME Outfitters BriefCase series, two expert clinicians – a cardiologist and a nephrologist, view 4 short patient care videos in real-time. After each vignette, they provide frank and candid commentary punctuated by clinical tips and pearls you can use in your own practice.
Among the topics covered: Should stroke and VTE prophylaxis take precedent over the risk of bleeding? Should advanced age and risk of falls be contraindications to anticoagulation? Are direct oral anticoagulants (DOACs) considered first-line in 2024 – and for which patients? Does chronic kidney disease (CKD) warrant lower DOAC and/or warfarin doses in patients with NVAF or VTE? How does an individual’s social determinants of health inform shared decision-making when it comes to choices in anticoagulation?
Please join us for Anticoagulation Considerations in Renally-Impaired Patients with NVAF or VTE: Case Simulations and Commentary and learn how to strike the right balance for your own renally-impaired patients with NVAF or VTE.
Chronic kidney disease (CKD) is a common comorbidity among patients with non-valvular atrial fibrillation (NVAF) and/or venous thromboembolism (VTE). Paradoxically, declining kidney function increases both thromboembolic and bleeding risks in patients with these conditions, requiring a fragile balance when implementing anticoagulation therapy to prevent ischemic stroke, deep vein thrombosis, and pulmonary embolism. Adding to the complexity of decision-making is a paucity of robust study results, as patients with CKD were often excluded from large anticoagulation clinical trials for patients with NVAF and VTE. Fortunately, newer studies and a wealth of real-world experience now provide practical guidance to optimize quality of care and outcomes. In particular, some of the direct oral anticoagulants (DOACs) have shown significant safety and efficacy versus warfarin in many patients with CKD and NVAF/VTE, but these therapies are still underused or underdosed because of clinician concern for increased bleeding.
In this CME Outfitters activity, experts in cardiology and nephrology discuss the challenges of striking the ideal risk-benefit ratio in anticoagulation for renally-impaired patients with NVAF or VTE. They explore the roles that shared decision making and recognition of each patient’s social determinants of health play in improving adherence to therapies. Importantly, the faculty demonstrates how cultural humility and awareness of implicit bias, particularly in communities of color, can improve equitable care and ensure best outcomes.
In this CMEO Outfitters recorded symposium, expert faculty discuss recognizing the frequency of bowel urgency in patients with CD and the impact on patient QoL, incorporating assessments for bowel urgency through symptom evaluation, and engaging patients in open communication about their bowel urgency as part of shared decision-making in order to improve clinical outcomes, and the faculty also review real-world patient cases.
Millie D. Long, MD, MPH, is board certified in internal medicine, preventive medicine, and gastroenterology. Dr. Long received her medical degree from University of Virginia in 2002. She then completed residency in internal medicine and a chief residency at University of Alabama at Birmingham. She completed fellowships in gastroenterology and hepatology, preventive medicine, and inflammatory bowel disease, all at University of North Carolina. She is currently Professor of Medicine in the Department of Medicine and Director of the Gastroenterology and Hepatology Fellowship Program at University of North Carolina at Chapel Hill.
Dr. Long’s clinical practice is at the UNC Multidisciplinary Inflammatory Bowel Diseases (IBD) Center. Her research interests include prevention of complications of IBD, women’s health, and clinical epidemiology. Dr. Long has contributed to over 200 peer-reviewed publications, book chapters, and review articles and to the medical literature. She is the current co-Editor in Chief of the American Journal of Gastroenterology. She also serves as an invited reviewer for journals such as Inflammatory Bowel Diseases and Gastroenterology.
Dr. Long is a fellow of the American College of Gastroenterology, where she serves on the Board of Trustees. She is also a fellow of the American Gastroenterological Association and the Crohn’s and Colitis Foundation, where she co-chairs the Clinical Research Alliance.
With the advent of ICI therapy and emerging ICI combination therapies, clinicians need to have knowledge of where and how maintenance therapy may play a role in improving PFS in EC. During this podcast, international gynecologic cancer experts Drs. Richard Penson and Nicoletta Colombo discuss the most recent data from these EC trials, focusing on how it has changed recommended practice patterns and how it should be incorporated into the care of patients with EC.
Richard T. Penson, MD, MRCP, is a Medical Oncologist at Massachusetts General Hospital, and Associate Professor of Medicine at Harvard Medical School. A key opinion leader, Dr. Penson was a longstanding member of the Gynecologic Oncology Group Ovarian and Quality of Life Committees and now serves on the Foundation’s Investigator Council. He is the national Principal Investigator (PI) of the olaparib registration trial (SOLO-2) and the international PI of SOLO3, and the OVAL trial. He has taught on Harvard’s Practice of Medicine Course, the Bigelow General Medical Service at Massachusetts General Hospital, and is one of the Chairs of the Institutional Review Board of Dana-Farber Harvard Cancer Center.
Despite advances in the treatment and management of dermatologic conditions such as psoriasis, significant disparities in both treatment and outcomes persist for patients from racial/ethnic underserved groups. Patients of color are not only more likely to present with more severe disease, but they are also more likely to receive either no treatment, or only topical treatments, despite wide availability of effective biologic medications. In fact, Black patients with moderate to severe psoriasis are 70% less likely to receive biologic treatment than their White counterparts. It is imperative that each member of the multidisciplinary care team works together to address these disparities in order to improve equity in treatment and outcomes for all patients.
In this CMEO BriefCase, expert faculty will utilize case-based learning to illustrate these pervasive disparities through the stories of two patients, Miguel and LaToya, while offering strategies to integrate therapies that optimize long-term outcomes and address racial/ethnic inequities in the diagnosis and treatment of patients with psoriasis.
Monica Peek, MD, MPH, MSc is an Ellen H. Block Professor of Health Justice in the Department of Medicine. She is also the Associate Director, Chicago Center for Diabetes Translation Research, and Director of Research, MacLean Center for Clinical Medical Ethics. She is a practicing internist, medical educator, and clinician investigator. Her research pursues health equity and social justice, with a focus on promoting equitable doctor/patient relationships among racial minorities, integrating the medical and social needs of patients, and addressing health care discrimination and structural racism impacting health outcomes (e.g., diabetes, COVID-19). Dr. Peek has authored more than 200 peer-reviewed publications and abstracts on health care disparities, diversity, and bias; has been the principal investigator of multiple grants to address health disparities; and has been invited to speak at numerous local and national medical meetings.
Despite the rising prevalence of inflammatory bowel disease (IBD) among racial and ethnic underserved populations, disparities in diagnosis, treatment, and outcomes remain. Patients of color are more likely to present with more severe disease, sometimes with extraintestinal manifestations. However, even after controlling for disease severity for both ulcerative colitis and Crohn’s disease, Black and Hispanic patients are not only less likely to receive appropriate biologic therapy, but also have higher rates of cumulative surgeries than their White and Asian counterparts. It is imperative that each member of the multidisciplinary care team works together to address these disparities in order to improve equity in treatment and outcomes for all patients.
In this CMEO BriefCase, expert faculty will utilize case-based learning to illustrate these pervasive disparities through the stories of two patients, Harold and April, while offering strategies to address inequities in the treatment and outcomes of patients with IBD.
Anita Afzali, MD, MPH, MHCM, is a Professor of Clinical Medicine and a gastroenterologist that specializes in Inflammatory Bowel Disease (IBD). She has recently transitioned to the University of Cincinnati after successfully building the first standalone multidisciplinary IBD Center and serving as the Medical Director at The Ohio State University Wexner Medical Center for five years. Dr. Afzali is now the Executive Vice Chair of the Department of Internal Medicine at the University of Cincinnati and Associate Chief Medical Officer of UC Health Systems and Cincinnati Children’s Hospital. She received her medical degree and completed both an Internal Medicine residency and Gastroenterology fellowship at the University of Washington in Seattle, WA. While in fellowship, Dr. Afzali worked in outcomes research and epidemiology and graduated with a Master’s in Public Health. She recently obtained an additional Master’s in Health Care Management for physician executive leadership and business administration from Harvard University. Her areas of research interest include clinical outcomes and clinical trials for investigative therapies and diagnostics in IBD. She is a healthcare redesign leader with interests in clinical operations and transformative medical care delivery. Dr. Afzali has extensive peer-reviewed publications and is a clinical trialist in over 20 investigative drug and diagnostic trials. She is also an invited lecturer on national and international programs and serves on several international advisory boards and scientific committees. Dr. Afzali is the incoming Chair of the American College of Gastroenterology (ACG) Educational Affairs Committee and the incoming Chair of the World Gastroenterology Organization (WGO) Publications Committee, as well as Co-Editor of the WGO quarterly global newsletters.
Monica Peek, MD, MPH, MSc is an Ellen H. Block Professor of Health Justice in the Department of Medicine. She is also the Associate Director, Chicago Center for Diabetes Translation Research, and Director of Research, MacLean Center for Clinical Medical Ethics. She is a practicing internist, medical educator, and clinician investigator. Her research pursues health equity and social justice, with a focus on promoting equitable doctor/patient relationships among racial minorities, integrating the medical and social needs of patients, and addressing health care discrimination and structural racism impacting health outcomes (e.g., diabetes, COVID-19). Dr. Peek has authored more than 200 peer-reviewed publications and abstracts on health care disparities, diversity, and bias; has been the principal investigator of multiple grants to address health disparities; and has been invited to speak at numerous local and national medical meetings.