Program Overview

Activity Description

Cardiovascular disease is well established as the leading cause of death in the United States and other developed countries. Many well-designed studies support the effectiveness of lipid-modifying therapies for reducing the risks of CVD and its associated mortality. For people with abnormal levels of blood cholesterol, the standard first-line medications for reducing these risks are the statins. These agents act by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, an enzyme involved in hepatic cholesterol synthesis. Low-dose statin regimes successfully lower LDL cholesterol to target levels in many, but not all, individuals. For those who require intensive lipid-modifying therapy, a key clinical decision is whether to increase the dose of statin monotherapy or to combine a statin with another class of lipid-modifying therapy (eg, ezetimibe, a fibrate, niacin, a bile acid sequestrant, or an omega-3 fatty acid). In 2009, the Agency for Healthcare Research and Quality published a systemic review of studies that addressed various aspects of this decision. This educational activity summarizes the key findings of the review and poses potential applications to clinical practice.

Learning Objectives

At the conclusion of this activity, the participant should be able to:

• Describe the long-term clinical benefits and harms of increased doses of statin monotherapy versus the combination of a statin and another cholesterol-lowering agent for patients requiring intensive therapy
• Review the effects of higher-dose statin monotherapy versus combination therapy on cholesterol targets, short-term side effects, tolerability, and adherence
• Summarize the comparative benefits and harms of higher-dose statin monotherapy versus combination therapies in selected patient subgroups
• Apply relevant findings to patient-centered treatment decisions, education, and promotion of adherence

Target Audience

This CME activity is designed to meet the educational needs of physicians, physician assistants, nurse practitioners, pharmacists, nurses, case managers, dieticians, medical assistants.

Method of Participation

To receive a certificate for this activity, you should:

• Complete the learner assessment pretest
• View the entire activity online
• Complete an online evaluation & post-test
• Print your certificate online

The estimated time to complete this activity, including review of the materials, is 1.0 hour.

Term of Approval

March 31, 2011 through March 30, 2013. Original release date: March 31, 2011

Acknowledgement of Support

There is no fee for this CME/CE activity. This activity is sponsored by PRIME Education, Inc (PRIME^®) and funded under contract HHSA290201000006G from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS).

Faculty Biographies and Disclosures

Accreditation/Credit Designation

This program is no longer accredited.

Faculty Disclosures

Disclosure Policy

PRIME Education Inc (PRIME^®) endorses the standards of the ACCME, as well as those of the AANP, ANCC and ACPE, that require everyone in a position to control the content of a CME/CE activity to disclose all financial relationships with commercial interests that are related to the content of the CME/CE activity. CME/CE activities must be balanced, independent of commercial bias and promote improvements or quality in healthcare. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession.

A conflict of interest is created when individuals in a position to control the content of CME/CE have a relevant financial relationship with a commercial interest which therefore may bias his/her opinion and teaching. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, stocks or other financial benefits.

PRIME^® willidentify, review and resolve all conflicts of interest that speakers, authors, course directors, planners, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. 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. Disclosure information for speakers, authors, course directors, planners, peer reviewers, and/or relevant staff are provided with this activity.

Presentations that provide information in whole or in part related to non FDA approved uses of drugs and/or devices will disclose the unlabeled indications or the investigational nature of their proposed uses to the audience. Participants should refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. Participants should verify all information and data before treating patients or employing any therapies prescribed in this educational activity. The opinions expressed in the educational activity are those of the presenting faculty and do not necessarily represent the views of PRIME^®, the ACCME, AANP, ACPE, ANCC and other relevant accreditation bodies.

Content validation methods are consistently utilized by PRIME^® to ensure that all program content is evidence-based, fair-balanced, and developed with scientific rigor and integrity. All clinical recommendations are based on evidence accepted within the medical profession. All scientific research referred to, reported or used to support a clinical recommendation conforms to accepted standards of experimental design, data collection and analysis. In addition to review of content by course directors and expert faculty, content is also validated through independent peer reviewers selected for their expertise in the content area, as well as their experience in the intended audience. All peer reviewers, planners, course directors, faculty and relevant staff utilized by PRIME^® complete disclosures which are related to their role in the educational activity.

Accessibility

PRIME^®is committed to providing access to our CME programs for individuals with disabilities as identified in Section 508 of the Rehabilitation Act for all web-based programs. This website is 508 compliant.

1. Access the Activity:

Adobe Acrobat Reader or equivalent is required to view this program. A text version is also available for screen readers.

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Post-Test & Evaluation

Clinician & Consumer Summaries on Cholesterol

Download these free summaries for your reference and/or patient handouts. You may also order bulk copies free of charge from the AHRQ Publication Clearinghouse below.

Clinician Summary

Treating Cholesterol With Combination Therapy: Clinician's Guide

Consumer Summary

Treating High Cholesterol: A Guide for Adults

Spanish Summary

Tratamientos para el colesterol alto: Guía para adultos

Order from Clearinghouse Order from Clearinghouse Order from Clearinghouse