Program Overview

Pulmonary arterial hypertension (PAH) is a complex disease with multiple etiologies. The IMPACT PH program was established to provide physicians and allied health professionals with up-to-date information on this disease in order to facilitate patient identification, establish an effective diagnosis and to understand the risks and benefits of the various treatments now available.

The learning modules in this program cover a range of topics, from the more general aspects of PAH to specific situations, such as pulmonary hypertension associated with connective tissue diseases, like scleroderma. The programs use a case-based approach so that health professionals can follow the diagnostic pathway, using the appropriate tools, to finally arrive at the PAH diagnosis and determine the appropriate treatment.

Target Audience

These activities have been designed to meet the educational needs of physicians, registered nurses, and other healthcare professionals involved in the care of patients with pulmonary hypertension.

Overarching Educational Objectives

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

• Review the recent updated definition of pulmonary arterial hypertension, its diagnosis and treatment according to the 6th WSPH consensus task forces.
• Discuss the importance and methods of risk assessment for pulmonary hypertension.
• Debate methods for and implementation of advanced PAH therapy for patients no longer responsive to oral medical treatment, including use of parenteral prostacyclins, and advanced techniques bridging patients to transplantation.
• Discriminate between different pulmonary hypertension phenotypes and processes for implementing guideline-based treatment.
• Identify the strategies that impact allied health professional roles in the diagnosis and management of pulmonary hypertension patients and review tools, opportunities and guidelines available to augment patient satisfaction and quality of life.

Available Topics

PAH in 2019 - What Are the Basics? A New Look at PAH Pathology and Definitions of This Disease

Program Summary

In 2018, the World Symposium on Pulmonary Hypertension (WSPH) met in Nice, France to discuss the state of understanding of pulmonary hypertension and its management. Central to the consensus panels’ work was a new look at the underlying mechanisms of disease, the tissue and cellular level changes that contribute to pulmonary hypertension and most importantly the hemodynamic definition of the disease. In light of these new consensus opinions, the algorithm for pulmonary hypertension has been modified into 2-part approach. This program looks at some of the central, new, consensus findings of the 2018 WSPH, including the revised hemodynamic definition of PH, and the tissue- and gene-level perturbations that are now thought to contribute to the etiology of pulmonary hypertension. These new consensus findings are presented in light of the revised algorithm and procedures for diagnosing pulmonary hypertension.

Learning Objectives

• Review the basic presenting symptoms for PAH
• Examine the update on pathobiology of the pulmonary vasculature
• Briefly discuss the genetic contributions to pathogenesis of PAH and their testing
• Debate the revised hemodynamic definition of PAH based on findings from the 6th WSPH consensus panel and the ERS
• Discuss the impact of the new definition on diagnosis of PH, including use of exercise testing and in light of current and traditional diagnostic procedures

Guideline Update: What Do I Need to Know About the Diagnosis and Classification of PH?

Program Summary

Since the early 1970s pulmonary hypertension (PH) has been arbitrarily defined as a mean pulmonary artery pressure (mPAP) of >25 mmHg as measured by right heart catheterization. However, data acquired in healthy individuals indicates a normal mPAP to be 14 + 3 mmHg. This has led the recent World Symposium on Pulmonary Hypertension (WSPH) to reexamine the definition of PH and recommend a new 2-part algorithm for diagnosing this disease. This program reviews the consensus findings of the recent 6th WSPH and its recommendations on the definition, classification and diagnosis of PH. The program includes a patient case, which highlights concepts around the screening, diagnosis and treatment of a patient with “borderline” PH.

Learning Objectives

• Discuss the recent revision of the hemodynamic definition of PAH by the World Symposium on Pulmonary Hypertension and how this new definition impacts identification of pre-capillary hypertension patients
• Review how the new hemodynamic definition of pulmonary hypertension has impacted on the classification of PH
• Debate the 2018 WSPH revision of the PH diagnostic algorithms as they are influenced by the new hemodynamic definition of PH
• Discuss the 2018 WSPH recommendations on screening for PAH, particularly in high risk groups

How Sick is my Patient? Assessing Risk and Implementing a Treatment Plan

Program Summary

The expanding array of PAH medications has dramatically improved the treatment of PAH. In spite of this, patients continue to experience morbidity and mortality risks. The 2018 World Symposia on Pulmonary Hypertension (WSPH) devoted an entire consensus task force on the issues of patient risk assessment and treatment. This emphasized the critical importance of thorough and regular risk assessments of PAH patients before and during their treatment course. This program examines the benefits and measurements of risk in the PAH patient, the various models available to assess risk and explores how treatment strategies are now based on a risk assessment strategy. Participants will have the opportunity to examine a risk-based case management and discuss options and choices for treatment.

Learning Objectives

• Review the importance of and methods for patient risk assessment following diagnosis of PAH
• Discuss how periodic risk assessment can be used to determine and guide patient treatment
• Review the revised PAH treatment algorithm as proposed by the 6th WSPH consensus panel
• Discuss options when medical therapy does not lead to improvement

Is My Patient Well Enough? Understanding Treatment Goals and Escalating Care

Program Summary

The concepts underlying pulmonary hypertension are changing as the field gains new, more expansive knowledge of the pathophysiology and management of the disease. At the recent 6th WSPH conference, new definitions and concepts of PH were proposed. How these new concepts may affect the assessment of patient risk and the management of PH treatment are of critical importance for the future of the PH patient. This program examines the newly proposed definitions of PAH, risk assessment and the goals and escalation of treatment. These emerging, revised concepts are examined in light of an actual patient case where treatment adjustments are required to progress the patient toward current goals.

Learning Objectives

• Discuss the rationale and changes for the hemodynamic definition of PAH, as proposed by the 2018 WSPH consensus guidelines
• Review the importance of periodic risk assessment and how this pertains to current goals for PAH treatment
• Describe how the level of a patient’s risk for clinical worsening is used to guide PAH treatment and escalation of that treatment in the event of worsening of risk status
• Review the 2018 WSPH consensus recommendations for initial therapy and escalation of PAH therapy when patients fail to improve towards established treatment goals

Improving the Patient Experience in PAH: A Road Map to Better Patient Outcomes

Program Summary

The recent World Symposium for Pulmonary Hypertension met in 2018 to reexamine the hemodynamic definition of PAH and its diagnostic and treatment algorithms. This program considers these new consensus findings and factors for the provider to consider in applying new medical treatment concepts the PAH patient in a risk-based management strategy. The effect of treatment choices are considered in light of potential side effects and their impact on the quality of life of the patient. A patient case is presented to highlight these new diagnosis and treatment concepts in a real-world situation.

Learning Objectives

• Review definition, diagnosis and management of pulmonary hypertension from the 6th World Symposium
• Review patient’s needs, expectations and perspectives regarding diagnosis, disease process, and treatment
• Examine how team-oriented dialogue can potentially improve patient compliance and minimize burden of disease
• Discuss management of PAH medication side effects as one way to to improve quality of life

Accreditation Information

Physician Continuing Medical Education

Accreditation Statement
These activities have 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 Annenberg Center for Health Sciences at Eisenhower and Total CME. The Annenberg Center for Health Sciences at Eisenhower is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
The Annenberg Center for Health Sciences at Eisenhower designates each live 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.

Continuing Nursing Education

Accreditation Statement
Annenberg Center for Health Sciences is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Credit Designation
1.0 contact hour may be earned for successful completion of each activity.

California Board of Registered Nursing
Provider approved by the California Board of Registered Nursing, Provider Number 13664, for 1.0 contact hour.

Disclosure of Conflicts of Interest
The Annenberg Center for Health Sciences at Eisenhower requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to the Annenberg Center for Health Sciences at Eisenhower policy.  The existence or absence of COI for everyone in a position to control content will be disclosed to participants prior to the start of each activity.

Fee Information
There is no fee for these educational activities.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and will be emailed to you within three weeks.

Jointly provided by the Annenberg Center for Health Sciences at Eisenhower and Total CME in collaboration with Postgraduate Institute for Medicine

These activities are supported by independent educational grants from Actelion Pharmaceuticals US, Inc. and United Therapeutics Corporation.

Available Formats

Grand Rounds
Your institution will select a faculty presenter and topic, and provide the in-hospital venue. Mentor Meetings and Events will work with an on-site representative to assist with logistical planning as needed.

Dinner Meeting
Held at a restaurant, this program will include the selection of a speaker and topic(s) for a one-hour program with question-and- answer session. Site selection will comply with ACCME and PhRMA guidelines, and will include a modest meal selection. These are generally private programs for an individual practice group.

Lunch (or breakfast) Meeting
Held at your practice, this program includes a one-hour program with question-and-answer session. This format will include a modest meal selection, compliant with ACCME and PhRMA guidelines. This program may be for a single practice, or multiple practice groups.

Symposium
This format may include multiple speakers and lecture topics. Please speak to a representative at Mentor Meetings and Events to plan this event.

Compliance with Sunshine Act

The National Physician Payment Transparency Program (Sunshine Act) is a section of the Patient Protection and Affordable Care Act of 2010 that requires pharmaceutical and medical device companies to report to the Federal government certain payments (e.g. meals and other meeting expenses) they make to physicians and teaching hospitals. IMPACT PH programs fully comply with the Sunshine Act and, as a result, payments may be reportable based upon these requirements. For detailed information, please visit www.cms.gov.

Americans with Disabilities Act

Event staff will be glad to assist you with any special needs (i.e., physical, dietary, etc.). Please contact Mentor Meetings prior to the live event at +1 475-414-0084.