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CME: Addressing barriers to optimal care in schizophrenia with pharmacotherapy

Activity Description / Statement of Need:

Schizophrenia is a mental health disorder characterized by disrupted neurochemical pathways, thought processes, emotions, and social interactions. While schizophrenia is a heterogeneous disease both across and within patients, it is nonetheless a debilitating disorder for many individuals. An estimated 0.25% to 0.75% of the population suffer from schizophrenia, resulting in about 20.9 million cases and 13.4 million years of life lived with disability worldwide. The goals of treatment for schizophrenia should include not only reducing the number of acute psychotic episodes and reducing the risk for future relapse but also improving quality of life and function beyond symptom relief, such as outcomes related to school, work, and relationships. To achieve these goals, a combination of pharmacologic and non-pharmacologic interventions are recommended. Although current guidelines are explicit about the importance of engaging patients in goal setting and valuing patient preferences, psychiatrists not uncommonly undervalue the importance of improving daily living and capacity for work, suggesting an important practice gap.

Target Audience:

Psychiatrists and primary care physicians; nurse practitioners, physician assistants, and pharmacists who specialize in psychiatry; and those who otherwise commonly care for or clinically encounter patients who have schizophrenia.


This program is supported by an educational grant from Indivor.

Learners may participate in this activity free of charge.


Release Date: November 27, 2020 -- Expiration Date: November 27, 2022

Faculty: Joseph Pierre, MD

Agenda

Faculty introduction, disclosures

Primer on schizophrenia

  • Epidemiology and statistics
  • Pathophysiological development and progression
    • Role of receptors
    • Mechanism of action of first- and second-generation antipsychotics
  • Comorbid neuropsychiatric conditions
  • Diagnostic criteria
  • Differential diagnosis

Updates in schizophrenia treatment and strategies for barriers to care

  • Pharmacotherapy
    • Acute
    • Maintenance
    • The role of adjunctive treatment
    • Targeting positive vs negative symptoms
    • Treatment principles for refractory disease
  • Emerging treatment options and trends
    • Novel therapies
    • Fixed-dose combinations
    • Long-acting injectables
  • 2020 APA guidelines
    • Recommendations
    • Individualizing care
    • Clinical pearls
  • Treatment principles that take consider barriers to care
    • Adherence
    • Adverse event management and mitigation
    • Forming a therapeutic alliance
  • Best practice: Putting it all together
  • Patient cases

Summary, conclusions, and best practice recap

Learning Objectives

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

  • Describe challenges to the successful management of schizophrenia relating to treatment adherence and develop corresponding solutions.
  • Prioritize agents from both first- and second-generation antipsychotics, given a patient case and using patient-centered decision-making.
  • Describe the ways in which understanding of schizophrenia neuropathology has changed and pair that knowledge with treatment mechanisms.
  • List present and emerging treatment options for schizophrenia, including those targeted at negative symptoms and apply them to patient cases using evidence-based medicine.

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.

CME-MOC_badge

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) program. 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.

PhysiciansFor 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 this section, then it does NOT provide MOC credit. Also, MOC credit is award only for the board(s) specified.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. 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 # 0574-0000-20-051-H01-P. CPE credit effective 11/27/20 and expires 11/27/22. This is a Application (A)-type activity.

PharmacistsYou 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 Disclosure: Joseph M. Pierre, MD, Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, has no relevant conflicts of interest to disclose.

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

Disclosures of Peer Reviewers:
Roberto Castaños, MD, has no relevant conflicts of interest to disclose.
Ira D. Glick, MD is a stockholder of Johnson and Johnson and has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This program is supported by an educational grant from Indivor.

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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