Program Description
(AS OF 2/9/2010- THIS PROGRAM HAS EXPIRED)
Treatment options for chronic constipation and irritable bowel syndrome with constipation (IBS-C) range from dietary and lifestyle changes to over-the-counter and prescription medications. In this segment, leading gastroenterologists will discuss the latest evidence on the efficacy of nonpharmacologic and pharmacologic treatment options for chronic constipation and IBS-C.
Hosted by
Shira Johnson, MD
Learning Objectives
- Understand the most recent data on available nonpharmacologic and pharmacologic treatment options for constipation and IBS-C and formulate evidence-based therapeutic strategies that take into consideration the efficacy, safety, and tolerability of available options.
Target Audience
MDs, PAs, NPs, nurses, and pharmacists.
Faculty/Disclosures
Lin Chang, MD
Professor of Medicine
Division of Digestive Diseases
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, CA
William Chey, MD, AGAF, FACG, FACP
Professor of Internal Medicine
Director, GI Physiology Laboratory
Division of Gastroenterology
University of Michigan Health System
Ann Arbor, MI
Faculty Disclosures:
In accordance with the Accreditation Council for Continuing Medical Education (ACCME), the Texas Academy of Family Physicians (TAFP) requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest.
Accordingly:
Dr. Chang reported that she receives grant or research support from Prometheus and Rose Pharma A/S. She also reported that she is a consultant to Prometheus; Takeda Pharmaceuticals North America, Inc.; Salix Pharmaceuticals, Inc.; Albireo; Ironwood Pharmaceuticals, Inc.; Forest Laboratories, Inc.; Tioga Pharmaceuticals; and Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Dr. Chey reported that he is a consultant to and speaker for Procter & Gamble; Salix Pharmaceuticals, Inc.; and Takeda Pharmaceuticals North America, Inc. He also reported that he is a consultant to AGI Therapeutics plc and Ironwood Pharmaceuticals, Inc.
Helen Kim, medical writer for TCL Institute, LLC, has nothing to disclose.
TAFP and TCL Institute staff members that were involved in the development of this activity have no financial relationships with any commercial interests that are relevant to this activity.
To resolve identified conflicts of interest, the educational content was fully peer reviewed by a physician member of the TAFP Content Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.
Accreditation
Physicians: This activity has been planned and implemented in accordance with the Essentials and Standards of the ACCME through the cosponsorship of TAFP and TCL Institute, LLC. TAFP is accredited by the ACCME to provide continuing medical education for physicians.
TAFP designates this educational activity for a maximum of 0.50 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This activity has been reviewed and is acceptable for up to 0.5 Prescribed credits by the American Academy of Family Physicians (AAFP). Of these credits, 0.25 conforms to the AAFP criteria for evidence-based CME (EB CME) clinical content. CME credit has been increased to reflect 2 for 1 credit for only the EB CME portion. AAFP accreditation begins 2/9/09. The term of approval is for 1 year from this date, with option for yearly renewal. When reporting AAFP credit, report total Prescribed and Elective credit for this activity. It is not necessary to label credit as EB CME for reporting purposes.
The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since clinical research is ongoing, AAFP recommends that learners verify sources and review these and other recommendations prior to implementation into practice.
PRACTICE RECOMMENDATION: The use of polyethylene glycol and lubiprostone for the management of chronic constipation is appropriate when dietary management is inadequate.
Name of Source (Web site or Journal) Used: National Guideline Clearinghouse Web
• Ternent CA, Bastawrous AL, Morin NA, et al. Practice parameters for the evaluation and management of constipation. Dis Colon Rectum. 2007;50:2013-2022.
Strength of Evidence: Level of Evidence: Class II; Grade of Recommendation: A
Levels of Evidence
I. Meta-analysis of multiple well-designed, controlled studies, randomized trials with low false-positive and low false-negative errors (high power)
II. At least one well-designed experimental study; randomized trials with high false-positive or high false-negative errors or both (low power)
III. Well-designed, quasi-experimental studies, such as nonrandomized, controlled, single-group, preoperative-postoperative comparison, cohort, time, or matched case-control series
IV. Well-designed, nonexperimental studies, such as comparative and correlational descriptive and case studies
V. Case reports and clinical examples
Grades of Recommendations
A. Evidence of Type I or consistent findings from multiple studies of Type II, III, or IV
B. Evidence of Type II, III, or IV and generally consistent findings
C. Evidence of Type II, III, or IV but inconsistent findings
D. Little or no systematic empirical evidence
Physician Assistants: AAPA accepts Category 1 credit from AOACCME, Prescribed credit from AAFP, and AMA Category 1 CME credit for the PRA from organizations accredited by the ACCME.
Nurse Practitioners: This program has been approved for 0.50 contact hours of continuing education by the American Academy of Nurse Practitioners. Program ID 0812567.
Nurses: TCL Institute, LLC is a provider approved by the California Board of Registered Nursing, Provider Number 15225, for 0.6 contact hours. RNs outside of California must verify with their licensing agency for approval of this course.
Pharmacists:
Purdue University School of Pharmacy and Pharmaceutical Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This is a knowledge-based, continuing education activity of Purdue University, an equal access/equal opportunity institution. Universal Program Number (UPN): 018-999-09-005-H01-P, 0.50 contact hour (.05 CEU). Release date: February 9, 2009. Expiration Date: February 9, 2010.
Provider
This activity has been planned and produced by TAFP and TCL Institute, LLC strictly as a nonpromotional continuing education activity.
This activity is part of a larger educational curriculum on constipation and IBS. For more information, please visit www.totalmeded.com.
Commercial Support
This activity is supported by an educational grant from Sucampo Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.
Legal Disclaimer
The material presented in all activities is offered solely for educational purposes. TAFP; Sucampo Pharmaceuticals, Inc.; Takeda Pharmaceuticals North America, Inc.; and TCL Institute, LLC disclaim any and all claims that may result from use of information presented in this activity. Material contained herein may be graphic but is intended for clinical use.
It is the policy of TAFP that all CME planning committee members and TAFP and TCL Institute, LLC staff disclose relationships with commercial entities. Disclosure documents are reviewed for potential conflicts of interest, and if a conflict is identified it is resolved prior to confirmation of participation. Only those participants who have no conflict of interest or who agree to an identified resolution process prior to their participation were involved in developing this CME activity.