Target Audience (click to view)
This activity is designed to meet the needs of physicians and nurses.
Learning Objectives(click to view)
Upon completion of the educational activity, participants should be able to:
- Discuss the key findings of five studies presented at the 2016 World Allergy Organization International Scientific Conference.
Method of Participation(click to view)
Release Date: 03/10/2017
Expiration Date: 03/10/2018
Statements of credit will be awarded based on the participant reviewing monograph, correctly answer 2 out of 3 questions on the post test, completing and submitting an activity evaluation. A statement of credit will be available upon completion of an online evaluation/claimed credit form at akhcme.com/akhcme/lessons/42. You must participate in the entire activity to receive credit. If you have questions about this CME/CE activity, please contact AKH Inc. at firstname.lastname@example.org.
Credit Available(click to view)
CME Credit Provided by AKH Inc., Advancing Knowledge in Healthcare
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and Physician’s Weekly’s. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME.
AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
This activity is awarded 0.5 contact hours.
Commercial Support(click to view)
There is no commercial support for this activity.
Disclosures(click to view)
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.
Disclosure of Unlabeled Use & Investigational Product(click to view)
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer(click to view)
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant’s misunderstanding of the content.
Faculty & Credentials(click to view)
Discloses no financial relationships with pharmaceutical or medical product manufacturers.
Dorothy Caputo, MA, BSN, RN- CE Director of Accreditation
Discloses no financial relationships with pharmaceutical or medical product manufacturers.
AKH planners and reviewers have no relevant financial relationships to disclose.
Complete the Post Test(click to view)
Assessing Asthma Exacerbation Susceptibility
Previous research indicates that 50% of patients with asthma report having had an exacerbation in the previous year despite the majority of these individuals reporting that they have “mild” disease. Few studies have assessed the characteristics and determinants of exacerbations. For a study, researchers assessed exacerbations and their associations among African Americans with asthma. Asthma control was assessed using the 5-item Asthma Control Questionnaire (ACQ5). The likelihood of a future exacerbation increased with worsening ACQ5 scores. The investigators identified an exacerbation susceptibility phenotype that was independent of asthma control and may require more precise therapeutic targeting.
Milk Allergy & QOL
Current data are lacking on quality of life (QOL) measures among patients with an allergy to cow’s milk. Patients who are allergic to cow’s milk (or their guardians) and were candidates for oral food challenge or desensitization completed a QOL questionnaire over a 3-year period for a study. Among respondents, 45% reported in the fields of “emotional impact” and “symptoms of disease” that food allergies affected their life in moderation. About 52% reported that they were affected somewhat by the negative repercussions of their allergy. Nearly half (49%) of participants reported that the impact of social and dietary restrictions was serious. Also, 55% said they were slightly affected by personal expectations regarding their disease and its repercussions. Additionally, 72% had only discrete future expectations regarding improvement of their disease.
Selecting Patients for Thermoplasty
Brochial thermoplasty (BT) is an endoscopic treatment for severe persistent asthma in which heat is applied to the small airway for 10 seconds, causing atrophy of the small muscles. BT is performed as three separate outpatient procedures 3 weeks apart. Anecdotal evidence suggests that cost and insurance approval are major obstacles to patient access to BT. Researchers at the University of Cincinnati created a comprehensive work-up for patients with severe persistent asthma in order to help obtain insurance approval. Among patients referred for BT, 74% were obese or morbidly obese. In addition, 80% were on oral corticosteroids, 90% were on inhaled corticosteroids, 95% were on long-acting beta-agonists, 96% were on short-acting beta-agonists, and 56% were on an anti-leukotriene receptor antagonist. Participants had an average FEV1 of 1.99 liters. Comorbidities included excessive dynamic airway collapse (30%), vocal cord dysfunction (8%), and laryngopharyngeal reflux (18%). Interestingly, only 44% of patients completed thermoplasty. Insurance approval was not given to 42% of patients who were good candidates for the treatment, and 14% were deemed inappropriate candidates for BT.
Oral Immunotherapy for Food Allergies
The prevalence of food allergies in the United States has increased significantly over the past 10 years, according to published data. With few options for treatment, there has been increasing interest in the potential of using food oral immunotherapy (FOIT). For a study, researchers assessed experiences and treatment outcomes among patients treated with FOIT over an 8-year period. Participants received FOIT doses beginning with less than 5 mcg of nuts or 100 mcg of other food proteins, with target protein doses of 3,600 mg (egg whites) to 8,000 mg (wheat) and 10,826 mg (four nuts). Of the 88% of patients who reached their target dose and began maintenance, egg-treated patients were more likely to continue their therapy than milk- and peanut-treated patients. Peanut FOIT was discontinued primarily because of eosinophilic esophagitis-like oral immunotherapy-related gastrointestinal syndrome or systemic reactions. Among peanut-treated participants who reached maintenance, about 9% later discontinued treatment.
Understanding Beta Lactam Allergy Prevalence
Previous studies show that approximately 90% of patients who avoid penicillin as a class of antibiotics appear to be tolerant of these medications upon allergy testing. Other research indicates that most patients with a true penicillin allergy lose their sensitivity to this reaction over time. Patients who are deemed “penicillin allergic” tend to have poorer health outcomes and accrue higher healthcare costs. For a study, researchers conducted a chart review of patients with a recent history of a reaction to a beta-lactam antibiotic who were subsequently evaluated for beta-lactam allergies. Less than 1% of patients in the study had positive intradermal tests or reacted with an oral drug provocation test with symptoms consistent with immunoglobulin E-mediated hypersensitivity. Overall, about 96% of participants did not require future avoidance of any beta lactam antibiotic. Additionally, a higher risk of anaphylaxis was ruled out in more than 99% of cases.
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