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Case Studies in Chronic Constipation: Diagnosis and Treatment in Long-Term Care Residents Release Date: July-19-08 Credit Expiration Date: December-31-09 . Medical directors, other physicians, nurses, and consultant pharmacists caring for older adults Physicians: 1 hour Nurses: 1 contact hour Pharmacists: 1 contact hour (0.1 CEU) Podcast (MP3 & PDF) Constipation is the most common digestive complaint in the general population and is associated with substantial economic costs. Epidemiologic data show that the prevalence of constipation increases with age, most markedly in those 65 years of age and older. In seniors, roughly 26% of men and 34% of women complain of constipation, and severe constipation appears to predominate in women. Severe constipation is not a benign condition; it can lead to serious medical problems such as stercoral ulcers. The occurrence of fecal impaction is a sentinel event in nursing facilities, and its prevalence is one of the quality indicators. As the aging population increases, more people are requiring treatment for symptoms of constipation. Recent advances in drug development have led to promising agents that effectively treat chronic constipation safely. However, chronic constipation must be differentiated from other forms of constipation, and secondary causes, since the management principles vary. Continuing education focused on safe and effective evidence-based treatment strategies may improve clinical outcomes for residents with chronic constipation in various long-term care settings. NOTE: If you received credit by attending one of the live symposia by the same name or by completing the online version of this program, you are not eligible to apply for credit through this podcast version. Upon completion of this educational activity, the participant should be able to: 1. Assess the impact of chronic constipation in the elderly as it relates to quality of life, psychological effects, and healthcare economics. 2. Describe ways to tailor management strategies and treatment plans for the various etiologies of chronic constipation often encountered in residents of long-term care, including medication-related causes. 3. Evaluate the role of traditional and newer pharmacologic treatment options for chronic constipation in elderly patients with various comorbid conditions. 4. Apply principles of an interdisciplinary approach to monitor treatment progress and to assess the efficacy and safety of chronic constipation therapies in elderly patients. Presenting Faculty: Eric G. Tangalos, MD, FACP, AGSF, CMD Professor of Medicine and Chair (Emeritus) Primary Care Internal Medicine Mayo Clinic College of Medicine Rochester, Minnesota It is the policy of ASCP, in accordance with the guidelines set forth by the Accreditation Council for Pharmacy Education, and AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty 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 conflict of interest is resolved by ASCP and AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose. Dr. Tangalos has received honoraria for serving as a consultant from Sucampo Pharmaceuticals and Takeda Pharmaceuticals North America, Inc. This educational activity may contain discussion of investigational uses of pharmaceutical agents or surgical devices. Some of these agents/devices may not have been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Physicians: 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 sponsorship of AKH Inc. and Medical Communications Media. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc. designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Nurses: AKH Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. AKH Inc. designates this educational activity for 1.0 contact hour (0.1 CEU). Pharmacists: The American Society of Consultant Pharmacists (ASCP) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program (ACPE # 203-999-08-070-H01-P) is accredited for 1.0 Contact Hour (0.1 CEU). Credit is awarded for a score of 70% or better on the online post-test. Two re-takes are allowed on the post-test. Supported by an educational grant from Sucampo Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc. This program consists of a Podcast/MP3 audio file and a printable PDF of the post-test that can be submitted for credit and/or used to assist learning. You may play the audio online or download the file to an MP3 audio player, such as an iPod. You will also need Adobe Acrobat Reader to view and print the PDF post-test and evaluation. 1. Click on the "Start program" icon. This will bring you to the login/registration page where you will be able to register as a new CMEcorner.com member or check/revise existing registration information. 2. Update your existing registration information, if necessary. When ready, click on the "Continue to Program" icon at the top or bottom of the screen. This will take you to the podcast description page for CMEcorner2go. 3. Save the PDF file to your computer or open the file using the Adobe Acrobat Reader. Print a copy of the PDF, which includes CME information and a link to the online post-test and program evaluation. 4. Download or play the audio file by clicking on the appropriate button. Instructions for utilizing this program on a portable MP3 player such as an iPod can be found on this page. 5. Listen to the presentation before filling out the post-test and evaluation. It should take approximately 60 minutes to listen to the audio and complete the post-test and evaluation. 6. To receive CME credit, follow the link to the post-test. Successful completion of the post-test and evaluation will enable you to immediately print a statement of credit. $0.00 None of the contents of this activity may be reproduced in any form without prior written permission of the publisher. The opinions expressed in this activity are those of the speakers and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, the American Society of Consultant Pharmacists, AKH Inc., Sucampo Pharmaceuticals, Inc., or Takeda Pharmaceuticals North America, Inc. Any medications, or other diagnostic or treatment procedures discussed by the program speakers should not be utilized by clinicians without evaluation of their patients’ conditions and of possible contraindications or risks, and without a review of any applicable manufacturer’s product information and comparison with the recommendations of other authorities.

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