Supplement
Issue:
Reassessing the Stroke Prevention Paradigm: Evolving Strategies for Managed Care of Patients With Atrial Fibrillation [CME/CPE]
Volume:
16
Number:
10 Suppl
Method of Participation
This is a self-study activity; completion involves reading the monograph, which includes charts/graphs, and completing the online posttest
and evaluation form. There is no fee to participate in this activity.

Release date: November 15, 2010  |  Expiration date: November 14, 2011
Estimated time to complete activity: 1 hour

This activity is supported by an educational grant from Boehringer Ingelheim Corporation.

This activity is sponsored by the University of Michigan Medical School in partnership with TCL Institute, LLC.

Intended Audience
This activity is accredited for directors of managed care, primary care physicians, and other healthcare professionals who treat patients with atrial fibrillation (AF).

Statement of Educational Need
Although there has been considerable recent progress in the prevention of stroke, the new 2020 Impact Goals of the American Heart Association encourage continued improvement, calling for a 20% reduction in deaths due to stroke by the year 2020. While clinicians generally recognize the importance of AF in raising a patient’s risk of stroke, a tendency to overestimate the risks of anticoagulant therapy and underestimate its efficacy can lead to missed opportunities for preventing stroke in AF.

Educational Objectives
After completing this activity, the participant should be better able to:
  • Utilize a risk-versus-benefit evaluation within clinical practice that will help clinicians to better identify and treat patients with AF who are at high risk of stroke, and implement a safe, effective treatment strategy for all qualified patients.
  • Develop treatment strategies for patients, taking into consideration managed care implications for physicians and hospital systems.
  • Evaluate emerging agents for stroke prevention in AF, and determine how newly approved agents may be incorporated into clinical practice, including effective methods of converting patients from older therapies to newer agents.
  • Employ long-term strategies for stroke prevention that take into account patient preferences and pharmacoeconomic realities.

Continuing Medical Education
Accreditation / Credit Designation
Physicians
The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Education (ACCME) to provide continuing medical education for physicians. The University of Michigan Medical School designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physician Assistants
The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Nurse Practitioners
The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Nurses
TCL Institute, LLC is a provider approved by the California Board of Registered Nursing, Provider Number 15225, for 1.2 contact hours. Registered nurses outside of California must verify with their licensing agency for approval of this course.

Pharmacist Continuing Education
Accreditation / Credit Designation
Purdue University College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education (ACPE) 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 Activity Number (UAN): 0018-9999-10-147-H01-P, 1.0 contact hour (0.1 CEU).

The contents of this supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

Faculty
Christopher P. Cannon, MD
Associate Professor of Medicine
Harvard Medical School
Harvard University
Associate Physician, Division of Cardiology
Brigham and Women’s Hospital
Boston, MA

A. Mark Fendrick, MD
Professor of Internal Medicine
Professor of Health Management and Policy
School of Public Health
University of Michigan
Ann Arbor, MI

Eric C. Stecker, MD, MPH
Assistant Professor of Medicine
Cardiovascular Medicine
Oregon Health & Science University
Portland, OR

Disclosures
In accordance with the ACCME, the University of Michigan Medical School and TCL Institute, LLC require 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.

Christopher P. Cannon, MD
Consultant/advisory board: Alnylam Pharmaceuticals, Inc.; Bristol-Myers Squibb; Novartis Corporation; and sanofi-aventis U.S. LLC.
Grants: Accumetrics, Inc.; AstraZeneca; GlaxoSmithKline; InteKrin Therapeutics Inc.; Merck & Co., Inc.; and Takeda Pharmaceuticals North America, Inc.
Lectureship: AstraZeneca and Pfizer Inc.
Clinical advisor/stock ownership: Automedics Medical Systems

A. Mark Fendrick, MD
Consultant: Abbott Laboratories; ActiveHealth Management, Inc.; AstraZeneca; Avalere Health LLC; Blue Cross and Blue Shield Association; GlaxoSmithKline; Hewitt Associates LLC; MedImpact HeathCare Systems, Inc.; Perrigo; Pfizer Inc.; The Regence Group; sanofi-aventis U.S. LLC; WebMD, LLC; and UCB, Inc.
Lectureship: Merck & Co., Inc.; Pfizer Inc.; and sanofi-aventis U.S. LLC.
Grants: Abbott Laboratories; AstraZeneca; Eli Lilly and Company; GlaxoSmithKline; Merck & Co., Inc.; Novartis Corporation; Pfizer Inc.; and sanofi-aventis U.S. LLC.

Eric C. Stecker, MD, MPH
Consultant: AstraZeneca
Patent royalty: Medtronic, Inc.

The staff from the University of Michigan Medical School, TCL Institute, LLC, and The American Journal of Managed Care that were involved in the development
of this activity have no financial relationships with any commercial interests that are relevant to this activity. Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, NJ.

Disclosure of Unlabeled or Investigational Drugs
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. 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.

Disclaimer
The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of the University of Michigan
Medical School, TCL Institute, LLC, or Boehringer Ingelheim Corporation. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

The contents of this supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

System Requirements
PC-based participants
Required: Windows® 7, Vista, XP, 2003 Server or 2000

Macintosh®-based participants
Required: Mac OS® X 10.4.11 (Tiger®) or newer

© 2010 Managed Care & Healthcare Communications, LLC
ARTICLES
Eric C. Stecker, MD, MPH
Christopher P. Cannon, MD
A. Mark Fendrick, MD
Christopher P. Cannon, MD; and Eric C. Stecker, MD, MPH
POSTTEST
Supplement