Ensuring Optimal Integration of the GLP-1 Receptor Agonists: Review of the Latest Advances and Current Gaps in Care

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This program has been endorsed by the International Diabetes Center at Park Nicollet.

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Release Date: January 30, 2020
Expiration Date: January 30, 2021

PROGRAM OVERVIEW
Almost 10% of the US population has diabetes, and half are not achieving glycemic goals. GLP-1 receptor agonists (GLP-1 RAs) work by decreasing glucagon secretion in a glucose-dependent manner and by activating the GLP-1 receptor, increasing insulin release in the presence of elevated glucose concentrations. There are common misperceptions about injectable GLP-1 RAs, including an overestimation of patient fears of injection pain, that cause these agents to be under-prescribed.

Based on recent clinical-trial data, one GLP-1 RA is approved not only as an adjunct to diet and exercise to improve glycemic control in adults with T2DM, but also to reduce the risk of major cardiovascular events in adults with T2DM and established cardiovascular disease. GLP-1 RAs represent a unique approach to T2DM treatment, with potential benefits extending beyond glucose control and including positive effects on body weight, blood pressure, and beta-cell function. This activity, “Ensuring Optimal Integration of the GLP-1 Receptor Agonists,” will update primary care clinicians on the safety and efficacy data for approved GLP-RAs, review the most recent guideline and expert recommendations for their use, and suggest strategies to overcome barriers to their use in appropriate patients.

TARGET AUDIENCE
This activity is intended for primary care providers (PCPs) involved in the education and management of adults eligible for treatment with GLP-1 RAs.

EDUCATIONAL OBJECTIVES 

This program is designed to address ACGME and NAM competencies, including delivering patient-centered care and practicing evidence-based medicine.

At the conclusion of this activity, participants should be able to:

  • Evaluate the latest safety and efficacy data for each approved GLP-1 RA

  • Incorporate GLP-1 RAs into effective T2DM treatment plans based on the latest expert and guideline recommendations

  • Develop strategies to overcome misconceptions and barriers with the use of GLP-1 RAs in patients with T2DM

ACCREDITATION STATEMENT
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 Boston University School of Medicine and Rockpointe. Boston University School of Medicine is accredited by the ACCME   to provide continuing medical education for physicians.

CME DESIGNATION STATEMENT
Boston University School of Medicine designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

.For information about the accreditation of this program, please email: cme@bu.edu.

ABIM MOC DESIGNATION STATEMENT
 Successful completion of this CME activity, which includes participation in the evaluation component, enables   the participant to earn up to 1.00 Medical Knowledge MOC points in the American Board of Internal   Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

To receive CME credit and/or MOC points, you MUST pass the post-test and complete the evaluation. For ABIM MOC points, your information will be shared with the ABIM through BUSM’s ACCME Program and Activity Reporting System (PARS). Please allow 6-8 weeks for your MOC points to appear on your ABIM records.

MIPS CREDIT DESIGNATION
 Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality   Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS).


AMERICAN ACADEMY OF FAMILY PHYSICIANS (AAFP) CREDIT
This Enduring Material activity, Ensuring Optimal Integration of the GLP-1 Receptor Agonists Review of the Latest   Advances and Current Gaps in Care , has been reviewed and is acceptable for up to 1.00 Prescribed credit(s) by   the American Academy of Family Physicians. AAFP certification begins 1/30/2020. Term of approval is for one   year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the  activity.

JOINT PROVIDER STATEMENT
 In support of improving patient care, this activity has been planned and implemented by the Postgraduate   Institute for Medicine and Rockpointe Corporation. Postgraduate Institute for Medicine is jointly accredited by   the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy   Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

NURSING CREDIT DESIGNATION
The maximum number of hours awarded for this Continuing Nursing Education activity is 1.0 contact hours. Designated for 0.6 contact hours of pharmacotherapy credit for Advanced Practice Registered Nurses.

PHYSICIAN ASSISTANT CREDIT DESIGNATION
Postgraduate Institute for Medicine has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until 1/30/2021. PAs should only claim credit commensurate with the extent of their participation.

PROGRAM FACULTY
 Richard S. Rosenthal, MD
 Professor of Medicine
 Division of Endocrinology, Diabetes, and Metabolism
 Associate Chief Medical Quality Officer, Ambulatory Services
 UAB Medicine
 Birmingham, AL

Richard S. Rosenthal, MD is a Professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism at the University of Alabama at Birmingham (UAB). He has served in this capacity since April 1997. Dr. Rosenthal is also a Fellow of the American College of Endocrinology and frequently lectures on various endocrine disorders, including diabetes, thyroid, and cholesterol disorders. He completed his endocrine fellowship at UAB and is active in various teaching ventures. He also participates on several hospital committees, is the Associate Chief Medical Quality Officer of Ambulatory Services, and holds many other leadership positions.

STEERING COMMITTEE
 Sara Alexanian, MD
 Director, Inpatient Diabetes Program
 Clinical Associate Professor
 Boston University School of Medicine
 Section of Endocrinology, Diabetes, Nutrition, and Weight Management
 Boston Medical Center
                              Boston, MA

Sara Alexanian, MD is a Clinical Associate Professor in the Department of Endocrinology, Diabetes, Nutrition, and Weight Management at Boston Medical Center. After graduating from Kalamazoo College with a double major in biology and French language and literature, she completed her medical degree at Dartmouth School of Medicine.

Following an internal medicine residency at Mount Auburn Hospital in Cambridge, Dr. Alexanian completed her endocrinology fellowship training at Boston Medical Center. She then joined the faculty and is currently the Director of the Inpatient Diabetes Program at Boston Medical Center, as well as the Quality Improvement Director for her section. In addition to seeing patients with diabetes in the ambulatory setting, she specializes in the inpatient management of diabetes and has an interest in fellow and resident training. She is an active presenter for both trainees and faculty. Her academic interests include quality improvement, in particular as it relates to inpatient diabetes care.

 M. Susan Burke, MD, FACP
 Clinical Associate Professor of Medicine
 Sidney Kimmel Medical College at Thomas Jefferson University
 Senior Advisor, Lankenau Medical Associates
 Lankenau Medical Center
 Wynnewood, PA

M. Susan Burke, MD, FACP is Clinical Associate Professor of Medicine at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA; an Adjunct Associate Professor of Geriatrics at the Philadelphia College of Osteopathic Medicine in Philadelphia; and Senior Advisor of Lankenau Medical Associates at the Lankenau Medical Center in Wynnewood, PA, where she has been a clinician and teaching attending for more than 30 years. Having earned her medical degree from the University of Pennsylvania Perelman School of Medicine (Philadelphia), she completed a residency in internal medicine at Lankenau Hospital (now the Lankenau Medical Center). Dr. Burke is board-certified in internal medicine and geriatrics and is a Fellow of the American College of Physicians.

A two-time recipient of the Osler-Blockley Award for Excellence in Clinical Teaching from Thomas Jefferson University, Dr. Burke also has received the Residents’ Award for Best Teacher from the Lankenau Internal Medicine house staff. She has been named a Best Doctor for Women and, more recently, a Top Doctor by Main Line Today magazine. Dr. Burke lectures nationally and has published chapters and articles on numerous primary care and geriatric topics on CME websites, as well as in publications such as the Journal of the American Osteopathic Association and Annals of Long-Term Care.

DISCLOSURES OF CONFLICTS OF INTEREST
This educational activity has been produced in adherence with the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.

Boston University School of Medicine asks all individuals, and their spouses/partners, involved in the development and presentation of Continuing Medical Education (CME) and Continuing Nursing Education (CNE) activities to disclose all relevant financial relationships with commercial interests. This information is disclosed to CME activity participants prior to the start of the educational activity. Boston University School of Medicine has procedures to resolve all conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and devices is being discussed.

Faculty and Steering Committee Disclosures

The faculty and steering committee reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Sara Alexanian, MD: Nothing to disclose

M. Susan Burke, MD, FACP: Speaker: Merck & Co, Inc.

Richard S. Rosenthal, MD: Nothing to disclose

Elliot Sternthal, MD (BUSM Course Director): Nothing to disclose

Non-faculty Disclosures

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Terry Ann Glauser, MD, MPH; Blair St. Amand; Elizabeth Drury; Natalie Sanfratello, MPH; Brian Jack, MD; PIM Planners and Managers: Nothing to disclose

DISCLOSURE OF UNLABELED USE
The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

DISCLAIMER
THIS CONTINUING MEDICAL EDUCATION PROGRAM IS INTENDED SOLELY FOR EDUCATIONAL PURPOSES FOR QUALIFIED HEALTH CARE PROFESSIONALS. IN NO EVENT SHALL BOSTON UNIVERSITY BE LIABLE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE INFORMATION CONTAINED IN THE PROGRAM. IN NO EVENT SHOULD THE INFORMATION CONTAINED IN THE PROGRAM BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE. NO PHYSICIAN-PATIENT RELATIONSHIP IS BEING ESTABLISHED.

FDA DISCLOSURE 
The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

SYSTEM REQUIREMENTS
In order to view this presentation, your computer must have audio capabilities (working speakers or headphones) and must have an internet browser capable of playing an HTML5 video.

INSTRUCTIONS FOR PARTICIPANTS AND OBTAINING CME CREDIT
There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME activity in its entirety, and then complete the post-test, with a score of 70% or better, and evaluation. The estimated time for completion of this activity is 1 hour. To receive their certificates, participants must demonstrate mastery of the presented material via the post-test.  Participant is allowed to take the post-test multiple times.

PROVIDER
Jointly provided by Boston University School of Medicine, Postgraduate Institute for Medicine, and Rockpointe.

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SUPPORTER
This activity is supported by an educational grant from Novo Nordisk Inc.