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CME: Short bowel syndrome: therapeutic updates and optimizing treatment

Activity Description / Statement of Need:

In this online, self-learning activity:

Short bowel syndrome (SBS) is a condition in which a patient exhibits malabsorption-induced diarrhea, dehydration, electrolyte imbalances, and malnutrition due to decreased nutrient absorption that results from extensive surgical resection of the intestine or congenital defects. It is a form of intestinal failure (IF), which is defined as a need for supplementary parenteral or enteral nutrition when intestinal function is insufficient to meet the body’s nutritional requirements. The prevalence of SBS has been estimated to be 3–4 per million patients in the U.S. based on home parenteral nutrition (HPN) data, and in adults undergoing intestinal resection, SBS is estimated to occur in 15% of adult patients, with 75% of patients undergoing a single massive resection.

Target Audience:

The following healthcare professionals: gastroenterologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in gastroenterology; and any other healthcare professionals with an interest in or who clinically encounter patients with short bowel syndrome.


This activity is supported by an educational grant from Shire.


Release Date: May 02, 2019 -- Expiration Date: May 02, 2021

Faculty: Douglas Nguyen, MD

Agenda

Introduction and disclosures

Pathophysiology, diagnosis, and complications

·        Epidemiology

·        Etiology

·        Risk factors, diagnosis

·        Parenteral Nutrition-Related Complications

·        Bowel Anatomy-Related Complications

Short bowel syndrome management

·       Nutrition therapy (acute, transition, and chronic management): diet, EN, PN, adjunct pharmacotherapy for fluid loss

·         Teduglutide: role in therapy, dosing and administration

·         Vitamin D supplementation: serum 25-OHD and BMD monitoring

·         Autologous surgical reconstruction

·         Patient and provider education

·         Practice Gaps

Summary, conclusions

Learning Objectives

By the end of the session the participant will be able to:

  • Identify patients at risk for short bowel syndrome
  • Describe proper diagnostic of short bowel syndrome
  • Define patient-specific goals, identify treatments directly managing SBS, and incorporate both in the development of a treatment plan in patient cases
  • Describe barriers to care in the optimal treatment of SBS and suggest strategies for ameliorating them

Accreditation

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

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) activity. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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Physicians: For applicable courses, to attain maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in the "Accreditation" section on this page, then it does NOT provide MOC credit.

Pharmacists

 

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This activity is approved for 1.0 hours (0.1 CEUs) of continuing education.  Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test.   Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.  ACPE # 0574-0000-19-017-H01-P.  ACPE Accreditation effective 5/12/19 expires 5/12/21. This is a Knowledge (K)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

 

Faculty & Planner Disclosures:

Douglas Nguyen, M.D., Associate Clinical Professor of Medicine, Univ of California, Irvine, discloses that he is a consultant and on speaker's bureau for Abbvie, Janseen, Nestle, and Gilead.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This activity is supported by an educational grant from Shire.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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