Accreditation Information

In support of improving patient care, Creative Educational Concepts 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.

Medicine (ACCME)

CEC designates this live educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacy (ACPE)

This knowledge-based activity is approved for 1.0 contact hour (.10 CEUs) of continuing pharmacy education credit (JA0007101-0000-18-010-L01-P).

Nursing (ANCC)

This activity is designated for 1.0 contact hour.

Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity.

Physician Assistants (AAPA)

Creative Educational Concepts 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. PAs should only claim credit commensurate with the extent of their participation.

Upon completion of a CE request form, statements of credit for physicians, physician assistants, and nurses will be issued within 30 business days. Pharmacy credit will be reported directly to the National Association of Boards of Pharmacy® (NABP®) CPE Monitor electronic CE tracking system.

Needs Statement

Venous thromboembolism (VTE) is a condition of vast morbidity and mortality, with nearly 100,000 attributable deaths annually. 1 Comprising of both deep vein thrombosis (DVT) and pulmonary embolism (PE), VTE is also associated with increased rehospitalization rates and robust healthcare expenditures, leading to a yearly cost burden ranging from $2 billion to $10 billion.2,3 Half of new VTE cases occur during or within 90 days of a hospital stay, suggesting a substantial unmet need for effective prophylaxis in acute medical illness. 1

Though thromboprophylaxis has long been a standard of care in surgery, the benefit of anticoagulation in medical patients has been more recently documented.3 Based on criteria outlined by the American College of Chest Physicians (ACCP), more than 7 million hospitalized medical patients are at risk of VTE each year.4 However, less than 40% of these patients receive appropriate VTE prophylaxis.5 Fortunately, the advent of novel agents is breaking barriers. While traditional therapies are restrictive, requiring parenteral administration, lab monitoring, and/or dose titration, direct oral anticoagulants (DOACs) allow for fixed oral dosing and do not require laboratory monitoring (e.g., the factor Xa inhibitors rivaroxaban, apixaban, and betrixaban).6,7 More recently, betrixaban exhibited improved VTE risk reduction vs. enoxaparin without significantly increasing the risk of bleeding, leading to its approved indication for extended-duration VTE prophylaxis in acutely ill hospitalized patients.8,9,10

As thrombotic risk is greatest during transitions of care, both during the hospital stay and at discharge, effective interprofessional education is essential.11 The objective of this Grand Rounds series is to help physicians, pharmacists, nurses, physician assistants, and other healthcare professionals promptly identify patients at high risk for VTE and enable them to select appropriate prevention strategies to optimize patient outcomes at discharge and beyond.

1Streiff MB, et al. MMWR. 2014; 2Lawall H, et al. Thromb Haemost. 2011; 3Beckman MG, et al. Am J Prev Med. 2010; 4Anderson FA, et al. Am J Hematol. 2007; 5Cohen AT, et al. Lancet. 2008; 6Imberti D, et al. Intern Emerg Med. 2013; 7Albertsen IE, et al. Drugs. 2012; 8Chi G, et al. Thromb Haemost. 2017; 9Cohen AT, et al. N Engl J Med. 2016; 10https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm564422.htm; 11Maynard G. AHRQ. 2016.

Objectives

At the conclusion of this application-based activity, participants will be able to:

  1. Examine the risk of VTE in patients with acute medical illness and the current recommendations for prophylaxis in these patients.
  2. Identify patient groups who are at increased risk for VTE following acute medical illness and discuss methods for selecting patients who would benefit from extended prophylaxis.
  3. Explore clinical trial data for extended VTE prophylaxis in patients in acute medical illness with agents such as factor Xa inhibitors.
  4. Discuss the importance of evaluating VTE prophylaxis in transitions of care during hospital stays and in the post-hospitalization setting.

Target Audience

Cardiologists, internal medicine physicians, emergency department physicians, surgeons, residents/fellows, physician assistants, nurse practitioners, nurses, pharmacists, and other healthcare professionals involved in the management of patients with acute medical illness.

Faculty Disclosure

Planner and Faculty Disclosures

In accordance with the Food and Drug Administration, the speakers have disclosed that there is the potential for discussions concerning off-label uses of a commercial product/device during this educational activity.

Any person who may contribute to the content of this continuing education activity must disclose relevant relationships (and any known relationships of their spouse/partner) with commercial interests whose products or services are discussed in educational presentations. A commercial interest is defined as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Relevant relationships include receiving from a commercial interest research grants, consultant fees, travel, other benefits, or having a self-managed equity interest in a company.

Disclosure of a relationship is not intended to suggest or condone any bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

 

Planners:

Vanessa Carranza, PharmD - has no relevant financial relationships to disclose in relation to the content of this activity.

Gregory Piazza, MD - has disclosedthat he is a consultant for Pfizer, Portola, and Thrombolex. He also receives grant/research support from Bristol-Myers Squibb, BTG/EKOS, Daiichi-Sankyo, and Janssen. 

Bryan C. Taylor, PharmD - has no relevant financial relationships to disclose in relation to the content of this activity.

Toby C. Trujillo, PharmD, FCCP, FAHA, BCPS-AQ Cardiology - has disclosedthat he is a consultant for CSL Behring, Janssen, and Portola.

 

Presenters:

Aaron P. Kithcart, MD, PhD - has no relevant financial relationships to disclose in relation to the content of this activity.

Gregory Piazza, MD - has disclosedthat he is a consultant for Pfizer, Portola, and Thrombolex. He also receives grant/research support from Bristol-Myers Squibb, BTG/EKOS, Daiichi-Sankyo, and Janssen.

Sean Pokorney, MD, MBA – has disclosed that he is a consultant for and receives grant/research support from Bristol-Myers Squibb, Janssen, and Pfizer.

Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCCP - has disclosed that he is a consultant for AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Janssen, Pfizer, and Portola. He also receives grant/research support from AstraZeneca, Boehringer Ingelheim, CSL Behring, Daiichi-Sankyo, Janssen, and Portola.