12th Annual CMHC

October 4-7

Boston, MA

2017 CME/CE Satellite Symposia

Business of Medicine CME Symposium · Wednesday, October 4, 2017 · 1:20 – 2:20pm

Best Practices: Efficient and Cost-Effective Management of the Authorization Process

Faculty: Pamela B. Morris, MD; Kim K. Birtcher, PharmD, MS

This symposium will focus on the prior authorization (PA) process, which requires healthcare providers to seek approval for medication and procedure coverage. Because PA is often necessary for imaging and branded medication prescriptions, treatment strategies are often impacted. A recent survey by the American College of Cardiology (ACC) found that 78% of surveyed cardiologists cite the documentation and administrative burden associated with PA to be a barrier to using newer therapies. During this activity, faculty will provide participants with recommendations and resources for streamlining the PA process in their practices, with the goal of reducing the associated burdens on healthcare providers, minimizing related stress for patients, and preserving time for direct patient care. Faculty will also present a challenging patient encounter and supply evidence-based strategies which learners can apply in a clinical setting for optimal success.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Describe steps that can be taken by healthcare providers to reduce the time and expenses associated with submissions for prior authorizations
  • Summarize available resources that may facilitate the prior authorization process
  • Discuss current advocacy efforts to streamline the preauthorization process and how they may affect clinical practice

Supported by an educational grant from Sanofi US and Regeneron Pharmaceuticals.

CME Breakfast Symposium · Thursday, October 5, 2017 · 6:40 – 7:55am

Closing the Gap Created by Clinical Inertia: New Strategies for T2DM Treatment

Faculty: Robert H. Eckel, MD (Chair); Yehuda Handelsman, MD; Athena Philis-Tsimikas, MD; Julio Rosenstock, MD

The prevalence of T2DM in the United States is 29.1 million and it is the seventh leading cause of death and a major cause of morbidity, including microvascular, macrovascular, cerebrovascular, and peripheral vascular disease complications. Clinicians face several challenges in helping patients with T2DM reach their glycemic goals, including an increasing armamentarium which gives rise to confusion regarding proper selection and sequence, multiple sets of available evidence-based guidelines, and “clinical inertia” – the failure to close the gap between best practice and the patient’s usual level of care. The goal of this educational activity is to increase awareness among clinicians of the challenges in reaching T2DM glycemic targets, to review the clinical guidelines for T2DM treatment using an array of antihyperglycemic agents, and to present evidence on emerging basal insulin/GLP-1RA fixed-ratio combination products.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Outline the stepwise approach to T2DM treatment as recommended by current ADA/EASD and AACE/ACE guidelines
  • List potential barriers to treatment escalation in T2DM and the role of clinical inertia in reaching glycemic targets
  • Describe the complementary actions of basal insulin and GLP-1RA inhibitors in treating T2DM
  • Identify the role of emerging fixed-ratio basal insulin/GLP-1RA products in the treatment of patients with T2DM

Supported by an educational grant from Sanofi US.

CME Lunch Symposium · Thursday, October 5, 2017 · 12:15 – 1:15pm

Navigating Updated Guidelines and New Therapies for the Diagnosis and Treatment of Heart Failure

Faculty: Keith C. Ferdinand, MD (Chair); Clyde W. Yancy, MD ; JoAnn Lindenfeld, MD

As the prevalence of cardiometabolic risk factors, such as obesity, high blood pressure, diabetes, abnormal cholesterol levels, and hypercoagulability, continue to increase, as well as aging of the population, the incidence of heart failure (HF) will continue to rise, along with the unmet needs of patients. Recent studies have shown that only 40% of patients with HF receive evidence-based treatment recommended by guidelines; less than half of patients with HF take beta-blockers and only a third take angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs). Additionally, only 7% of African Americans diagnosed with HF are receiving guideline recommended fixed-dose hydralazine and isosorbide dinitrate. This symposium will focus on identifying the risk of HF in patients with cardiometabolic disease, provide an overview on the most recent focused update of the HF guidelines, identify the safety and efficacy of recently approved pharmacotherapies for HF, and implement coordination of care strategies to optimize patient outcomes. Expert faculty will also provide patient cases to provide participants with real world solutions to clinical challenges.

Learning Objectives
After completing this activity, the participant should be better able to:

  • List the most recent guidelines for the diagnosis and treatment of patients with HF
  • Describe appropriate treatment regimens for high risk HF patients, considering the safety, efficacy, and pharmacology of newer HF pharmacotherapy
  • Explain care coordination strategies and protocols within a multidisciplinary team, and patient education to optimize HF patient outcomes during hospitalization and post discharge to reduce readmission rates

Supported in part by an educational grant from Novartis Pharmaceuticals Corporation.

CME Dinner Symposium · Thursday, October 5, 2017 · 7:00 – 8:00pm

Advances in Insulin Therapy: Addressing Provider and Patient Safety Concerns

Faculty: Anne L. Peters, MD (Chair); Deborah J. Wexler, MD, MSc

Intensive insulin regimens often cause a higher risk of hypoglycemia and weight gain, which can contribute to a greater cardiometabolic burden in patients with T2DM. Hypoglycemia has been linked to several adverse outcomes, including falls, depression, autonomic dysfunction, cardiovascular morbidity, and thus a poor prognosis. Given the growing elderly population, improving glycemic control while preventing hypoglycemia is a focus of T2DM management. This CME symposium will address the use of new insulin therapies and combination treatments that have been shown to reduce cardiometabolic and hypoglycemic risk while achieving glycemic control.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Discuss the risk factors for hypoglycemia and the barriers to insulin intensification
  • Compare the safety, efficacy, and pharmacological data on new insulin therapies and combinations
  • Individualize insulin therapy based on a clinical understanding of the features of established and new insulin formulations and patient-specific needs and preferences

Supported in part by an educational grant from Novo Nordisk.

CME Breakfast Symposium A · Friday, October 6, 2017 · 6:45 – 7:45am

Interventional Cardiology Delivered With a Fork

Faculty: Stephen Devries, MD

Nutritional interventions are powerful tools that are rarely utilized to full advantage in medical care. This symposium will highlight new advances in clinical nutrition science with an emphasis on practical application to the practice of busy health care professionals.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Identify the magnitude of benefit possible from dietary interventions
  • Describe systems for categorizing dietary carbs and fats and their relation to vascular health
  • Explain how self-care among health professionals enhances lifestyle counseling
  • Discuss practical steps to effectively incorporate nutritional interventions in a busy practice

Supported by educational funding from Tarsus Cardio Inc. dba Cardiometabolic Health Congress.

CME Breakfast Symposium B · Friday, October 6, 2017 · 6:45 – 7:45am

Ensuring Access to Evidence-Based Therapies in High Risk Special Populations: Statin Intolerance, Racial/Ethnic Minorities and Familial Hypercholesterolemia

Faculty: Keith C. Ferdinand, MD; Catherine Davis Ahmed, MBA

Despite advances in medical therapies and new treatment modalities for patients with or at high risk for cardiovascular diseases, health equity and access to care remain significant areas of concern. This symposium will introduce learners to The Access to Health Care Initiative of the Association of Black Cardiologists (ABC) who will address these critical issues in a changing health care landscape by revealing disparities faced by minorities and high-risk patients and promulgating solutions to diminished access, especially to newer medications and therapies.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Discuss the disproportionate burden of heart disease and stroke for high risk and minority patients and the mission of the ABC Access Initiative
  • Summarize the barriers to access of quality care for high risk and minority patients, and the solutions proposed in the ABC Access Initiative to improve access, especially to newer therapies
  • Identify evidence-based treatment recommendations to aggressively manage cardiovascular risk factors in high risk and minority patients, thereby reducing the incidence and consequence of CVD and stroke

Supported by educational grants from the Association of Black Cardiologists, Inc. and Tarsus Cardio Inc. dba Cardiometabolic Health Congress.

CME Lunch Symposium · Friday, October 6, 2017 · 12:25 – 1:40pm

CV Protection: Is It Achievable in Patients With T2DM?

Faculty: Jay S. Skyler, MD (Chair); Wendy S. Lane, MD; Robert H. Eckel, MD; Benjamin M. Scirica, MD

According to 2014 data from the Centers for Disease Control and Prevention, 29.1 million individuals, or 9.3% of the US population, have type 2 diabetes mellitus (T2DM). Death from CV disease is 70% higher in adults with diabetes compared to those without diabetes, and patients with diabetes have a decreased life expectancy, mostly due to premature CV death.

Evidence is accumulating that other factors besides impaired glucose metabolism play a role in the pathophysiology of T2DM and that a comprehensive approach against insulin resistance, obesity, hypertension, and dyslipidemia in addition to diet and exercise is required. In addition, because certain pharmacologic therapies were found to increase the risk of CV events, all new drugs introduced since 2008 have been mandated by the FDA to undergo CV safety outcome trials (CVOT) in high-risk T2DM patients. As a result, a growing body of evidence is accumulating on the ability of certain drugs to reduce CV mortality, overall mortality, and hospitalizations for worsening heart failure in high-risk patients with T2DM. This symposium will review the prevalence of CV comorbidities in T2DM patients, present new data on the results of recent CVOTs, and discuss approaches to treatment that is targeted to maximizing outcomes in the T2DM patient with CVD.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Describe the prevalence of CVD among patients with T2DM
  • Outline the benefits and risks of SGLT2 inhibitors and GLP1-RAs in T2DM patients as demonstrated in current and emerging CV outcomes trials
  • Identify a logical addition to existing antihyperglycemic treatment for T2DM patients based on evidence-based guidelines, benefits and risks of second-line antihyperglycemic treatments, and patient profiles and preferences

Multi-supported by educational grants from Novo Nordisk, Boehringer Ingelheim Pharmaceuticals, Inc. and Lilly USA, LLC.

CME Breakfast Symposium · Saturday, October 7, 2017 · 6:45 – 7:45am

Hyperkalemia Management and Monitoring in High-Risk Patients: Improving Heart Failure Management and Outcomes

Faculty: George L. Bakris, MD (Chair); JoAnn Lindenfeld, MD

Hyperkalemia is frequently prevalent and recurrent in patients who suffer from heart failure (HF), chronic kidney disease (CKD), and/or hypertension (HTN). Management of patients who are at chronic risk for hyperkalemia can be challenging for clinicians particularly when weighing the risk of hyperkalemia against the risk of discontinuing reno- and cardio-protective therapies. Although the short-term management of hyperkalemia can be very effective, the utility of current strategies to manage hyperkalemia is limited, with no long-term outcome data to guide in the management of this condition. New therapies to manage hyperkalemia are currently available and in development that may provide safer, more consistent management. Through didactic lectures and challenging patient cases, faculty will address these challenges. Expert faculty will give an overview on the incidence of hyperkalemia and patients who are at high risk of developing this condition. Faculty will also address HF management and treatment strategies in patients with hyperkalemia and the efficacy and safety of new, emerging treatments for hyperkalemia.

Learning Objectives
After completing this activity, the participant should be better able to:

  • Identify patient populations at risk of hyperkalemia
  • Describe the impact of poor assessment and management of hyperkalemia on acute heart failure outcomes
  • Explain how to implement evidence-based guideline recommendations for HFrEF management and appropriate monitoring for renal function and hyperkalemia
  • Evaluate the efficacy and safety data of available and emerging treatments when differentiating therapeutic options for hyperkalemia in patients with chronic kidney disease and/or chronic heart failure

Supported in part by an educational grant from Relypsa, Inc.