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Pharmacy-Based Cardiovascular Disease Risk Management is an interactive certificate training program that explores the pharmacist’s role in cardiovascular disease risk management. This practice-based activity is the first step for pharmacists interested in learning the essential skills to successfully assess risk, promote cardiovascular disease prevention, and encourage patient adherence to therapy.

Activity Type: Practice-based

Target Audience: Pharmacists in all practice settings

Learning Level: 2 — Experience with the topic is recommended, but advanced expertise or specialty practice in the subject area is not necessary. This activity will focus on expanding the learner’s knowledge and application of new and/or more complex information.

This ACPE activity does not provide a certification in this topic but rather advanced professional training which upon successful completion the learner will be able to download a certificate of achievement.

Goals and Learning Objectives

Educate pharmacists on current evidence-based treatment goals and clinical management recommendations for dyslipidemia and hypertension.

Familiarize pharmacists with important concepts related to healthful lifestyle changes that focus on cardiovascular disease prevention.

Introduce techniques and skills for encouraging patient adherence to prescribed therapies.

Ensure pharmacist proficiency in blood pressure measurement technique and point-of-care lipid testing.

Enhance pharmacist experience in applying elements of motivational interviewing with respect to medication adherence and lifestyle modifications.

Self-Study Learning Objectives Module 1.Cardiovascular Disease Risk Assessment> At the completion of this activity, participants will be able to: Explain the relationship between atherosclerosis development and cardiovascular disease.

Describe major risk factors that affect the incidence of cardiovascular disease.

Describe lifestyle factors that affect risk for atherosclerotic cardiovascular disease (ASCVD).

Determine whether a patient is an appropriate candidate to use aspirin for primary prevention of ASCVD.

Describe the development of the American College of Cardiology and American Heart Association Pooled Cohort Equations and use calculators based on these equations to assess ASCVD risk for individual patients.

List novel risk factors that can be used to further refine ASCVD risk assessments. Module 2. Lifestyle Modifications and Risk Factor Management At the completion of this activity, participants will be able to: Describe the effect of various dietary factors and patterns on risk for atherosclerotic cardiovascular disease (ASCVD).

Explain which dietary factors have favorable and detrimental effects on cardiovascular risks.

Discuss physical activity levels that are associated with reduced risk for ASCVD.

Describe the effects of overweight and obesity on cardiovascular risks and explain the benefits of weight loss.

Describe strategies for supporting weight loss, including pharmacologic treatment options and bariatric surgery.

Summarize strategies for supporting tobacco cessation including pharmacologic treatment options, and discuss the ramifications of smokeless tobacco products. Module 3. Managing Dyslipidemia At the completion of this activity, participants will be able to: Describe cholesterol synthesis and metabolism.

Discuss associations among various types of lipids and atherosclerotic cardiovascular disease.

Explain the risks and benefits of medications that are approved for the treatment of dyslipidemia.

List dietary supplements that are used for the treatment of dyslipidemia.

Describe approaches to dyslipidemia management found in guidelines from the American College of Cardiology and American Heart Association.

Explain controversies surrounding the dyslipidemia guidelines from the American College of Cardiology and American Heart Association. Module 4. Managing Hypertension At the completion of this activity, participants will be able to: Explain the etiology and pathophysiology of hypertension.

Describe how to measure a patient’s blood pressure.

Discuss the role of lifestyle modifications in the management of hypertension.

Describe the classes of medications that are used in the treatment of hypertension, including mechanism of action, role in therapy, and safety considerations.

Summarize recommendations from guidelines for the treatment of hypertension, including treatment targets and medication selection for various patient populations. Module 5. The Pharmacist’s Role in Cardiovascular Disease Prevention and Management At the completion of this activity, participants will be able to: Explain the impact of pharmacists’ patient care services on risk reduction for atherosclerotic cardiovascular disease (ASCVD).

Describe activities that pharmacists can perform to reduce patients’ ASCVD risk.

Discuss practice opportunities for pharmacists to provide ASCVD risk management services.

List billing options for the provision of ASCVD risk management services.

Explain strategies that pharmacists can use to support behavior change, including motivational interviewing. Seminar Learning Objectives At the completion of this activity, the participant will be able to: Assess a patient’s risk for atherosclerotic cardiovascular disease.

Describe how to use patient factors that are not included in risk calculators to guide treatment selections.

Explain how to apply national treatment guidelines for hypertension and dyslipidemia to individual patients.

Discuss how to identify patients who are appropriate for the use of aspirin for primary prevention.

Describe how treatment approaches for dyslipidemia and hypertension should be modified for special populations, including those with diabetes, renal insufficiency, and elevated hepatic transaminase levels.

Recommend appropriate lifestyle interventions that reduce cardiovascular risk.

Apply patient education and counseling strategies, including motivational interviewing, to support lifestyle modifications.

Demonstrate how to measure blood pressure.

Discuss the use of point-of-care lipid testing in cardiovascular risk management.

Discuss how to implement cardiovascular risk management services in various practice settings, including potential billing options and quality measures. Seminar Agenda Check-in

Welcome, Introductions and Acknowledgements

Cardiovascular Disease Risk Assessment and Treatment Decisions

Break

Special Situations and Clinical Updates

Lifestyle Modifications and Motivational Interviewing

Lunch and Networking

Motivational Interviewing Activity

Patient Assessment Skills

Blood Pressure Measurement Practice

Break

Business and Practice Models

Transitions of Care Patient Case

Take Home Points and Final Instructions

Adjournment

Accreditation Information

The American Pharmacists Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Pharmacy-Based Cardiovascular Disease Risk Management certificate training program is approved for a total of 20.0 contact hours of continuing pharmacy education (CPE) credit (2.0 CEUs). The ACPE Universal Activity Numbers (UAN) for this activity are listed below.

Successful completion of the self-study component involves passing the self-study assessment with a grade of 70% or higher and will result in 12 contact hours of CPE credit (1.2 CEUs). ACPE UAN: 0202-0000-18-247-H01-P / 0202-9999-18-247-H01-P

Successful completion of the live seminar component involves attending the full live seminar, successfully demonstrate competency in the utilization and/or evaluation of these devices, and completing the online assessment and evaluation. Successful completion of this component will result in 8 contact hours of CPE credit (0.8 CEU). ACPE UAN: 0202-0000-18-248-L01-P / 0202-9999-18-248-L01-P

To obtain 20.0 contact hours of CPE credit (2.0 CEUs) for APhA's Pharmacy-Based Cardiovascular Disease Risk Management certificate training program, the learner must complete all components listed above, and CLAIM credit for each component. Participants will need to have a valid APhA (pharmacist.com) username and password, as well as a CPE Monitor account to claim credit. After credit has been claimed, please visit CPE monitor for your transcript. The Certificate of Achievement will be available online upon successful completion of the necessary activity requirements on the participant’s My Training page on www.pharmacist.com.

APhA continuing pharmacy education policy provides you with two opportunities to successfully complete the continuing pharmacy education assessment. Please note that you will not be permitted to submit the assessment a third time. The current policy of the APhA Education Department is not to release the correct answers to any of our CPE tests. This policy is intended to maintain the integrity of the CPE activity and the assessment.

Release Date: September 1, 2018

Expiration Date: September 1, 2021 - PLEASE NOTE: NO Home Study credit granted after this date; Live Credit can only be granted within 60 days from the day of the seminar attended.

Development

Pharmacy-Based Cardiovascular Disease Risk Management was developed by the American Pharmacists Association. Copyright © 2018 by the American Pharmacists Association.

Acknowledgements and Disclosures

Advisory Board Joseph Saseen, PharmD, FASHP, FCCP, FNLA, BCPS, CLS (Chair), Professor and Vice Chair, Department of Clinical Pharmacy, Professor, Department of Family Medicine, University of Colorado, Aurora, Colorado

Stacey Frede, PharmD, BCACP, CDE, Kroger Pharmacy

Susanne Higginbotham, B.S.,Pharm.D.,BCACP, Director of Center for Pharmacy Care, Residency Program Director, Adjunct Faculty, Duquesne University, Pittsburgh, Pennsylvania

Karen McConnell, Pharm.D., FCCP, BCPS-AQ Cardiology, System Director of Clinical Pharmacy Services, Catholic Health Initiatives, Greater Denver Area, Colorado

Staci Marie Norman, PharmD, CD , Clinical Coordinator, Martin's Pharmacy, South Bend, Indiana APhA Staff Members The following APhA staff members contributed to the development of this program: Helen Ali-Sairany, PharmD, BCACP, Director, Content Development, Education

Kelly French, Director, Advanced Training

Misty Knack, Associate Director, Advanced Training The original publication was prepared by Judy Crespi Lofton, MS, of JCL Communications, on behalf of APhA. Disclosures All individuals involved in the development of this material declare no conflicts of interest or financial interests in any product or service mentioned in this activity, including grants, employment, gifts, stock holdings, and honoraria. For complete APhA staff disclosures, please see the Education and Accreditation Information section at www.pharmacist.com/apha-disclosures.

Conflicts of interest have been resolved through content review by Helen Sairany, PharmD, BCACP, Director of Content Development at the American Pharmacists Association.

The material presented here does not necessarily reflect the views of the American Pharmacists Association. Every attempt has been made to ensure the accuracy of the information contained herein at the time of writing; however, owing to the nature of pharmacy practice, standards and recommendations change regularly. Pharmacists are advised to verify all information and data before treating patients or employing the practices described in this educational activity.

System Requirements

Computer and Internet access are required to complete this activity. Please visit our website to view the Technology System Requirements in order to have a positive learning experience.