Globally, lung cancer is the most commonly diagnosed cancer in both sexes combined. The development of targeted therapies has proven to be more effective and better tolerated than previously used chemotherapy regimens for the treatment of non-small cell lung cancer (NSCLC) with up to 69% of patients having an important driver mutation. ALK rearrangements in advanced NSCLC contribute to up to 7% of cases. The treatment of ALK-positive advanced NSCLC has evolved rapidly over the past decade with the development of ALK inhibitors, and use of these agents has almost doubled the progression-free survival of patients with ALK rearrangement-positive NSCLC. With 5 ALK inhibitors currently approved by the FDA, the selection of the inhibitor goes beyond efficacy due to the complex management of adverse effects and adherence in patients self-administering these medications. This activity also addresses the role of pharmacists in counseling patients on adverse effect management to improve outcomes.

The use of digital technology and wireless communication systems has become more common in health care and has enabled patients to communicate important information about their vital signs, specific symptoms, and adherence to health care providers in multiple locations. Many patients with multiple sclerosis (MS) have expressed interest in the use of technology for their own self-management, including use of apps that help provide social support and self-management of their disease. Pharmacists need to understand the role of technology for patients with MS, including the use of smart auto-injectors as well as how innovative technology can be applied to improve health care decisions, improve adherence, and enhance engagement to improve patient outcomes. This program focuses on digital and mobile technology systems that are being utilized in patients with MS and explains how data may be applied for specific patient case- and population-based decisions.

The National Institute for Occupational Safety and Health is concerned about the risk and exposure of health care workers who handle, prepare, or administer hazardous drugs (HDs), such as chemotherapeutic agents, or those who work in areas where these drugs are used. Due to potential health risks associated with unintentional exposure to these agents, it is necessary to implement proper policies and procedures for safe handling, from delivery through disposal. This activity will highlight ways that health-system pharmacists can stay well informed on current best practices and appropriate measures to prevent unintentional exposure to HDs.

Pulmonary arterial hypertension (PAH) is a rare, debilitating, and fatal disease. Therapies are available that can improve symptoms and slow clinical deterioration of PAH; however, these therapies are characterized by complex management needs. This activity will provide a disease state overview, summarize PAH treatments and recommendations for management, and incorporate updates from the recently published consensus documents from the 6th World Symposium on Pulmonary Hypertension.

An estimated 19,520 new cases of acute myeloid leukemia (AML) were estimated to occur in the United States in 2018, with an estimated 5-year overall survival of 27.4%. Despite years of clinical research, intensive induction and consolidation chemotherapy is the primary therapeutic approach for patients with AML; however, only 40% to 45% of younger adults and 10% to 20% of older adults with AML will be cured after traditional chemotherapy. Chromosomal abnormalities and characterization of specific mutations help to predict outcomes and are a major part of risk stratification. Recent advances in the treatment of AML include new formulations of chemotherapy agents as well as targeted approaches and are rapidly transforming the landscape. The evolving role of the pharmacist as well as the benefits of services pharmacists can provide within the health care team and for patients with AML will also be highlighted. 

In 2018, there were an estimated 268,670 new cases of breast cancer and 41,400 deaths in the United States. Clinical treatment decisions are guided by the presence (+) or absence (–) of the hormone receptor (HR), which encompasses the estrogen receptor (ER) and the progesterone receptor (PR), and the human epidermal growth factor 2 receptor (HER2). Over 70% of invasive breast cancers are HR+. The cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors palbociclib, ribociclib, and abemaciclib approved for use in patients with HR+/HER2– advanced breast cancer are contributing to quickly evolving treatment paradigms. Although these agents benefit patients with breast cancer, they also add markedly to the complexity of care, including the need for proactive management of treatment-related toxicities. It is critical that the pharmacist supports the health care team with his/her knowledge of the efficacy, safety, and special patient considerations of the CDK4/6 inhibitors. This program will also address specific patient education and counseling points for pharmacists to discuss with patients receiving these agents.

Agents approved by the FDA for the treatment of cancer are being brought to market at a rapid pace, and many of them have novel targets and mechanisms of action. From June 2017 to April 2018, 10 new agents were approved, and 24 agents were approved for expanded indications. With the rapid advancement of care for patients with cancer, pharmacists will be challenged to keep up-to-date with the specific characteristics of each agent as well as to educate peers and patients. This reference guide will provide an overview of each of these agents to equip pharmacists with the knowledge needed to optimally fulfill their role on the oncology health care team. 

This activity will review the public health issues surrounding rabies prevention, prophylaxis, and treatment.  The current agents available for postexposure prophylaxis, and their recommended use, will be highlighted.

Hereditary angioedema (HAE) is a rare autosomal dominant condition characterized by recurrent attacks of edema at different locations of the body. This potentially life-threatening disease affects approximately 1 in 67,000 individuals, with no identified differences in sex or ethnicity. This educational activity will provide an overview of current and emerging diagnostic and treatment strategies, with a focus on recent clinical trial data, that will reduce the likelihood of fatalities resulting from swelling attacks. New options for on-demand treatment and long-term prophylaxis have substantially improved the burden of disease and health-related quality of life in patients with HAE. Although several new therapies to both treat acute HAE attacks and provide prophylaxis for patients with recurrent episodes have been introduced in the past several years, the disease has a significant economic impact with high direct and indirect costs, and high charges related to the new therapies developed for patients to reduce symptoms and attack recurrence.

Psoriasis affects 2.2% of the US population; 10% to 20% of these patients will develop psoriatic arthritis. Early diagnosis and treatment are critical to improve patient outcomes, but this is often challenging due to varying presentations of extradermal complications of psoriasis in patients. Differentiating the various treatment regimens and exploring how to implement cost-effective therapies to improve quality of life for the patient will be some highlights discussed by an expert clinician and specialty pharmacist.

Immunoglobulins have been used since the 1950s and, over time, the number of available products has increased. In addition to the rationale for use, it is important to understand that these products differ in indications, methods of administration, ingredients, and production methods. After attending this program, participants will be able to explain the differences between available immunoglobulin products and their place in therapy.

This Pharmacy Times Continuing Education program will highlight the pharmacotherapy of cystic fibrosis and the role of the specialty pharmacist.

Rheumatoid arthritis (RA) is an autoimmune disease associated with joint pain, inflammation, and stiffness that can result in permanent disability and disfigurement if not properly treated. Disease-modifying antirheumatic drugs (DMARDs) have been the gold standard for treatment. The emergence of biosimilar drugs provides additional treatment options for patients with RA, but the substitution of biosimilars for these reference drugs may be challenging. This program will provide participants with the key tools to identify appropriate treatment options to maintain remission and improve quality of life in patients with RA.

Hereditary angioedema (HAE) is a rare but potentially life-threatening disorder characterized by intermittent attacks of swelling in any part of the body, without the presence of hives. HAE is commonly associated with a deficiency in functional C1 esterase inhibitor (C1-INH) activity. This educational activity will provide an overview of current and emerging diagnostic and treatment strategies, with a focus on recent clinical trial data, that will likely reduce swelling attacks. New options for on-demand treatment and long-term prophylaxis have substantially improved the burden of disease and health-related quality of life in patients with HAE. Early diagnosis is vital, so it is of utmost importance that providers recognize the most common clinical features of HAE and evaluate patients to effectively diagnose, prevent, and treat future attacks.

Topical skin disorders, such as facial and truncal acne, melasma, and photoaging, can have a significant impact on a patient’s quality of life. Azelaic acid is a dicarboxylic acid with anti-inflammatory and antibacterial properties. Based on the results of clinical data, it is safe and effective for the treatment of facial and truncal acne, melasma, and photoaging. Current research suggests that its use in dermatologic conditions continues to evolve. This activity will provide pharmacists with an understanding of the pharmacologic effects, clinical data, and appropriate use of azelaic acid.

Many patients with primary and secondary immunodeficiency syndromes require lifelong intravenous immunoglobulin (IVIG) therapy to reduce the risk of infection. The production process of IVIG leads to variability among different products that can potentially impact tolerability and safety. Specialty pharmacists should be aware of IVIG product differences and patient populations most vulnerable to adverse effects (AEs) related to these differences. This activity reviews the process of IVIG production, key characteristics of available IVIG products, and considerations between subcutaneous (SC) and intravenous administration of immunoglobulin.

New and emerging therapies have demonstrated significant efficacy in the treatment and management of moderate to severe plaque psoriasis. This educational session will discuss the advancing therapeutic landscape of plaque psoriasis and the clinical efficacy and safety profiles of newer biologic agents indicated for the treatment of psoriasis. Identifying the most appropriate patients with plaque psoriasis for the new therapies and the role of specialty pharmacists to optimize pharmacologic treatment and therapy adherence in psoriasis care will be explained.

Emerging therapies with PCSK9 inhibitors in hyperlipidemia have changed the treatment landscape. Specialty pharmacists need to know about the appropriate use for patients with high LDL levels. This webinar will explore the economic burden of cardiovascular complications caused by high cholesterol, criteria for patients to benefit from PCSK9 inhibitors, and their appropriate role in cardiovascular therapy. It is imperative for pharmacists to understand evidence-based indications for PCSK9 inhibitors, while implementing strategies for optimizing their use in appropriate patient populations.

At the completion of this activity, the participant will be able to: Explore the treatment landscape of lung cancer; compare different systemic treatment and novel treatment approaches in lung cancer therapy; identify the adverse event profile of oncology treatments and the proper management of these events; interpret different guidelines available for the treatment of lung cancer; examine the role of pharmacists on collaborative lung cancer care teams in different treatment settings to achieve optimal patient care.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive disease characterized by fibrosis and worsening lung function that predominantly affects individuals aged 60 years and older. IPF remains difficult to diagnose and manage, however, because of its unknown etiology, varied clinical course, associated comorbidities, and nonspecific respiratory symptoms. In fact, data show that when compared with age-, gender-, race-, and region-matched controls, patients with IPF have a 126% increased risk of emergency room visits and a 134% higher risk of hospitalization (per person-years, respectively). Consequently, IPF-related hospitalizations and acute exacerbations are associated with a high economic burden, accentuating the need for treatments that slow disease progression and improve patients’ quality of life. Two agents, nintedanib and pirfenidone, were FDA-approved for the treatment of IPF in 2014 and received conditional recommendations for use in the updated American Thoracic Society IPF Clinical Practice Guidelines. However, use of these medications is expected to significantly increase cost of care, considering each treatment regimen exceeds $90,000 annually. To optimize pharmacoeconomic outcomes, the use of these medications requires innovative strategies to manage costs associated with drug utilization and clinical management. Specialty pharmacies have emerged and continue to play a significant role in managing drugs with high acquisition costs through medication dispensing, disease management programs, and negotiating discounts and rebates to optimize patient care. As a result, it is critical that specialty pharmacists understand evolving treatment paradigms, the clinical course and evolution of disease, as well as the safe and appropriate use of medications in the management of IPF.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive disease that is characterized by worsening dyspnea, declining lung function, nonspecific respiratory symptoms, a varied clinical course, as well as a host of comorbid conditions, making diagnosis and management challenging. Prior to the approval of pirfenidone and nintedanib in 2014, lung transplant and palliative care were the only options for management of IPF. With the addition of these 2 agents in the updated American Thoracic Society IPF Clinical Practice Guidelines with conditional recommendations, cost of care for IPF is expected to increase significantly. Pharmacists can play an important role for patients by knowing the nonpharmacologic and pharmacologic treatment options for patients with IPF, and providing education and guidance on the therapies to improve adherence.

This webinar will focus on pulmonary arterial hypertension (PAH) as a disease state as well as treatment guidelines and goals, which require a multidisciplinary approach from healthcare personnel. Health-system pharmacists’ involvement can enhance patient education and improve medication use as patients with PAH commonly use multiple treatments for the disease including supportive therapy, which significantly increases the chances of adverse effects and drug interactions. In addition, the options for treating symptoms of PAH have increased with several different drug classes and delivery routes available. This activity will highlight the information on the various therapeutic options to keep hospital pharmacists updated in order to provide the appropriate clinical guidance to the healthcare team.

The treatment landscape for multiple myeloma (MM) is evolving rapidly, and pharmacists need to be aware of the increasing number of therapeutic options. With the introduction of new classes of drugs, such as immunomodulatory drugs, proteasome inhibitors, monoclonal antibodies, and histone deacetylase inhibitors, patient care is becoming increasingly complex. This session will explore the current and emerging treatment of multiple myeloma and managing therapy-induced adverse effects. With appropriate patient education, medication adherence and treatment outcomes can be optimized.

Immunotherapy is established as an effective treatment for numerous types of cancer and has emerged as a fourth pillar of cancer care, in addition to surgery, cytotoxic therapy, and radiotherapy. Given the rapid expansion of indications for immunotherapy agents and combination therapies, oncology pharmacists must take on a larger role to ensure patients understand their treatment regimens. This activity will provide information on available immunotherapy agents and approaches to ensure access and adherence to newly approved immunotherapy-based treatments, appropriate supportive care measures, and support for financial issues related to patients’ treatment.

Pharmacists and other healthcare practitioners must have a basic understanding of the wound healing process in order to help patients select appropriate wound care therapies. This activity will describe the wound healing process, analyze the current evidence-base for the use of alternative or herbal medications such as calendula officinalis, and suggest tips regarding patient counseling and education in the community setting.

Explain the current treatment guidelines, pharmacologic options, and the potential for treatment failure in rheumatoid arthritis. Investigate new and emerging rheumatoid arthritis therapies. Examine the changing landscape of rheumatoid arthritis biosimilar products. Identify the role of specialty pharmacists in the care of patients with rheumatoid arthritis.

Targeting the right pathways in inflammatory bowel disease (IBD) and providing the right medication for the pathways involved can have significant effects on outcomes for patients with this condition. There is a wide range of pharmacologic agents in the treatment of IBD and research indicates that there is a need to educate specialty pharmacists about this range of current and emerging pharmacologic treatments, as well as the best manner in developing a benefits design strategy which can minimize the economic burden of the disease.

Illustrate the impact CF has on patients and caregivers. Identify patients who qualify for CFTR modulator therapy. Apply methods to counsel patients and improve access and adherence to therapy.

Explain the pathophysiology and diagnostic criteria for atopic dermatitis. Identify pharmacologic options for management of moderate to severe atopic dermatitis, including guideline recommendations and emerging treatments. Examine the economic implications and the role of the specialty pharmacist in atopic dermatitis patient care.

This 1.5 hour on-demand webcast will focus on available and emerging treatment options for hemophilia to better individualize therapy and address the clinical and economic burden that patients face when dealing with this challenging disorder. The didactic information presented will be supported by an interactive discussion by a panel consisting of a physician and clinical pharmacist to enhance the multidisciplinary approach to the management of hemophilia.

Early initiation of combination targeted therapy to address multiple sites of pathophysiology (the physiologic approach) might slow T2D progression and improve patient outcomes. Complementary mechanism of actions and weight and glycemic effects of basal insulin and GLP-1 RAs support this combination. New fixed dose basal insulin and GLP-1 RA combination products could facilitate the application of the physiologic approach, reduce injection burden, and increase medication adherence. Pharmacists should be aware of appropriate candidates for insulin and GLP-1 RA combination therapy and how to effectively counsel patients starting on these therapies. This activity will provide key strategies and case scenarios to optimize patient education and management of diabetes with the GLP-1 RA/ basal insulin combination.

Pharmacy Times Continuing Education™ has built three (3) CE accredited, detailed simulation-based, branching patient cases (for a total of 2 CE credits) that match the patient population, medical conditions and situations encountered in patients with diabetes that are on fixed-dose combination therapy. Participants are given multiple ways to progress through the simulation and, based on the learners’ choices, the simulation evolves, decision by decision. This simulation provides an approach for teaching clinical reasoning because the learner makes decisions that impact the outcome of his or her patient. The activity will be accredited for a total 2.0 credits after completing all 3 cases.

Vaccination has significantly decreased the burden of preventable infectious diseases around the world, but many populations remain unvaccinated. Each year, approximately 40,000 to 50,000 adults and 300 children die from preventable illness or complications associated with preventable illness. This presentation will review the 2016-2017 Advisory Committee on Immunization Practices’ guidelines for vaccinations including the varicella vaccine, influenza vaccine, pneumococcal vaccine, and hepatitis A and B vaccine. The role of convenient care providers and pharmacists as advocates for preventable diseases and vaccination will be discussed.

Insomnia is one of the most prevalent patient complaints with more than 95% of people experiencing some degree of insomnia during their lifetime. Unfortunately, insomnia remains underdiagnosed and undertreated. This presentation will describe nonpharmacologic and pharmacologic treatment options for insomnia based on published guidelines, and will review the potential role of the convenient care provider and pharmacist in the management of this condition.

In the United States, approximately 50% of pregnancies are unintended and may significantly impact the social, economic, and health outcomes of both the mother and child. Long-acting reversible contraception is significantly underutilized despite an effectiveness rate of greater than 99%. In addition to long-acting, safe, and reliable contraception, LARC provides additional non-contraceptive benefits. This presentation describes LARC methods, such as intrauterine devices and implants, and reviews current recommendations regarding LARC use for the convenient care provider and pharmacist.

This application-based activity will focus on the pharmacist's role in the management of patients with poorly controlled asthma through counseling and patient education. It will also present the current treatment guidelines and the advantages and disadvantages of each medication.

Asthma is a common, chronic problem affecting up to 18% of the population in different countries. It is defined as a heterogeneous disease usually characterized by chronic airway inflammation. Asthma symptoms are variable and can intensify and vary over time due to multiple environmental and/or health conditions. It is important that all members of the healthcare team understand the nature and variability of asthma. As an integral member of the healthcare team, pharmacists also need to recognize the conditions that can mimic symptoms of asthma or be found in conjunction with asthma.

Lung cancer is the leading cause of cancer deaths in the US and as therapy advancements develop, so do the complexity of the regimens. This has led to the evolution of pharmacy practice in the oncology clinic as well as the specialty retail pharmacy, and pharmacists practicing within these settings are becoming more involved in the management of oncology patients. A multidisciplinary panel discussion will explore the various treatment options and guidelines for lung cancer therapy and apply it to the patient perspective to identify the roles of each health care professional in optimizing treatment. This activity will also include a skills workshop to provide the unique opportunity of applying didactic knowledge to real-life scenarios to reinforce the information presented.

This podcast will review the guidelines for screening and diagnosing patients with cystic fibrosis (CF) and highlight how to appropriately identify patients who qualify for cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy. Specialty pharmacists are in the perfect position to have consistent communication with patients with CF as well as with other healthcare providers, including the prescribing physician and the health-system/center-for-excellence CF pharmacist. The specialty pharmacist may be the last healthcare professional the patient will interact with prior to taking their medication; therefore, counseling on adherence to therapy will play a large part in patients’ day-to-day activities. This podcast will focus on information on the newest CF therapies and provide best practices for patient education on CF and how to help improve patient access to these therapies.

In the United States, approximately 1 in 8 women will develop invasive breast cancer during their lives. Although death rates have decreased since 1989, breast cancer remains the second leading cause of cancer death, behind lung cancer, in women. This on-demand webinar will provide information on the use and proper role of CDK4/6 inhibitors in the care of patients with ER+/HER2-negative breast cancer. Also discussed will be strategies for pharmacists to incorporate a collaborative care model into practice, and evaluate patient-reported outcomes and indirect treatment comparisons for formulary considerations.

ALS is a progressive disease in which the motor neurons eventually die, and mortality is usually the result of respiratory failure. Currently, there is no cure for ALS. However, in the last decade advances have been made in both discovery and research that are promising. As new therapies enter the forefront of ALS care, a multitude of healthcare professionals will need to understand more about the disease state, therapy, and their role within ALS care. This activity will explain the impact of amyotrophic lateral sclerosis (ALS) and the value of early diagnosis; examine recent ALS therapy advances, including the efficacy and mechanism of action of new agents; analyze the implications of ALS therapy in the managed care setting; and distinguish the need for integrations among physicians and specialty and managed care pharmacists in the coordination of care for patients with ALS.

Over the past decade, the number of therapeutic options for CLL have increased. As our knowledge of the biology of CLL has grown, targeted therapies directed at B-cell receptor signaling and other aberrant B-cell processes have emerged. Therapy has become more patient-specific through an understanding of risk factors and prognostic indicators. Chemoimmunotherapy remains the mainstay of treatment of CLL but newer targeted therapies such as ibrutinib, idelalisib, and venetoclax are becoming standards of care, as demonstrated by the adoption of targeted therapies into national guidelines. In addition to clinical efficacy, adverse event profiles must be considered. This activity will discuss new CLL treatment options and their place in therapy.

This continuing education activity will enable pharmacists to become more knowledgeable about current and emerging pharmacologic treatment options in rheumatoid arthritis. Requirements necessary for approval of a biosimilar agent will be explained. Pharmacists will learn that to minimize treatment failure, maximize adherence, and optimize outcomes, patient communication is vital in the management of rheumatoid arthritis