Supplement
Issue:
Balancing Therapeutic Safety and Efficacy to Improve Clinical and Economic Outcomes in Schizophrenia [CME/CPE]
Volume:
20
Number:
8 Suppl
Release date: June 17, 2014 |  Expiration date: June 17, 2015
Estimated time to complete activity: 2.5 hours
Type of Activity: Knowledge | Activity fee: Free of charge
Medium: Print with Internet-based posttest, evaluation, and request for credit.

This activity is supported by educational grants from Jazz Pharmaceuticals, Inc and Otsuka America Pharmaceutical, Inc.

Intended Audience
Managed care clinicians and administrators, including physicians, pharmacists, medical and formulary directors, and other managed care professionals involved in the care of patients with schizophrenia.

Activity Overview
Schizophrenia is a complex psychiatric disorder that is linked to substantial clinical and economic burdens. This supplement to The American Journal of Managed Care is designed to provide a detailed clinical understanding of schizophrenia, discuss the far-reaching impact of disease on patient health and quality of life, review the various pharmacologic and nonpharmacologic treatment options, and examine the managed care implications associated with schizophrenia and its management.

Statement of Educational Need
Schizophrenia is a chronic and disabling psychiatric disorder with profound effects on patients, families, and caretakers due to the tremendous personal, social, and economic burdens that the disease imposes. In addition to psychotic symptoms that may alter an individual’s perception, thoughts, affect, and behavior, schizophrenia is associated with increased morbidity and mortality, reduced life expectancy, and a greater likelihood of homelessness and unemployment, resulting in an estimated annual economic burden of $62.7 to $65 billion. Although much research has been conducted regarding schizophrenia, its exact etiology has yet to be determined, though it is likely multifactorial. The goals of treatment for schizophrenia are to alleviate acute symptoms, maximize quality of life and functioning, and maintain recovery from acute illness. To achieve these goals, optimal management of schizophrenia requires an integrated approach that combines psychosocial, educational, and pharmacologic modalities. Many of the antipsychotic agents typically used to manage schizophrenia are associated with undesirable adverse effects that contribute to metabolic abnormalities, cardiovascular disease, and mortality. Clinicians and managed care professionals are thus tasked to balance the effective treatment of this complex disease with the implementation of managed care strategies to improve patient outcomes while reducing healthcare expenditures. A thorough understanding of both the clinical and managed care facets of schizophrenia is vital to achieving this delicate balance.

Educational Objectives
Upon completion of the educational activity, the participant should be able to:
  • Examine the epidemiology, pathophysiology, and clinical progression of schizophrenia
  • Describe common adverse events that often accompany schizophrenia therapies, and strategies for monitoring and mitigating these adverse events
  • Identify issues regarding the management of schizophrenia and conditions associated with schizophrenia treatment in managed care
  • Examine disease management opportunities to improve economic and clinical outcomes in schizophrenia, and conditions associated with the treatment of schizophrenia
Disclosure Policy
The National Committee for Quality Assurance (NCQA) endorses the Standards of the Accreditation Council for Continuing Medical Education, which specify that sponsors of continuing medical education activities and presenters at and planners for these activities disclose any relevant financial relationships either party might have with commercial companies whose products or services are discussed in educational presentations.

For sponsors, relevant financial relationships include large research grants, institutional agreements for joint initiatives, substantial gifts, or other relationships that benefit the institution. For presenters or planning committee members, relevant financial relationships include the receipt of research grants from a commercial company, consultancies, honoraria, travel, or other benefits, or having a self-managed equity interest in a company; or having an immediate family member or partner with such a relationship.

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

Program content was peer reviewed to ensure that it is fair balanced and free from commercial bias.

Physician Credit
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 the National Committee for Quality Assurance (NCQA) and Pharmacy Times Office of Continuing Professional Education (PTOCPE). The National Committee for Quality Assurance is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
The National Committee for Quality Assurance designates this Enduring Material Activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Credit
Accreditation and Credit Designation
Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (0.25 CEUs) under the ACPE universal activity number 0290-9999-14-049-H01-P. The activity is available for CE credit through June 17, 2015.
Obtaining Credit: Testing and Grading Directions
Participants must read each article in this supplement, complete the online posttest achieving a passing score of 70% or higher, and complete an online evaluation and request for credit.

This CE/CME activity is also available online at www.ajmc.com/ce and www.PharmacyTimes.org, where you will be directed to the activity in its entirety, including the online pre-test and posttest, activity evaluation, and request for credit. Instant online grading along with a downloadable CME certificate (for physicians) or CE statement of credit (for pharmacists) is also available.


Faculty

Daniel C. Javitt, MD, PhD
Director
Schizophrenia Research
Nathan Kline Institute
Orangeburg, New York

Professor and Director
Division of Experimental Therapeutics
Columbia University
New York, New York

Junqing Liu, PhD, MSW
Research Scientist
National Committee for Quality Assurance
Washington, District of Columbia

Editorial Support

Mei T. Liu, PharmD, BCPP
Clinical Assistant Professor
Department of Pharmacy Practice and Administration
Ernest Mario School of Pharmacy
Rutgers, the State University of New Jersey
New Brunswick, New Jersey

Psychiatry Clinical Pharmacist
Princeton House Behavioral Health
Princeton, New Jersey

Megan Maroney, PharmD, BCPP
Clinical Assistant Professor
Department of Pharmacy Practice and Administration
Ernest Mario School of Pharmacy
Rutgers, the State University of New Jersey
New Brunswick, New Jersey

Clinical Psychiatric Pharmacist
Monmouth Medical Center
Long Branch, New Jersey

A. Scott Mathis, PharmD
Regional Directory of Pharmacy
Pharmacy Department
Monmouth Medical Center
Long Branch, New Jersey

Faculty Disclosures 
Daniel C. Javitt, MD, PhD, has disclosed the following relevant commercial financial relationships or affiliations in the past 12 months:
Grant/research support: Pfizer Inc, Roche
Consultant: Bristol-Myers Squibb, EnVivo, Lilly, Omeros, Otsuka, SK Biopharmaceuticals, Sunovion, Takeda
Stock/shareholder: Glytech

Junqing Liu, PhD, MSW; Mei T. Liu, PharmD, BCPP; Megan Maroney, PharmD, BCPP; and A. Scott Mathis, PharmD, have no relevant financial relationships with commercial interests to disclose.

The American Journal of Managed Care
Publishing staff—Jeff D. Prescott, PharmD, RPh; Ida Delmendo; and Tara Petersen have no relevant financial relationships with commercial interests to disclose.

National Committee for Quality Assurance (NCQA)
Planning staff—Bart Ecker, Jackie Lombos, and Jennifer D’Alessandro have no relevant financial relationships with commercial interests to disclose.

Pharmacy Times Office of Continuing Professional Education
Planning staff—David Heckard; Steve Lin, PharmD, RPh; Donna Fausak; and Nathalie Harden have no relevant financial relationships with commercial interests to disclose.

Off-label Disclosure and Disclaimer
The contents of this CME/CE 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 and pharmacists 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.

For additional information about approved uses, including approved indications, contraindications, and warnings, participants are advised to consult prescribing information for all products discussed. The information provided in this CME/CE activity is for continuing medical and pharmacy education purposes only and is not meant to substitute for the independent medical or pharmacy judgment of a physician or pharmacist relative to diagnostic, treatment, or management options for a specific patient’s medical condition.

The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of The American Journal of Managed Care, Pharmacy Times Office of Continuing Professional Education, and National Committee for Quality Assurance, or any of the companies that provided commercial support for this CME/CE activity.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements.

Publisher’s Note: The opinions expressed in this supplement are those of the authors, presenters, and/or panelists and are not attributable to the sponsor or the publisher, editor, or editorial board of The American Journal of Managed Care. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this supplement are not necessarily the same as indicated in the package insert for the product and may reflect the clinical experience of the authors, presenters, and/or panelists or may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

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

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

© 2013 Managed Care & Healthcare Communications, LLC
ARTICLES
Daniel C. Javitt, MD, PhD
Daniel C. Javitt, MD, PhD
Junqing Liu, PhD, MSW
AUTHOR INDEX
CE/CME QUIZ