T. S. Dharmarajan, MD, FACP, AGSF
Professor of Medicine and Associate Dean
New York Medical College
Valhalla, New York
Vice-Chair, Department of Medicine
Clinical Director, Division of Geriatrics
Director, Geriatric Medicine Fellowship Program
Montefiore Medical Center, North Division
Bronx, New York
Wendy St. Peter, PharmD, FCCP, FASN, BCPS
Professor, Department of Pharmaceutical Care & Health Systems
University of Minnesota College of Pharmacy
Hennepin County Medical Center
Chronic Disease Research Group/
United States Renal Data System Coordinating Center
Debra Bakerjian, PhD, MSN, FNP
President and CEO
Claire M. Fagin Postdoctoral Fellow
Assistant Adjunct Professor, School of Nursing
Department of Social and Behavioral Sciences
University of California San Francisco
San Francisco, California
Physicians: 1 hour
Pharmacists: 1 contact hour (0.1 CEU)
Nurses: 1 contact hour Medium
THIS PROGRAM WAS ORIGINALLY PRESENTED AS A LIVE AUDIOCONFERENCE SERIES BEGINNING JULY 21, 2009. IF YOU RECEIVED CREDIT FOR PARTICIPATING IN THE AUDIOCONFERENCE, YOU ARE NOT ELIGIBLE TO RECEIVE CREDIT FOR THIS ONLINE ACTIVITY.
Approximately 40% of LTC residents have advanced chronic kidney disease. The anemia that develops in these individuals often is not evaluated and managed sufficiently. In older residents, inadequate diagnosis and treatment of anemia may lead to adverse outcomes, including disability and death. Interdisciplinary care planning in the nursing home provides the "road map" to guide those involved in the resident's care. In residents with CKD, the use of erythropoiesis-stimulating agents (ESAs) to improve anemia and avoid its consequences may be appropriate.
This activity will heighten the clinician's awareness of anemia and CKD and its consequences if left untreated. It will help practitioners understand how to evaluate those at risk and be familiar with evidence-based treatment strategies that are appropriate for the elderly. Finally, it will help guide the care team to integrate these strategies into an interdisciplinary care plan so residents are treated and monitored appropriately. Target Audience
This activity was designed for pharmacists, physicians, and nurses who care for patients with anemia of chronic kidney disease in long-term care settings.
Upon completion of this application-based educational activity, the participant should be able to:
Discuss the identification and evaluation of anemia in older adults to determine an etiology.
Explain the assessment of kidney function and the staging of chronic kidney disease.
Describe the consequences of anemia in older patients.
Implement appropriate treatment strategies for anemia in residents with chronic kidney disease.
Evaluate ways to overcome barriers that hinder the appropriate assessment and management of anemia in long-term care settings.
Develop interdisciplinary strategies to monitor and maintain Hgb levels in the recommended target range.
It is the policy of ASCP, in accordance with the standards 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 speakersí 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.
T. S. Dharmarajan, MD, FACP, AGSF has no commercial interests to disclose.
Wendy St. Peter, PharmD, FCCP, FASN, BCPS discloses that she has received research support from Amgen Inc., Genzyme Corporation, and Shire.
Debra Bakerjian, PhD, MSN, FNP discloses that she has served on the speakers bureau of Forest Pharmaceuticals.
Pharmacy Continuing Education: The American Society of Consultant Pharmacists (ASCP) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This educational activity (ACPE #203-999-09-065-H01-P) was developed by ASCP and is approved for 1.0 Contact Hour (0.1 CEU).
Continuing Medical Education: 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, Inc. 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 AMA PRA Category 1 Credit TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Nursing Continuing Education: NADONA/LTC is an approved provider of continuing nursing education by Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Centerís Commission on Accreditation #1088. This program provides 1 contact hour by NADONA/LTC.
Participants must successfully complete the post-test and submit an evaluation to receive credit. Credit will be awarded for a score of 70% or better, and a certificate/statement may be printed immediately after passing the post-test if the post-test and evaluation are completed online or within 6 weeks if they are sent by mail.
The initial release date of this activity is July 21, 2009.
Commercial Support Statements
Supported by an educational grant from Centocor Ortho Biotech Inc.