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CME: Managing Anticoagulated Patients with Obesity: Focus on Direct Oral Anticoagulants

Activity Description / Statement of Need:

***Please note that, in order to access these course materials, you must create a user profile if you do not already have one. Your profile one ScientiaCME's website is unrelated to your profile on North American Thrombosis Forum's (NATF's) website.***

 

This activity addresses the complexity of managing patients with obesity who require anticoagulation, with a particular focus on the use of direct oral anticoagulants (DOACs). As obesity has become increasingly common, how to best treat these patients with anticoagulation is a frequently encountered clinical question. In this program, speakers from several subspecialties (endocrinology, cardiology, hematology, and bariatric surgery) review the current medical literature on DOAC use in patients with obesity and provide their unique perspectives to address this question. The activity concludes with a case-based debate and Q&A session to facilitate interdisciplinary discussion and provide insights on best management strategies.


The content of this internet enduring material activity was originally presented as part of a live event.

Target Audience:

Physicians, nurse practitioners, physician assistants, pharmacists, and other clinicians specializing in:

  • Cardiology
  • Emergency Medicine
  • Endocrinology
  • Family Medicine
  • Hematology/Oncology
  • Hospital Medicine
  • Internal Medicine
  • Surgery
  • Vascular Medicine

Supported by an educational grant from Janssen Pharmaceuticals, Inc., administered by Janssen Scientific Affairs, LLC.

Participation in this activity is free of charge.


Release Date: May 09, 2022 -- Expiration Date: May 08, 2023

Faculty: Multiple Faculty,

Agenda

An Internist’s Perspective: Understanding Obesity and its Management
Judy Shiau, MD, Dipl.of ABOM – Associate Professor, Division of Endocrinology and Metabolism and Program Director for the Bariatric Medicine Fellowship at the University of Ottawa; General Internist and Medical Director of LEAF Weight Management Clinic

A Cardiologist’s Perspective: How I Treat my Patients with Obesity and CVD
(including AFib)
Aaron Aday, MD, MSc – Investigator, Vanderbilt Translational and Clinical Cardiovascular Research Center at Vanderbilt University Medical Center

A Hematologist’s Perspective: How I Treat my Patients with Obesity and VTE
Tzu-Fei Wang, MD, MPH – Associate Professor of Medicine at The University of Ottawa in the Division of Hematology

A Bariatric Surgeon’s Perspective: How I Treat my Anticoagulated Patients
Undergoing Bariatric Surgery
Malcolm K. Robinson, MD – Associate Professor at Harvard Medical School; Vice Chairman of the Department of Surgery for Clinical Operations, Surgical Director of Perioperative Services, and Director of the Nutrition Support Service at Brigham and Women’s Hospital

Case-Based Debates and Q&A:
Moderated by Dr. Allen Taylor, MD – Chairman of Cardiology at MedStar Heart and Vascular Institute

Case 1: DOAC Use in a Patient with Obesity and AFib
Aaron Aday, MD, MSc – Investigator, Vanderbilt Translational and Clinical Cardiovascular Research Center at Vanderbilt University Medical Center

Case 2: DOAC Use in a Patient with Obesity and VTE
Tzu-Fei Wang, MD, MPH – Associate Professor of Medicine at The University of Ottawa in the Division of Hematology

Case 3: DOAC Use in a Patient Who Has Undergone Bariatric Surgery
Malcolm K. Robinson, MD – Associate Professor at Harvard Medical School; Vice Chairman of the Department of Surgery for Clinical Operations, Surgical Director of Perioperative Services, and Director of the Nutrition Support Service at Brigham and Women’s Hospital

Panel Discussion

Learning Objectives

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

  • Describe best practices for defining and measuring obesity, and the complexity revolving around the management of obesity
  • Recognize the unique clinical challenges that may impact DOAC use in patients with obesity
  • Discuss the latest data on indications for DOAC use in patients with obesity, including atrial fibrillation, VTE, and in the setting of bariatric surgery
  • Identify limitations of various guideline recommendations pertaining to DOAC use in patients with obesity
  • Assess optimal prophylactic and therapeutic anticoagulation strategies in patients with obesity

Accreditation

ACCME Activity #202289556

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 ScientiaCME and NATF. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of **2 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.

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.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2 contact hours (0.2 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 group of presentations and complete the course evaluation to receive continuing pharmacy education credit.  ACPE UAN: 0574-9999-22-003-H01-P.

This is an Application (A)-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.

The CPE statements of credit contain information provided to NABP from the Accreditation Council for Pharmacy Education (ACPE) via CPE Monitor®. ACPE policy states paper and/or electronic statements of credit may no longer be distributed directly to learners as proof of ACPE credit. The official record of credit may be located in the learner’s e-profile in CPE Monitor®.

Faculty Disclosure and Resolution of COI

  • Aaron Aday, MD, MSc: Paid Consultant – OptumCare
  • Allen Taylor, MD: Speaker – Amgen, Espirion
  • Judy Shiau, MD, Dipl.of ABOM: Speaker – Bausch Health, Novonordisk, Abbvie; Advisor – Bausch Health, Novonordisk; Research Grant – Bausch Health, Nestle Health Science
  • Tzu-Fei Wang, MD, MPH: Research Grant – Leo Pharma; Advisory Board – Servier

 

Individuals with no con´Čéicts of interest to disclose: 

  • Content reviewer: Charles J Turck, PharmD, BCPS, BCCCP, President, ScientiaCME
  • Malcolm K. Robinson, MD

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.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • 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.