Optimizing Coordination of Care for Patients with Diabetes with Carol H. Wysham, MD, FACP, FACE

CME/CE Information
References

Activity Progress
Pre-Activity Survey
Page 1
Post-Activity Survey
CME Evaluation/Print Certificate

Problem: This activity is closed

Optimizing Coordination of Care for Patients with Diabetes with Carol H. Wysham, MD, FACP, FACE

Carol H. Wysham, MD, FACP, FACE

Release Date: October 16, 2015

Expiration Date: October 15, 2016 (THIS ACTIVITY IS NO LONGER AVAILABLE FOR CREDIT)

Continue to Activity

ACTIVITY DESCRIPTION

In only 20 minutes, you can watch this on-demand, case-based activity from the proceedings of a CME/CE symposium at the American Diabetes Association’s 75^th Scientific Sessions. Learn about:

Team-based approaches to improve the coordination of care for your patients with type 2 diabetes
Identifying a diabetes management regimen for Joe, a patient with hypoglycemia concerns

LEARNING OBJECTIVES

Upon completion of this activity, the participant should be able to:

Implement into practice team care approaches to help improve the coordination of care for, and education of, patients who are not reaching their HbA1c goals
Select diabetes management regimens that maximize glycemic control while minimizing adverse effects and considering patient comorbidities, preferences, and concerns

FACULTY

Carol H. Wysham, MD, FACP, FACE

Clinical Associate Professor of Medicine

University of Washington School of Medicine

Seattle, WA

FACULTY BIOGRAPHY

Carol H. Wysham, MD, is Clinical Associate Professor of Medicine at the University of Washington School of Medicine, Seattle, and Research Professor, College of Pharmacotherapy at Washington State University, Spokane. She received her medical degree from the University of Iowa College of Medicine, Iowa City. She completed her residency and internship in internal medicine at Oregon Health Sciences University, Portland, and a fellowship in endocrinology and metabolism at the University of Iowa Hospitals and Clinics.

Dr Wysham has been involved in multiple clinical studies investigating diabetes therapies and has served as a principal investigator for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes (AIM-HIGH) trial. She is the Chair of the 2016 Endocrine Society Annual Meeting and is Past Chair of the Clinical Practice Committee of the American Diabetes Association. In addition, she is a member of several professional societies, including the American College of Physicians, the American Diabetes Association, The Endocrine Society, and the American Association of Clinical Endocrinologists.

DISCLOSURE STATEMENTS

In accordance with the Accreditation Council for Continuing Medical Education (ACCME), Dannemiller requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest.

The following faculty member has disclosures to be made:

Carol H. Wysham MD, FACP, FACE

Speakers Bureau: AstraZeneca LP; Boehringer Ingelheim Pharmaceuticals, Inc; Janssen Pharmaceuticals, Inc; Lilly USA, LLC; Medscape; Novo Nordisk; sanofi-aventis U.S. LLC; The Endocrine Society

Consultant/Advisory Board: AstraZeneca LP; Boehringer Ingelheim Pharmaceuticals, Inc; Janssen Pharmaceuticals, Inc; Lilly USA, LLC; sanofi-aventis U.S. LLC

Dr Wysham does not discuss information related to non–FDA-approved or investigational use of a product/device.

The following have no financial relationships with commercial interests to disclose:

INDEPENDENT REVIEWER

In order to resolve conflict of interest, presentations of this activity were peer reviewed by an independent reviewer. The reviewer has no relationship with a commercial interest. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

Bernard Abrams, MD, Clinical Content Reviewer, has no financial relationships with commercial interests.

EDUCATIONAL PLANNING COMMITTEE

Dannemiller

Gordon Ringler, Dannemiller Director of Medical Education, has no financial relationships with commercial interests.

Spire Learning

Lauren Waters and Elysa Ripa, Program Directors; Jaime Symowicz, PhD, Senior Clinical Director; and Lisa Conklin, Group Director, Grants and Education, have no financial relationships with commercial interests.

DISCLAIMER

The content and views presented in this educational activity are those of the presenter and do not necessarily reflect those of Dannemiller, Spire Learning, Boehringer Ingelheim Pharmaceuticals, Inc. or Lilly USA, LLC. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

OFF-LABEL STATEMENT

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Further, participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

LEVELS OF EVIDENCE

Level of Evidence	Description
A	Clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered, including Evidence from a well-conducted multicenter trial Evidence from a meta-analysis that incorporated quality ratings in the analysis Compelling nonexperimental evidence; i.e., “all or none” rule developed by the Centre for Evidence-Based Medicine at the University of Oxford Supportive evidence from well-conducted randomized controlled trials that are adequately powered, including Evidence from a well-conducted trial at one or more institutions Evidence from a meta-analysis that incorporated quality ratings in the analysis
B	Supportive evidence from well-conducted cohort studies Evidence from a well-conducted prospective cohort study or registry Evidence from a well-conducted meta-analysis of cohort studies Supportive evidence from a well-conducted case-control study
C	Supportive evidence from poorly controlled or uncontrolled studies Evidence from randomized clinical trials with one or more major or three or more minor methodological flaws that could invalidate the results Evidence from observational studies with high potential for bias (such as case series with comparison with historical controls) Evidence from case series or case reports Conflicting evidence with the weight of evidence supporting the recommendation
E	Expert consensus or clinical experience

Source: ADA evidence-grading system for “Standards of Medical Care in Diabetes Care” in Diabetes Care. 2015;38(Suppl 1):S1-S93.

TARGET AUDIENCE

This activity is designed for endocrinologists, primary care physicians (PCPs), physician assistants (PAs), nurse practitioners (NPs), and nurses with an interest in the management of Type 2 diabetes (T2DM).

ACCREDITATION

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Dannemiller and Spire Learning. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians.

Dannemiller designates this enduring activity for a maximum of .50 AMA PRA Category 1 Credits^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credits^TM from organizations accredited by ACCME.

Dannemiller is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners: AANP Provider Number 090419. This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards. It provides .50 credits of continuing education (which includes 0.25 hours of pharmacology).

METHOD OF PARTICIPATION

This activity has no fee and should take approximately 20 minutes to complete. Participants should first read the objectives and other introductory CME information, then complete the pre-assessment and participate in the online case activity. To receive credit for this activity, participants must complete the post-assessment with a passing score of 70% and then complete the evaluation. This credit is valid through October 15, 2016. No credit will be given after this date. In the event you have questions about this activity or are unable to print the certificate, please e-mail Lauren Waters at lwaters@spirelearning.com, and a certificate will be e-mailed within 2 weeks.

This educational activity is jointly provided by Dannemiller and Spire Learning.

This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc. and Lilly USA, LLC.

References for Optimizing Coordination of Care for Patients with Diabetes with Carol H. Wysham, MD, FACP, FACE

Sources/References:

Ali MK, et al. Achievement of goals in U.S. diabetes care, 1999-2010. N Engl J Med. 2013;368:1613-1624.

American Diabetes Association. Practical Insulin: A Handbook for Prescribing Providers. 3rd ed. Alexandria, VA. 2011;1-68.

American Diabetes Association. Standards of medical care in diabetes – 2015. Diabetes Care. 2015;38(suppl 1):S1-S93.

Bell RA, et al. Improving diabetes care among low-income North Carolinians: Project IDEAL. N C Med J. 2005;66:96-102.

Cabana MD, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458-1465.

Codispoti C, et al. The use of a multidisciplinary team care approach to improve glycemic control and quality of life by the prevention of complications among diabetic patients. J Okla State Med Assoc. 2004;97:201-204.

Diamant M, et al. Glucagon-like peptide 1 receptor agonist or bolus insulin with optimized basal insulin in type 2 diabetes. Diabetes Care. 2014;37:2763-2773.

Erhardt L, et al. Guidelines and their implementation: A discussion document focused on the best approaches to drive improvement. Vasc Dis Prev. 2004;1:167-174.

Garber AJ, et al. AACE/ACE comprehensive diabetes management algorithm 2015. Endocr Pract. 2015;21:438-447.

Garber AJ, et al. American Association of Clinical Endocrinologists’ comprehensive diabetes management algorithm 2013 consensus statement. Endocr Pract. 2013;19(suppl 2):1-48.

Handelsman Y, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan. Endocr Pract. 2011;17(suppl 2):1-87.

Hortensius J, et al. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health. 2012;12:167.

Inzucchi SE, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140-149.

National Diabetes Education Program. Redesigning the Health Care Team: Diabetes Prevention and Lifelong Management. http://ndep.nih.gov/media/NDEP37_RedesignTeamCare_4c_508.pdf.

Rosenstock J, et al. Advancing basal insulin replacement in type 2 diabetes inadequately controlled with insulin glargine plus oral agents: a comparison of adding albiglutide, a weekly GLP-1 receptor agonist, versus thrice-daily prandial insulin lispro. Diabetes Care. 2014;37:2317-2325.

Sadur CN, et al. Diabetes management in a health maintenance organization. Efficacy of care management using cluster visits. Diabetes Care. 1999;22:2011-2017.

Simmons D, et al. Discordance in perceptions of barriers to diabetes care between patients and primary care and secondary care. Diabetes Care. 2007;30:490-495.

Stark Casagrande S, et al. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010. Diabetes Care. 2013;36:2271-2279.

The MacColl Center. www.improvingchroniccare.org.

Optimizing Coordination of Care for Patients with Diabetes click here.

Factors to Consider When Incorporating New Therapies Into a Patient’s Antihyperglycemic Regimen Resource Tool click here.

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes.

http://care.diabetesjournals.org/content/38/1/140.full.pdf+html.

AACE/ACE Comprehensive Diabetes Management Algorithm 2015.

http://journals.aace.com/doi/pdf/10.4158/EP15693.CS.

American Diabetes Association Standards of Medical Care in Diabetes 2015.

http://care.diabetesjournals.org/content/38/Supplement_1.toc.

Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position

Statement of the American Diabetes Association, the American Association of Diabetes

Educators, and the Academy of Nutrition and Dietetics.

http://care.diabetesjournals.org/content/38/7/1372.full.pdf+html.

Suggested Related Content:

Incorporating New Therapies into Antihyperglycemic Regimens with Mark Stolar, MD

Click here.

Improving Patient Care Through Diabetes Self-Management Education with Davida F. Kruger, MSN, APN-BC, BC-ADM

Click here.