Fernando Visit 1: A 56-year-old male with persistent stiffness and swelling in multiple joints

Title:

Fernando Visit 1: A 56-year-old male with persistent stiffness and swelling in multiple joints

Topic: Rheumatology
Relevant Terms: Arthritis, Early Rheumatoid Arthritis, Joint Erosion, Joint Pain, Rheumatoid Arthritis
Primary Audience: Rheumatologists; Primary Care Physicians; Nurse Practitioners and Physician Assistants caring for patients with rheumatoid arthritis
Launch Date: 01-Sep-11
Credits: 0.5 AMA PRA Category 1 Credit
0.5 ANCC contact hour
Expiration Date: The accreditation for this activity has expired.
Curriculum Name: The Rheumatoid Arthritis Vital Education Initiative

Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

  1. Evaluate the risks and benefits of biologic RA therapy in general for specific patients
  2. Recognize the benefits of more intensive monitoring of RA treatment efficacy
  3. Implement more efficacious RA therapy without compromising safety
  4. Distinguish between comorbidities best addressed in the rheumatology vs. primary care settings
  5. Describe appropriate communication skills to assist patients in making informed decisions about the use of biologic RA therapy
  6. Apply practice improvement tools to better manage comorbidities through enhanced communication with PCPs and patients.

    Faculty

    Jonathan Samuels, MD
    RAVE Activity Director
    Assistant Professor of Medicine
    Division of Rheumatology
    NYU Hospital for Joint Diseases
    New York, NY
    Victoria Ruffing, RN
    Nurse Manager
    Johns Hopkins Arthritis Center
    Baltimore, MD
    Clifton O. Bingham III, MD
    RAVE Activity Director, Associate Professor of Medicine
    Director, Johns Hopkins Arthritis Center
    Divisions of Rheumatology and Allergy and Clinical Immunology
    The Johns Hopkins University, Baltimore, MD
    Presented by the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing.

    ....................
    ...

    Supported by Educational Grants from Abbott Laboratories, Centocor Ortho Biotech Services LLC, Genentech, Inc., and Pfizer, Inc.

    STATEMENT OF NEED
    Three central ideas emerged from our needs assessment. In order to provide optimal treatment to patients with RA, clinicians need:
    • Strategies and tools for accurately monitoring treatment efficacy in order to guide treatment decisions
    • The ability to manage patients' expectations regarding the safety and efficacy of DMARD or other RA therapies
    • The ability to recognize the importance of comorbidities in RA and to develop the framework, tools, and guidance to ensure comorbidities are properly managed

    INTENDED AUDIENCE
    This activity is intended for Rheumatologists, Nurse Practitioners and Physician Assistants caring for patients with rheumatoid arthritis.

    There are no prerequisites.

    ACCREDITATION STATEMENT
    This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

    The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

    The Institute for Johns Hopkins Nursing and the American Nurses Credentialing Center do not endorse the use of any commercial products discussed or displayed in conjunction with this educational activity.

    CREDIT DESIGNATION
    PHYSICIANS: The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
        
    NURSES: 0.5 contact hour Educational Activity is provided by the Institute for Johns Hopkins Nursing. Each RAVE virtual patient visit carries a maximum of 0.05 contact hour Education Activity provided by the Institute for Johns Hopkins Nursing; or a total of 2.0 contact hours for all RAVE virtual patient visits in this program.

    To obtain contact hours, you must complete this Education Activity and post-test before August 31, 2013.

    American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Physician assistants may receive a maximum of two hours of Category 1 credit for completing this program.
     
    Release Date: September 1, 2011
    Expiration Date: August 31, 2013

    COURSE FORMAT
    The RAVE Virtual Clinic will consist of four half-hour activities delivered online and certified for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Upon release of the RAVE Virtual Clinic, participants will have up to two years to complete the four RealCME virtual clinic activities in order to earn CME credit.

    Length of activity: 0.5 credit hours for this RAVE Virtual Clinic activity.

    Methods of participation: Review the interactive case, link to the post-test and upon achieving a score of 70% or higher and completing the evaluation you will be able to print your certificate from your own computer.  The RAVE Virtual Clinic also measures outcomes with separate knowledge assessment tools.

    POST-TEST
    The posttest can be accessed at the end of the activity. A passing grade of 70% or higher on the post-test is required to receive CME credit.

    PRIVACY STATEMENT
    The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protecting the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based program privacy statement. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine's CME program. CME collects only the information necessary to provide you with the services that you request.

    FACULTY DISCLOSURE
    As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentations.

    The following relationships have been reported for this activity:
     
    Company
    Clifton O. Bingham, III, MD

    Grants/Research Report: Bristol Meyers Squibb, Lilly, Roche/Genentech, UCB
    Consultant: Alios, Celgene, Centocor, Flexion, Millennium, Pfizer, Roche/Genentech, UCB
    Educational Grant Support: Abbott, Amgen/Wyeth, Bristol Myers Squibb, Roche/Genentech
    Victoria Ruffing, RN
    Discloses that she has no financial relationship with commercial supporters.
    Jonathan Samuels, MD Discloses that he has no financial relationship with commercial supporters.

     Planning Committee  Company                   
     
    Clifton O. Bingham, III, MD                                           
    Grants/Research Report: Bristol Meyers Squibb,
    Lilly, Roche/Genentech, UCB
    Consultant: Alios, Celgene, Centocor, Flexion,
    Millennium, Pfizer, Roche/Genentech, UCB
    Educational Grant Support: Abbott, Amgen/Wyeth,
    Bristol Myers Squibb, Roche/Genentech
    Victoria Ruffing, RN Discloses that he has no financial relationship with commercial supporters.
    Jonathan Samuels, MD Discloses that he has no financial relationship with
    commercial supporters.

    Grants to investigators at the Johns Hopkins University are negotiated and administered by the institution which receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

    OFF-LABEL PRODUCT DISCUSSION
    The following speakers have disclosed that their presentation will reference unlabeled/unapproved uses of drugs or products:
    Name
    Lecture Titles
    Product
    Clifton O. Bingham, III, MD
    Planner/Faculty Disclosure
    Emerging DMARDs
    Atacicept, Belimumab, Briobacept, Epratuzumab, Fostamatinib, INCB 18424, Secukinumab and Tofacitinib (CP690550)
    Clifton O. Bingham, III, MD
    Planner/Faculty Disclosure
    How to Best Manage Comorbidities JAK inhibitors
     
    DISCLAIMER
    The opinions and recommendations expressed by the faculty and other experts whose input is included in this program are their own. This material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of this educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

    STATEMENT of RESPONSIBILITY
    The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

    CONFIDENTIALITY DISCLAIMER for CME ACTIVITY PARTICIPANT
    I certify that I am attending a Johns Hopkins University School of Medicine CME activity for accredited training and/or educational purposes.

    I understand that while I am attending in this capacity, I may be exposed to "protected health information," as that term is defined and used in Hopkins policies and in the federal HIPAA privacy regulations (the "Privacy Regulations").  Protected health information is information about a person's health or treatment that identifies the person. 

    I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.

    I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality.  The contact information is:  Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.
    __________________________________ ____________________________________
    "The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as provider of this activity, has relayed information with the CME attendees/participants and certifies that the visitor is attending for training, education and/or observation purposes only." 
    For CME Questions, please contact the CME Office
    (410) 955-2959 or e-mail cmenet@jhmi.edu.
    For CME Certificates, please call (410) 502-9634. 
    Johns Hopkins University School of Medicine
    Office of Continuing Medical Education
    Turner 20/720 Rutland Avenue          Reviewed & Approved by:
    Baltimore, Maryland 21205-2195       General Counsel, Johns Hopkins Medicine (4/1/03)  Updated 4/09

    COPYRIGHT
    All rights reserved —  © 2011 JHUSOM and IJHN

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