Judith L. Beizer, PharmD, CGP, FASCP
College of Pharmacy & Allied Health Professions
St. John's University
Jamaica, New York
Brooks D. Cash, MD, FACP, FACG
Chief, Gastroenterology Division; National Naval Medical Center
Associate Professor of Medicine; USUHS
THIS PROGRAM WAS ORIGINALLY PRESENTED AS A LIVE AUDIOCONFERENCE BEGINNING ON SEPTEMBER 24, 2007. IF YOU RECEIVED CREDIT FOR PARTICIPATING IN THE AUDIOCONFERENCE, YOU ARE NOT ELIGIBLE TO RECEIVE CREDIT FOR THIS ONLINE ACTIVITY.
Constipation is a common condition in individuals 65 years and older and affects approximately 26% of elderly men and 34% of elderly women. The disorder is the most frequently cited gastrointestinal complaint in the elderly and up to 60% of this patient population reports using laxatives. Additionally, constipation is attributed to 2.5 million physician office visits in the US per year and is a major contributor to diminished quality of life.
Constipation is not a physiologic consequence of normal aging. Its etiology is multi-faceted and includes reduced physical exercise, issues with diet and eating habits, functional limitations from prior strokes, depression and psychological distress, structural abnormalities, metabolic and neurologic comorbidities, and medication use.
Traditional laxatives and fiber supplements often do not provide adequate relief of symptoms and may lead to further impairment of quality of life, higher health care utilization, and polypharmacy. However, recent advances in drug development have led to some promising agents that effectively treat chronic constipation. Because of the overwhelming prevalence of this disorder in the elderly, health care professionals working in long-term care settings need to be informed and educated about the causes and complications of constipation and available treatment strategies that effectively manage the condition.
Contemporary Management of Chronic Constipation in Long-Term Care will review the current diagnostic criteria for chronic constipation and constipation predominant IBS and identify primary and secondary constipation causes. In addition, the program will discuss disease burden and quality of life issues associated with constipation in elderly long-term care residents and evaluate traditional and newer treatment options. Target Audience
This program has been developed specifically for consultant pharmacists, long-term care medical directors, VA pharmacists, nurse practitioners, and nurses involved in long-term care.
Upon completion of this educational activity, the participant should be able to:
Review current diagnostic criteria for chronic constipation and constipation predominant IBS
Identify primary and secondary constipation causes in long-term care elderly patients, including transit time, dyssynergia, comorbidities, diet, and medication use
Discuss disease burden, related complications, and quality of life issues associated with constipation in long-term care residents
Describe management strategies for various etiologies of constipation that are often encountered in long-term care, including drug-related causes
Evaluate the clinical relevance of traditional and newer treatment options for elderly constipation patients based on specific criteria of drug interactions, patient age, health, and other factors
It is the policy of ASCP, in accordance with the guidelines set forth by the Accreditation Council for Pharmacy Education, and AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflict of interest is resolved by ASCP and AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.
The intent of this disclosure is not to prevent a presenter with significant financial interest or other relationship from making the presentation, but rather to provide the audience with information with which they can make their own judgments. It remains for the audience to determine whether the speakers’ interests or relationships may influence the presentation with regard to exposition or conclusion. Faculty are also expected to openly disclose any off-label, experimental, or investigational use of drugs or devices in their presentations.
Judith L. Beizer, PharmD, CGP, FASCP has no commercial interests to disclose.
Brooks D. Cash, MD, FACP, FACG has received fees as a member of speakers bureaus' for Novartis, Sucampo Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc. and Salix Pharmaceuticals and as a member of advisory boards for Salix Pharmaceuticals and Prometheus Laboratories.
Pharmacists: ASCP is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program is accredited for 1.0 contact hour (0.1 CEUs) of continuing education credit. Universal Program Number 203-999-07-140-HO1-P.
Nurses: NADONA/LTC is an approved provider of continuing nursing education by Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation #1087. This program has been approved for 1 contact hour by NADONA/LTC.
Nurse Practitioners: AKH Inc. is accredited by the American Academy of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number 030803. AKH Inc. designates this educational activity for 1 contact hour, which includes 0.5 pharmacology contact hour.
Physicians: 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 AKH Inc. and Medical Communications Media. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc. designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Commercial Support Statements
Supported by an educational grant from Sucampo Pharmaceuticals, Inc. & Takeda Pharmaceuticals North America, Inc.
Please turn off all pop-up blockers to assure access to the educational activity.
Click on the "Start program" icon. If you are not already logged in to the site, this will bring you to the login/registration page where you will be able to register as a new cmecorner.com member or check existing registration information. When ready, click on the "Continue to Program" icon at the bottom of the screen.
The next main menu screen will permit you to check for or download the Flash player required to run this program. Clicking on "Click here to start the Virtual Meeting" on this screen will begin the program presentation. The menu at the top of the presentation screen will allow you to view the question and answer segment, the reference list, and the CME/CE post-test and evaluation. The program will take approximately 60 minutes to complete.
Upon completion of the program, click on the post-test button to register and/or access the post-test and program evaluation. Please note that a link to the ASCP website is provided for all pharmacists requesting CPE credit.
Instructions for completing and submitting the post-test are provided on the post-test screen. A minimum score of 70% on the post-test is required for a CME/CPE/CE certificate/statement.
©2007, Medical Communications Media, Inc. All rights reserved. None of the contents may be reproduced in any form without prior written permission from the publisher. The opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or recommendations of their affiliated institutions, Medical Communications Media, AKH Inc., the American Society of Consultant Pharmacists, the National Association of Directors of Nursing Administration in Long-Term Care, Sucampo Pharmaceuticals, Inc or Takeda Pharmaceuticals North America, Inc. Any medications or other diagnostic or treatment procedures discussed by the program speakers should not be utilized by clinicians without evaluation of their patients’ conditions and possible contraindications or risks, and without a review of any applicable manufacturer’s product information and comparison with the recommendations of other authorities.