TARGET AUDIENCE
This activity has been designed to meet the educational needs of physicians, physician assistants, nurse practitioners, and registered nurses involved in the management of patients with dementia.

Original Release Date: April 2008
Expiration Date: April 30, 2009
Estimated Time to Complete this Activity/CNE: 1 hour
Medium: Printed journal and online CME/CNE

Sponsored by Postgraduate Institute for Medicine and Emeritus Educational Sciences.

This activity is supported by an educational grant from Novartis

Purpose
This educational activity will examine the continuously evolving role of the nurse practitioner (NP) and the physician assistant (PA) in the collaborative medical and psychosocial management of the geriatric patient who has dementia.  It will address practical considerations of early diagnosis and advances in the diagnostic workup, best practices for medication management, documentation, and appropriate interventions for behavioral and neuropsychiatric symptoms of dementia, and the role of NPs and PAs in caregiver education and counseling.

Statement of Need/Program Overview
In the United States approximately 4.5 million people have Alzheimer’s disease (AD), the most common form of dementia, and the prevalence of disease increases dramatically with increase in age. Additionally, the geriatrician’s time with the patient has become less and less due to issues of patient volume, limitations of reimbursement, as well as nihilism regarding the value of earlier diagnosis of dementia. This makes the disease extremely relevant to nurse practitioners (NPs) and physician assistants (PAs), particularly those in family medicine, or those who practice in rural and long-term care settings. Nonphysician providers fill a void that will only continue to grow with the aging population. NPs and PAs are uniquely positioned to provide both clinical and psychosocial support to both the patient with dementia and the caregiver through the use of collaborative and team approaches for enhanced patient care and health outcomes.

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

• Specify the differential diagnosis of reversible and nonreversible dementias, including atypical presentations.
• Identify the classes of medications that are currently available for the treatment of Alzheimer’s disease, including their efficacy, safety, and tolerability in monotherapy and combination therapy for dementia.
• Describe the burden of illness associated with behavioral symptoms of dementia and explain the role of antidementia medications in their management.
• Explain the value of the nurse practitioner and physician assistant in a collaborative care or team-oriented approach to managing patients who have dementia.

FACULTY
Danielle Arends, RN, APN/CNP, Nurse Practitioner, Rush Alzheimer’s Disease Center, Chicago, Illinois; Elizabeth M. Galik, PhD, RN, CRNP, Assistant Professor, Gerontological Nurse Practitioner Program, University of Maryland School of Nursing, Baltimore, Maryland.

Physician Continuing Medical Education Accreditation Statement
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 Postgraduate Institute for Medicine (PIM) and Emeritus Educational Sciences. PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for maximum of 1.0 AMA PRA Category 1 Credit^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

PHYSICIAN ASSISTANTS
The American Academy of Physician Assistants accepts AMA Category 1 credit for the PRA from organizations accredited by ACCME.

NURSING CONTINUING EDUCATION CNA/ANCC
This educational activity for 1 contact hour is provided by Postgraduate Institute for Medicine (PIM). PIM is an approved provider of continuing nursing education by the Colorado Nurses Credentialing Center’s Commission on Accreditation.

CALIFORNIA BOARD OF REGISTERED NURSING
Postgraduate Institute for Medicine is approved by the California Board of Registered Nursing, Provider Number 13485 for 1.2 contact hours.

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in health care and not a specific proprietary business interest of a commercial interest. The faculty reported the following financial relationships or relationships to products or devices they or their spouse/ life partner have with commercial interests related to the content of this CME activity: Danielle Arends, RN, APN/CNP, has no financial relationships to report. Elizabeth M. Galik, PhD, RN , CRNP, has provided consultant services to Pfizer.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity: Linda Graham, RN, BSN , BA (PIM), has no financial relationships to report. Tara Herrmann, PhD, has no financial relationships to report. Greselda Butler has no financial relationships to report.

METHOD OF PARTICIPATION
There are no fees for participating and receiving CME/CNE credit for this activity. During the period April 2008 through April 30, 2009, participants must:

1) read the learning objectives and faculty disclosures;

2) study the educational activity;

3) complete the posttest by recording the best answer to each question in the answer key on the evaluation form;

4) complete the additional evaluation questions by recording the relevant response to each question.

5) mail or fax the evaluation form with answer key to: Postgraduate Institute for Medicine, 367 Inverness Parkway, Suite 215, Englewood, CO 80112; Fax: (303)858-8848. This test also can be taken online at www.CliniciansCME.com. A statement of credit will be issued only upon receipt of a completed activity evaluation form and posttest with a score of 70% or better. Your statement of credit will be mailed to you within 30 days.

If you have any questions, call (800) 423-3576 or e-mail evaluations@pimed.com. A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Emeritus Educational Sciences, and Novartis do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Emeritus Educational Sciences, or Novartis. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management.

Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.