Jay Wish, MD
Professor of Medicine
Case Western Reserve University
School of Medicine
Division of Nephrology
University Hospitals Case Medical Center
Debra J. Hain, PhD, APRN, GNP-BC
Christine E Lynn College of Nursing
Florida Atlantic University
Cleveland Clinic Florida
Department of Nephrology
Richard A. Marasco, BS Pharm, FASCP, CGP, HRM
Pharmaceutical Care & Management Services
Joe Wiedemer, MD
Robert Wood Johnson School of Medicine
Phillips-Barber Family Health Center
Family Physicians: 0.5 Prescribed credit
Nurses: 0.5 Contact Hours
Pharmacists: 0.5 Contact Hour (0.05 CEU) Medium
The treatment of related anemia of chronic kidney disease (CKD) in older adults remains a major clinical challenge. Anemia is a common finding in older adults. Although anemia is often asymptomatic, even mild untreated anemia can lead to adverse outcomes, such as hospitalization, disability, and death. In order to effectively manage these patients, primary care providers and other senior care clinicians need to be competent in the appropriate recognition and differential diagnosis of anemia, as well as the evidence-based strategies for treating anemia, especially in those with anemia of CKD.
Despite the benefits of therapy, anemia of CKD often is not treated. This may be because clinicians are not aware of the consequences of anemia or do not view it as a threatening condition. Once therapy is started, appropriate monitoring ensures that therapy with an erythropoiesis-stimulating agent (ESA) is safe and effective. Data has shown that clinicians may be unaware not only of appropriate hemoglobin goals, but recommended timing for obtaining ESA hemoglobin levels. Anemia may lead to decreased functionality and quality of life in older patients. Because of its high prevalence and negative impact on older adults, continuing education in this area is essential for clinicians who serve this population.
. Target Audience
Senior care providers including physicians, nurses, consultant pharmacists, and others interested in the care of older patients with anemia of CKD.
Upon completion of this educational activity, the participant should be able to:
Implement appropriate diagnostic and therapeutic strategies for patients with anemia of CKD.
Individualize target hemoglobin levels for patients receiving ESA therapy.
Titrate ESA therapy to maintain hemoglobin levels in the individualized target range.
Monitor and maintain iron levels to optimize anemia management.
It is the policy of the AAFP, ASCP, and NADONA to ensure balance, independence, objectivity and scientific rigor in all of its educational activities including those which are sponsored and cosponsored. All faculty are expected to disclose any significant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation. 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 speaker's 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.
Dr. Wish discloses the following: Consultant/Advisory Board: Affymax, AMAG, GlaxoSmithKline, sanofi-aventis; Speakers' Bureau: AMAG, sanofi-aventis.
Mr. Marasco discloses the following: Grant/Research Support: Lilly, sanofi-aventis; Consultant: Boehringer Ingelheim.
Ms. Hain discloses the following: Advisory Board: Affymax, Amgen; Speakers' Bureau: Amgen.
Dr. Weidemier has no relevant financial conflicts to disclose.
Ms. Dechevalier has no relevant financial conflicts to disclose.
Dr. Gerber has no relevant financial conflicts to disclose.
Ms. Barrett has no relevant financial conflicts to disclose.
Ms. Dornberger has no relevant financial conflicts to disclose.
Dr. Thier has no relevant financial conflicts to disclose.
Dr. Paczolt has no relevant financial conflicts to disclose.
This educational activity may contain discussion of published and/or investigational uses of pharmaceutical agents. Some uses of these agents may not have been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Credit Statements
This Enduring Material activity, Anemia of Chronic Kidney Disease in the Older Patient Population: Selecting the Appropriate Treatment, has been reviewed and is acceptable for up to 0.50 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins September 9, 2011. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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 knowledge-based activity, ACPE Universal Activity #0203-9999-11-145-H01-P, has been assigned 0.5 Contact Hour (0.05 CEU).
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 #1088. This activity provides 0.5 contact hour by NADONA/LTC.
Participants must view the activity in its entirety, successfully complete the post-test, and submit an evaluation to receive continuing pharmacy education credit. Credit will be awarded for a score of 70% or better, and a statement may be printed immediately after passing the post-test.
There is no fee to participate in this educational activity. Commercial Support Statements
This activity is supported by an educational grant from Janssen Biotech, Inc.
Minimum System Requirements:
• Pentium III, 600 MHz or Equivalent Processor
• 512 MB of RAM
• Windows XP, Vista, or 7
• Mac OS X
• 800x600 Monitor Resolution
• 16-bit Color
• 16 bit Sound Card with Speakers
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Instructions for completing and submitting the post-test and evaluation are provided on the post-test screen.
© 2011, 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 educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, ASCP, NJAFP, NADONA, or Centecor Ortho Biotech Inc. Any medications, diagnostic procedures, or treatments discussed by the faculty should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.