Free CME

Activity Description / Statement of Need:

In this online, self-learning activity:

Advances in ALL management has led to considerable improvements in outcomes over the past several years, with modern-day treatment leading to remission rates of up to 99% and cure rates of about 90% in children with ALL. However, achieving these high rates of response require multiple phases of treatment, including induction, consolidation, interim maintenance, delayed intensification, and maintenance therapy. 

Chemotherapy was previously the standard of care in this setting but is associated with considerable toxicities. Novel, less toxic options are available or being studied for children who have relapsed after treatment as are new pharmacotherapies specific to patients with Philadelphia chromosome–positive disease and novel formulations of asparaginase. Helping the clinician discern the role of each of the first- and subsequent-line novel therapies based on the most up-to-date research merits continuing education programming in ALL. Indeed, a survey of oncology providers revealed that 86% indicated that added professional guidance would be helpful in incorporating more recent therapies into care.

And despite the inclusion of newer agents in pediatric ALL guidelines, a survey of oncologists and other providers who treat patients with the condition found that 40% of respondents had never prescribed, dispensed, or administered them. Challenges include lack of expertise and management of side effects. Furthermore, recently published guidelines, therefore, also inherently suggest a gap in medical practice and justify the need for educational programming.

Target Audience:

HCPs specializing in: pediatric hematology-oncology, hematology, oncology, pathology, and those who otherwise commonly care for or clinically encounter pediatric patients with ALL.

Activity Description / Statement of Need:

In this online, self-learning activity:

Atopic dermatitis (AD) is a chronic, highly pruritic inflammatory skin disease that is one of the most common skin disorders in children but may develop at any age. It affects 15-30% of children and two to ten percent of adults in developed countries, and between 10-30% of children who have the condition continue to experience it in adulthood. AD is thought to arise from a complicated interplay between multiple genes and environmental triggers, with known risk factors including family history and loss of function mutations in filaggrin. Complications include food allergy, asthma, and allergic rhinitis, and aside from genetics, its pathophysiology involves T-cell mediated inflammation and epidermal dysfunction. The disease is associated with a considerable healthcare burden placed on patients and their families; pruritis aside, patients not uncommonly suffer a loss of sleep and experience secondary infections, anxiety, and depression.

Target Audience:

The following HCPs: Pediatric and adult dermatologists, allergists, and internists; physician assistants, nurse practitioners, and pharmacists who treat patients with dermatologic conditions; and any other HCPs with an interest in or who diagnose, treat, or manage patients with AD.

Each year, over 268,000 cases of prostate cancer are diagnosed. Although early prostate cancer may be cured with surgery or radiation therapy, more than 50% of men will experience recurrence after definitive treatment. New treatment options for advanced prostate cancer have further improved survival and increased the number of patients living with castration-resistant prostate cancer (CRPC). But despite the established improvements in survival, a cornerstone of treatment, androgen deprivation therapy (ADT), has been associated with well-characterized negative effects on bone health like skeletal-related events (SREs) and bone metastases. These complications the primary drivers of morbidity and mortality among people with CRPC. Maintaining bone health in patients with CRPC requires routine monitoring and proactive management. Bone mineral density (BMD) loss places men with CRPC at elevated risk for osteoporosis and future fractures.

Each year, more than 290,000 cases of breast cancer are diagnosed, making it the leading cause of cancer among females in the United States. Although earlier screening and more effective treatment options have improved outcomes among people with breast cancer, more than 43,000 people die from this type of cancer each year. Throughout the course of breast cancer management, bone health remains an important consideration. In early breast cancer, chemotherapy-induced ovarian failure and endocrine therapy can contribute to BMD loss and subsequent osteoporosis and fracture. In advanced breast cancer, about 70% of all patients will experience bone metastases, placing patients at risk for SREs. In fact, breast cancer is associated with the highest risk of SREs among all tumor types.

Maintaining bone health in patients with breast cancer requires routine monitoring and proactive management to minimize the risk of BMD loss, osteoporosis, and SREs. Guidelines therefore recommend that patients with non-metastatic breast cancer initiating aromatase inhibitors or other treatment that causes bone loss undergo dual-energy X-ray absorptiometry (DXA) scans to assess baseline BMD. Furthermore, patients at risk for osteoporosis should receive regular follow-up DXA scans to monitor for BMD loss. This represents an opportunity for ongoing education about the need for monitoring to ensure maintenance of optimal bone health.

Activity Description / Statement of Need:

In this online, self-learning activity:

Neutropenia, a decrease in the number of a type of white blood cell (WBC) in the body, is a common complication in patients undergoing myelosuppressive chemotherapy that can result in serious, life-threatening infections. Febrile neutropenia (FN), or neutropenia accompanied by a fever, poses an even greater risk to patients and the frequent treatment complication results in over 100,000 hospitalizations in the U.S. each year. Neutropenia can manifest up to twelve days following treatment with a chemotherapy agent and FN occurs in about eight per 1,000 patients receiving chemotherapy. Fever is defined as a single oral temperature of 38.3+ °C or 38.0+ °C over the course of an hour, with neutropenia defined as less than 500 neutrophils/mcL or less than 1000 with a predicted decline to less 500 over the following 48 hours. Development of FN may lead to hospitalization with costs estimated at approximately $15,000 per visit, and it may also complicate care by reducing chemotherapy relative dose intensity (RDI) and possibly compromise treatment efficacy and lower survival rates.

Target Audience:

Oncologists and hematologists; physician assistants, nurse practitioners, and pharmacists who practice in oncology; and other HCPs with an interest in or who clinically encounter patients with FN or at risk of developing it.

Activity Description / Statement of Need:

In this online, self-learning activity:

Lung cancer is the leading cause of cancer-related death in the United States with over 235,000 new cases diagnosed and representing a quarter of all cancer deaths at a rate of 132,000 annually. While smoking contributes to 82% of lung cancer deaths, nonsmoking-related lung cancer deaths still fall in the top ten causes of cancer deaths and represents a growing proportion of cases. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer diagnosed, accounting for approximately 80% of patients diagnosed. Despite clear guidance on surveillance for disease in individuals at high risk, late diagnosis is a fundamental obstacle to improving lung cancer outcomes. 55% of NSCLC cases are diagnosed after metastasis, at which point the two- and five-year survival rates are 20% and 6.1%, respectively, whereas patients diagnosed with local disease experience survival rates of 81% and 61.4%, respectively. Treatment decisions are influenced by disease stage, histology (squamous vs. non-), and the tumor’s molecular features (e.g., PD-L1, EGFR, ALK, BRAF, NTRK, ROS1), although patient factors like performance status and comorbidities should also inform the development, optimization, and personalizing of individual treatment plans. First-line therapy for patients with advanced-stage NSCLC who are anti-programmed-death 1 (PD-1) positive is immunotherapy with a targeted monoclonal antibody. Targeted therapies are also preferred over platinum-based doublets as first-line therapy in patients whose tumors have targetable genetic mutations. The care plan need take into account management of adverse events from therapy, which may result in treatment delays, increased morbidity, or contribute to treatment failure.

Target Audience:

HCPs specializing in: Oncology, pulmonology, and pathology; physician assistants, nurse practitioners, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with advanced NSCLC.

Activity Description / Statement of Need:

In this online, self-learning activity:

Dry eye disease (DED) is a condition with a diverse group of etiologies and whose common symptoms include discomfort or pain, visual disturbance, tear film instability, and ocular surface inflammation. Compared with those without the condition, patients with DED experience higher rates of loss of work productivity, impaired of daily activities, medical visits, and sleep and mood disorders, and worse emotion well-being and overall quality of life. Although the prevalence of DED varies based on a variety of patient factors, estimates place it as high as 20% of the adult population and more than 34% in the elderly. The aggregate U.S. economic impact is estimated be over $3 billion in direct medical expenses and $55 billion in indirect expenses annually. Nonetheless, DED is both underdiagnosed and undertreated.

Target Audience:

The following HCPs: ophthalmology and optometry; physician assistants and nurse practitioners who practice or are interested in ophthalmology; and any other healthcare professionals with an interest in or who clinically encounter patients with dry eye.

Primary immunodeficiency disorders (PIDD) comprise a group of 430 different known inborn errors of immunity. The heterogeneous etiology of PIDD leads to a vast array of clinical presentations, including infection, malignancy, autoimmunity, and inflammation. Once thought to be exceedingly rare, PIDD is increasingly being recognized as an underdiagnosed disease affecting between one in 1,000 to one in 5,000 births.

Because a significant percentage of people with PIDD are undiagnosed, improving the recognition of PIDD signs and symptoms necessarily forms the foundation of PIDD-focused medical education efforts. Early treatment improves outcomes and health-related quality of life in children and adults with PIDD, yet time from symptom onset to diagnosis can exceed 4 years. Diagnostic lag has serious consequences for many patients with PIDD due to recurrent infections, which may take a toll on pulmonary function. In a large-scale analysis of patients with common variable immunodeficiency, a common form of PIDD, risk of death increased by 1.7% each year of diagnostic delay.  The most up-to-date guidance around the classification of PIDD and how to determine related genetic tests has been published relatively recently. Communicating related information to HCPs in a timely manner is a demonstrated need.

Activity Description / Statement of Need:

In this online, self-learning activity:

Glaucoma, a heterogeneous disease leading to progressive damage to the optic nerve, causes irreversible vision loss and affects approximately 64 million people worldwide.The prevalence of glaucoma is increasing, and more than 100 million people will have glaucoma by 2040. Approximately half of all individuals with glaucoma are unaware of their condition due to the asymptomatic nature of the disease. Although the incidence of glaucoma-related blindness has decreased over the last 20 years, thanks to effective management strategies, 13% to 40% of people with glaucoma still develop unilateral or bilateral blindness, typically at a rate of 1.1% per year.

Target Audience:

The following healthcare professionals: Ophthalmologists; physician assistants, nurse practitioners, nurses, and pharmacists with an interest in ophthalmology or diseases affecting the eye; and any other healthcare professionals with an interest in or who clinically encounter patients with glaucoma.

Activity Description / Statement of Need:

In this online, self-learning activity:

Osteoporosis is a disease common among elderly patients and is increasing in frequency as senior citizens begin to represent a larger share of the US population. In the US, fragility fractures are associated with 1.7 million hospitalizations, and the number of annual of osteoporotic fractures is expected to rise to three million annually in the next few years, with annual treatment costs expected to be $25.3 billion. Despite the morbidity and mortality associated with osteoporosis, practice gaps related to suboptimal screening, risk assessment, and management practices have led to underdiagnosis and undertreatment of this condition. Osteoporosis screening may identify people at increased risk of low-trauma fracture who may benefit from interventions to minimize risk. The USPSTF recommends screening for osteoporosis with BMD testing in all women 65 years or older and in postmenopausal women younger than 65 years but at increased risk of osteoporosis. However, the literature has consistently illustrated underutilization of screening and diagnostic measures. About 60% of women for whom the USPSTF recommends screening do not receive BMD testing,  with some patient populations more likely than others to miss out on screening and care. Clinicians should be aware that prior fragility fracture is sufficient for diagnosis of osteoporosis, and yet only one-quarter of patients with a prior fragility fracture were aware they had this condition. Underdiagnosis therefore represents a compelling safety consideration, as 20% of patients become dependent on long-term care after a hip fracture, and 20% die within a year from related complications.

Target Audience:

HCPs specializing in: endocrinology, internal medicine, geriatrics, and women’s health; physician assistants, nurse practitioners, and pharmacists who practice in those areas of specialty; and those who otherwise commonly care for or clinically encounter patients with postmenopausal osteoporosis.