ScientiaCME Free CME Courses

Activity Description / Statement of Need:

In this online, self-learning activity:

Immune thrombocytopenia (ITP) is a phenomenon characterized by a peripheral platelet count of less than 100 x 109/L in the absence of any discernable cause, with an increased risk of bleeding. Also known as thrombocytopenic purpura, it occurs in around two to four cases per 100,000 adults, with incidence peaking bimodally: Once between 20-30 years with female predominance and also at 60 years with even distribution between the sexes.

The diagnosis of ITP is one of exclusion and includes platelet autoantibody testing. However, it is complicated and associated with documented gaps in care, with preventable delays in diagnosis and misdiagnosis not uncommon. One study found that one in seven patients diagnosed with ITP were misdiagnosed and reclassified as they received additional clinical evaluation. Another study found that over 22% of patients with ITP did not receive guideline-recommended peripheral blood film examination. These diagnostic challenges have real-world consequences on patient lives, creating anxiety in 73% of patients who experience a delayed diagnosis.

Treatment goals include prevention of severe bleeding episodes, maintaining platelet counts for symptomatic patients, minimizing treatment toxicity, and maximizing health-related quality of life. Conventional therapy includes corticosteroids, intravenous immunoglobulin (IVIg), and anti-D IVIg. However, treatment challenges remain, including variability in practice between providers and high rates of relapse between following standard first-line therapies together with considerable patient frustration. Moreover, some patient subpopulations are more challenging to treat and are less likely to achieve therapeutic success.

Target Audience:

HCPs specializing in: hematology; physician assistants, nurse practitioners, nurses, pharmacists; and any other healthcare professionals with an interest in or who clinically encounter patients with ITP.

Activity Description / Statement of Need:

In this online, self-learning activity:

Hemophilia is a genetic disease caused by mutation of one of the genes for coagulation proteins leading to dangerous, uncontrolled bleeding. In hemophilia B, a mutation in the gene for factor IX (FIX) leads to an endogenous deficiency in the clotting factor. The incidence of hemophilia B is the same in all geographic regions, populations, and ethnic groups, affecting approximately 1 out of every 30,000 male births. The condition is diagnosed by measuring FIX activity, and patients with severe hemophilia have levels of 1% or less. Patients with severe hemophilia B are at risk for spontaneous, life-threatening bleeding episodes. Untreated, the life expectancy is approximately 20 years, and painful or even life-threatening morbidities include: intracranial hemorrhage, severe bleeding in other organ systems, musculoskeletal injury, and joint injury. In contrast, in people with moderate or mild hemophilia, abnormal bleeding usually occurs after minor trauma or surgery. Unfortunately, the literature shows that not only do clinicians struggle with the classification of hemophilia severity and that there are gaps in knowledge present that contribute to delayed diagnosis and treatment, with an attendant increase in morbidity and mortality. Challenges in diagnosis and classification are only the first of several gaps in care that patients with hemophilia face.

Target Audience:

The following HCPs: hematologists and pediatricians; physician assistants, nurse practitioners, and pharmacists who practice in hematology, and other HCPs who practice in hemophilia treatment center; and any other clinicians with an interest in or who clinically encounter patients with hemophilia B.

Activity Description / Statement of Need:

In this online, self-learning activity:

Pompe disease (PD) is a progressive, often fatal, autosomal recessive, neuromuscular disorder caused by mutations of the α-glucosidase gene on chromosome 17. PD is characterized by glycogen accumulation in skeletal, cardiac and smooth muscles due to a deficiency in α-glucosidase (GAA), an important lysosomal enzyme responsible for glycogen catabolism. PD is categorized into three groups based on symptoms and age of onset. The classic infantile form presents in the first year of life, usually in the first two months, with hypertrophic cardiomyopathy. The non-classic infantile form presents later in the first year of life, without or with less severe cardiomyopathy. The late onset form of PD presents any time after one year of life, usually without cardiac complications.

PD is rare, with one study estimating the incidence in the U.S. to be 1 in 22,000 births. The biggest risk factor for the disease is genetics; at conception, each sibling of an affected individual has a 25% chance of being affected, a 50% chance of being an asymptomatic carrier, and a 25% chance of being not a carrier. Nonspecific diagnostic findings for PD may include abnormal EMG, elevated serum creatine kinase, elevated transaminases and elevated lactate dehydrogenase. A definitive diagnosis for PD involves a dried blood spot test to determine GAA enzyme activity level; reduced GAA activity (less than 40% of normal) is indicative of a positive diagnosis. A gene mutation analysis, or another GAA enzyme test using a different area of tissue, is recommended to confirm the diagnosis. The disease is not uncommonly undiagnosed or is misdiagnosed, representing one practice gap that continued HCP education may address, particularly given that earlier treatment may minimize rapid and irreversible disease progression.

Target Audience:

The following HCPs: Neurologists, pediatricians, and primary care physicians; physician assistants and nurse practitioners in those areas of specialty; pharmacists who practice in specialty pharmacies that treat patients with rare diseases; and any other HCPs with an interest in or who may clinically encounter patients with PD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Pyruvate kinase (PK) is an enzyme that plays a major role in a metabolic pathway integral to the production of ATP, and a deficiency in the enzyme (PKD) is one of the most common enzyme-related glycolytic defects in a pathway integral to the production of ATP. It is transmitted as an autosomal recessive trait and is caused by mutations in the PKLR gene on chromosome 1, and over one hundred eighty of these mutations have been associated with PKD. While PKD affects approximately five people of European descent per 100,000 (data in other patient populations are lacking), it is one of the more frequent causes of chronic hemolysis. Anemia arising from the condition may range from mild and fully compensated to life-threatening in severity.

Target Audience:

Healthcare professionals specializing in: hematology; nurse practitioners, physician assistants, and pharmacists who specialize in hematology; and those who otherwise commonly care for or clinically encounter patients with PKD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Heart failure (HF) is a clinical syndrome arising from diminished ventricular filling or ejection of blood. HF with reduced ejection fraction (HFrEF) is characterized by abnormality in the systolic function and a left ventricular ejection fraction (LVEF) of <40%. The prevalence of HF is about 40 million people globally and approximately 6.5 million in the U.S., and as the global population continues to age, the prevalence of HF is expected to continue increasing over the coming decades. HFrEF constitutes a major public health concern, with five-year survival rates as low as 25%, and it carries with it a significant risk of emergency department visits and hospitalizations.

There has been increased focus recently on guideline-directed medical therapy (GDMT) in HFrEF, and evidence suggests that each ten percent improvement in measures of guideline-recommended composite care is associated with a thirteen percent lower odds of 24-month mortality. Nonetheless, research shows that substantial portions of patients are not treated with guideline-recommended doses, even after taking into account dose-limiting physiological parameters, and that guideline non-adherent practice is associated with poorer outcomes.

Target Audience:

The following HCPs: Cardiologists and PCPs; physician assistants, nurse practitioners, and pharmacists who practice in cardiology; and any other HCPs with an interest in or who clinically encounter patients with HFrEF.

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:

Non-alcoholic steatohepatitis (NASH) is a form of non-alcoholic fatty liver disease (NAFLD) characterized by steatosis, with the accumulation of fat in the liver in excess of five percent of the liver’s weight, together with hepatic inflammation in the presence or absence of fibrosis. Risk factors for NASH include a number of comorbid metabolic diseases and disorders, including metabolic syndrome, obesity, type 2 diabetes, hypertension, and dyslipidemia. The prevalence of NASH is estimated to be 1.5%-6.45% of the U.S. population, and prevalence of NASH among NAFLD patients to be 59.1% globally.

Target Audience:

The following HCPs in: Gastroenterology, hepatology, and endocrinology; physician assistants, nurse practitioners, and pharmacists who practice in the aforementioned areas of specialty; and those who otherwise have an interest in or commonly care for or clinically encounter patients with NAFLD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Irritable bowel syndrome (IBS) is among the most common disorders seen by primary care as well as gastroenterology specialty clinics. Patients with IBS usually present with chronic abdominal pain and altered bowel habit, in the absence of any other disease to cause these sorts of symptoms. While the precise pathophysiology is still an area of active investigation, it appears to include a neuro-enteric disconnect, leading to intestinal somato-visceral and motor dysfunction. Genetic, immune function, microbiome, psychological, and environmental factors may also predispose patients to develop of IBS. Its prevalence varies according to country and the criteria used to define it. In North America and Europe, it has a 10-15% prevalence, and it varies by country. In the U.S. and Canada, IBS symptoms are 1.5 to 2 times more prevalent among women. Women commonly report abdominal pain and constipation while men report diarrhea. The disorder is associated with annual healthcare expenditures of $20 billion and significant costs in lost work productivity and health-related quality-of-life. 

Target Audience:

The following HCPs: Gastroenterologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in gastroenterology and internal medicine; and any other HCPs with an interest in or who clinically encounter patients with IBS-C.

Activity Description / Statement of Need:

In this online, self-learning activity:

Ocular allergy (OA), also known as allergic eye disease, is an ocular surface hypersensitivity disorder resulting from an abnormal immunologic response of the eye to various antigens. It is not a single clinical entity, rather it includes the following conditions with differing hypersensitivity mechanisms, diagnostic criteria, pathogenesis, and management strategies: seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis, giant papillary conjunctivitis, and contact dermatoconjunctivitis. OA affects approximately 40% of the global population, with SAC and PAC specifically affecting 15 to 25%. Ocular itch associated with SAC and PAC is the hallmark symptom of the disease. The multifactorial dimensions of OA contribute to economic ramifications in the United States (US) estimated at $2 billion annually in prescriptions, with the costs associated with over-the-counter (OTC) medications projected to be tenfold higher than prescription sales.

Target Audience:

The following HCPs: ophthalmologists, allergists, and general practitioners; physician assistants and nurse practitioners in the aforementioned areas of specialty; and any other clinicians involved or interested in the treatment of ocular allergy.

Activity Description / Statement of Need:

In this online, self-learning activity:

Alzheimer disease (AD) is a degenerative disease that most commonly affects the elderly, although it is occasionally detected as early as middle age. AD’s prevalence has more than doubled since the year 2000, with recent data suggesting that it will double again by the year 2050. In 2020, AD was the seventh-leading cause of death in the US, and the COVID-19 pandemic has further increased AD-related mortality by 16%. Furthermore, AD impacts the family members and loved ones of people with AD. More than 11 million Americans are estimated to provide 15.3 billion hours of unpaid care, with costs expected to exceed $1 trillion by the year 2050.

AD has traditionally been difficult to diagnose because its onset is oftentimes insidious, with a definitive diagnosis made only on neural tissue examination. The disease is often undetected in its early stages because the symptoms can be similar to cognitive decline that is generally assumed to occur naturally with the aging process, such as forgetfulness and difficulty learning new information. When a patient presents with possible AD, the gathering of information from the family members and specific cognitive tests are used to rule out other possible diseases and to rule in the probable diagnosis of AD. While a number of different practice guidelines are available, but none are recent enough to cover the incorporation of monoclonal antibodies into care and developments in the treatment of early Alzheimer’s disease, including eligible candidates for therapy. Helping the clinician discern the role of these agents merits CME as research suggests that HCPs are unable to keep up with the  publishing of literature and evolution of clinical practice.

Target Audience:

The following HCPs: Neurologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in neurology; and any other HCPs with an interest in or who clinically encounter patients with AD or who frequently encounter them or their caregivers in practice.