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Managing Chronic Constipation When Treatment Fails: A Clinical Case Challenge Release Date: June-15-12 Credit Expiration Date: June-14-13 UAN: 0203-9999-12-027-H01-P . Primary and long-term care physicians, pharmacists, physician assistants, and other health care professionals involved in the care of older adults. 0.5 Contact Hour (0.05 CEU) 0.5 Credit Hour Clinical Case Challenge (Online) Chronic constipation, particularly in older adults, can dramatically impact quality of life and lead to serious medical problems. The estimated prevalence of chronic constipation in the United States is between 2% and 27%, but this rate increases to 40% among people over 65 years of age. Older adults are at particular risk due to additional chronic disease burdens, polypharmacy, immobility, and/or functional limitations. Effective management of chronic constipation requires a combination of provider and patient education, lifestyle and/or pharmacologic modifications, and the judicious use of pharmacologic and nonpharmacologic therapies. This clinical case challenge will address treatment strategies for older patients with chronic constipation who fail initial treatment and review the safety and efficacy of long-term medication management for patients with chronic constipation. Upon completion of this knowledge-based educational activity, the participant should be able to: 1. Outline effective treatment strategies for older patients with chronic constipation who fail initial treatment. 2. Describe the safety and efficacy of long-term medication management for patients with chronic constipation. Anthony Lembo, MD Associate Professor of Medicine Department of Medicine Division of Gastroenterology Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA It is the policy of ASCP 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 activities or with the commercial supporter of these continuing education activities. Identified conflict of interest is resolved by the providers prior to accreditation of the activities. ASCP, AKH Inc., and MCM Education planners and reviewers have no relevant financial relationships to disclose. Dr. Lembo serves as a consultant for Ironwood/Forest, Salix, Prometheus, Ardelyx, and Alkermes. Pharmacy Continuing Education: 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 knowledge-based activity, ACPE Universal Activity #0203-9999-12-027-H01-P, has been assigned 0.5 Contact Hour (0.05 CEU). Physician Continuing Medical Education: 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, Inc. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc. designates this enduring material for a maximum of 0.5 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. There is no fee to participate and receive credit. Supported by an education grant from Sucampo Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc. Minimum System Requirements: Pentium III, 600 MHz or Equivalent Processor • 512 MB of RAM • Windows XP, Vista, or 7. Or, Mac OS X • 800x600 Monitor Resolution • 16-bit Color • 16 bit Sound Card with Speakers 1. Please turn off all pop-up blockers to ensure access to the educational activity. 2. Click on the "Start program" icon at the bottom of this page. If you are not already registered as a user of this website, this will bring you to the login/registration page where you will be able to register as a new CMEcorner.com member or check existing registration information. When ready, click on the "Continue to Program" icon at the bottom of the screen. 3. The activity will take approximately 30 minutes to complete. 4. After the activity has finished, click on the "Post-test" button. 5. Instructions for completing and submitting the post-test and evaluation are provided on the post-test screen. A credit statement/certificate will be awarded for a score of 80% or better and may be printed immediately after passing the post-test. $0.00 © 2012, MCM Education. All rights reserved. None of the contents may be reproduced in any form without prior written permission from the publisher. The opinions expressed in this educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, ASCP, AKH Inc, Sucampo Pharmaceuticals, Inc., or Takeda Pharmaceuticals North America, Inc. Any medications, diagnostic procedures, or treatments discussed by the faculty should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.

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