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Online CME

COPD



Sandra G. Adams, MD, MS


CME Information



Sponsor: This activity is sponsored by The Foundation for Better Health Care.

Grantor: This activity is supported by an educational grant to the FBHC from Boehringer Ingelheim Pharmaceuticals, Inc/Pfizer Inc

Overview

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing, and by 2020 it is projected to be the fifth most common disease worldwide. In the US, COPD is now one of the leading causes of mortality and morbidity, and in a nationally representative sample of hospitalizations, any notation of COPD in the discharge diagnosis was associated with a higher likelihood of in-hospital mortality from other comorbidities.1

In the past, the much higher smoking rate among men caused many physicians to believe that COPD was a male disease. However, the increased rate of smoking among women has caused large increases in smoking-related lung disease. According to national mortality data compiled by the National Center for Health Statistics of the Centers for Disease Control, the COPD death rate for females increased by 382% from 1968 through 1999, whereas it increased among men by only 27% during the same period.2 As a result, the COPD death rate for US females is now approaching that of males.

Our understanding of the pathophysiology of COPD has progressed dramatically in recent years. A new definition for COPD has been conceived by the American Thoracic Society, which, coupled with the efforts of the European Respiratory Society, outlines the most current thinking concerning this illness.3 The definition describes progressive airflow limitation with an abnormal inflammatory response of the lungs and, although COPD is described as a "preventable and treatable disease," it is not thought to be fully reversible. These guidelines include revisions on the use of newer products, management of exacerbations, and maintenance therapy.4,5

A key diagnostic challenge in COPD is distinguishing this disease from asthma, an area that continues to be plagued by misunderstanding among patients and physicians alike. Treatments that are effective in both COPD and asthma can minimize the problem of misdiagnosis and maximize the impact of treatment without compounding the complexity of both conditions occurring together. Education highlighting the differences and similarities of asthma and COPD can enhance clinicians' management of COPD.

Finally, patients with COPD, in addition to requiring medication to maintain lung function, frequently develop exacerbations, leading to major clinical and health resource ramifications. Acute exacerbations of COPD, usually related to superimposed infection, occur commonly and, due to their difficult management and high mortality, require that clinicians remain updated on the most recent management guidelines in order to improve care of affected patients.

COPD continues to be an important concern for the healthcare system, and with new definitions, better management options, and a recognition that female patients are increasingly suffering from this condition, the need exists to educate clinicians who manage women with COPD.

Reference
1. Holguin F, Folch E, Redd SC, Mannino DM. Comorbidity and mortality in COPD-related hospitalizations in the United States, 1979 to 2001. Chest. 2005;128:2005-2011. [Evidence Level B]
2. Kazerouni N, Alverson CJ, Redd SC, Mott JA, Mannino DM. Sex differences in COPD and lung cancer mortality trends--United States, 1968-1999. J Womens Health (Larchmt) 2004;13:17-23. [Evidence Level B]
3. American Thoracic Society/European Respiratory Society Task Force. Standards for the Diagnosis and Management of Patients with COPD [Internet]. Version 1.2. New York: American Thoracic Society; 2004 [updated 2005 September 8]. Available at: http://www-test.thoracic.org/copd/. Accessed January 31, 2007. [Evidence Level C]
4. Global Initiative for Chronic Obstructive Lung Disease, World Health Organization, National Heart, Lung and Blood Institute. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease; 2005; Bethesda , Maryland. [Evidence Level C]
5. National Collaborating Centre for Chronic Conditions. Chronic obstructive pulmonary disease. National clinical guideline on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax. 2004;59 (Suppl 1):1-232. [Evidence Level C]

Intended Audience

This activity is designed for physicians and allied health professionals, such as nurse practitioners, nurses, and physician assistants, who provide women with principal and preventative healthcare.

Needs Assessment

Through needs assessment surveys, literature searches, advisory board suggestions, and previous meeting evaluations, The Foundation for Better Health Care has determined a need to address the current state of knowledge regarding the role of ACE inhibitors in CVD risk reduction.

Content Validation

The FBHC validates the content of its CME activities through a peer review process and by utilizing evidence-based medicine sources throughout the planning and implementation of its activities. Adopting the levels of evidence used by the American Academy of Family Physicians1 and the principles of evidence-based medicine outlined by Sackett et al,2 the FBHC rates the level of evidence of the literature used to determine needs and learning objectives, as well as all data cited and presented.

All recommendations involving clinical medicine are based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. Further, all scientific research referred to, reported, or used in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection, and analysis.

Levels of Evidence1



Learning Objectives

Upon completion of this activity, participants should be able to:



Accreditation

The Foundation for Better Health Care is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Foundation for Better Health Care takes responsibility for the content, quality, and scientific integrity of this CME activity.

Credit Designation

The Foundation for Better Health Care designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This Activity has been evaluated and approved by the Continuing Education Approval Program of the National Association of Nurse Practitioner in Women's Health for 1.5 contact hours of continuing education. NPWH Activity no CE 06-15. Each participant should claim only those contact hours that he/she actually spent in the educational activity.

Method of Clinician Participation

View the archived symposium and complete the posttest at click here. A minimum score of 80% must be obtained for credit to be awarded by the FBHC. There is no fee for this activity. Credit for the posttest is available until July 18, 2008.

Identifying and Resolving Conflicts of Interest

The FBHC requires all planning committee members, faculty, teachers, authors, and staff of a CME activity to identify all relevant financial relationships that benefit the individual and his or her spouse or partner in any financial amount within the past 12 months. Such relationships may create the opportunity to affect the content of CME regarding the products or services of the commercial interest.

The FBHC has created the FBHC Committee to Identify and Resolve Conflicts of Interest, which reviews Faculty and Staff Disclosure Statements, identifies and resolves conflicts of interest, and determines the level of participation of planning committee members, faculty members, teachers, and authors.

Faculty

Gerard M. Turino, MD
John H. Keating Sr. Professor of Medicine
College of Physicians and Surgeons (Emeritus)
Columbia University
Director, James P. Mara Center for Lung Disease
St. Luke's-Roosevelt Hospital Center
New York, NY


Independent Reviewer

Margaret Nachtigall, MD
Assistant Professor
New York University Medical Center
New York, New York


Faculty and Reviewer Disclosures

It is the policy of The Foundation for Better Health Care to ensure balance, independence, objectivity, and scientific rigor in all its sponsored educational activities. All faculty are expected to disclose to the activity audience any real or apparent conflict(s) of interest related to the content of their presentation(s). The following relationships have been disclosed:

Dr. Turino discloses the following:


Margaret Nachtigall, MD


FBHC Staff Disclosure

The FBHC, in keeping with the ACCME's Essential Areas and their Elements and Standards for Commercial Support, has asked each FBHC staff member who has developed and/or reviewed content for this activity to disclose to learners all financial relationships, including those of their spouse or partner, with the manufacturer(s) of any pharmaceutical product(s), device(s), or providers of commercial services in any financial amount within the past 12 months. The FBHC staff members have disclosed the following:



Eresso Aga, Scientific Director


LaTanya Brown, Project Director


Michelle Dien, Project Director


Annika Dronge, MD, Medical Director


Susan Duff, Managing Editor


Louise Farkas, Sr. Editor/Writer


Michael Hite, CEO


Lauren Janay, Content Coordinator


Nancy Larsen, Consultant


Nina Leeds, PhD, Scientific Director


Andrew McCrea, PhD, Executive Director


Natacha Menar, Sr. Editor/Writer


Sejal Patel, Senior Account Manager


Judy Seraphine, Consultant


Simone Stromer, MD, Medical Director


Emilie Wang, PhD, Scientific Director


Diane Zuckerman, RPh, Consultant


FBHC Disclosure Statement

The views expressed are those of the author(s). It should not be inferred or assumed that this publication expresses the views of Daiichi Sankyo, or any other manufacturer of pharmaceuticals. The Foundation for Better Health Care (FBHC) is an independent professional organization that does not endorse specific products of any pharmaceutical concern. This FBHC CME activity has been independently planned by the FBHC.

All rights reserved, including translation into other languages. No part of this Webcast may be reproduced or transmitted in any form or by any means-electronic or mechanical, including photocopying, recording, or storage in information storage and retrieval systems-without permission in writing from The Foundation for Better Health Care, 33 East 33nd Street, 8th Floor, New York, NY 10016.
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Release date:
July 18, 2007

Expiration date:
July 18, 2008

Estimated time to complete:
1.5 hours

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