Optimizing Treatment of Parkinson’s Throughout the Disease Course

Program Outcome Summary

Grant #8822

(Draft)

Richard Lewis, PharmD, MBA Executive Director, ProCE, Inc.

Office: (630) 540-2917 RLewis@ProCE.com

Prepared by: Valerie Smaga

Office: (630) 540-2848 vsmaga@ProCE.com

ProCE, Inc. is an independent continuing education provider that develops, delivers, and evaluates educational programs for healthcare professionals. This program is supported by an educational grant from TEVA Neuroscience.

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CONTENTS

Program Overview

– Learning Objectives – Outcome Methodology – Program Highlights – Participants – Faculty

Program Evaluation Summary

– Achievement and Impact of Learning Objectives – Impact of Program on Clinical Practice – Change in Practice Behavior – Effectiveness of Speaker and Overall Program – Additional Participant Comments – Suggestions for Future Programming

Addendum A – Outcome Levels

Addendum B – Evaluation Form

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Program Highlights

Data were obtained from 75 evaluation forms completed online after the conclusion of the seminar. (See Addendum B for evaluation form.) All attendees did not respond to every question. 84% of respondents intend to make a change in their practice based on the information provided

(Outcome Level 4 – Competence).

All of the attendees indicated that the learning objectives were achieved (Outcome Level 3A – Learning: Declarative Knowledge).

Approximately 86% of respondents rated the faculty’s teaching effectiveness (organization, delivery, and content) as very good to excellent (Outcome Level 2 – Satisfaction).

The measurements used in the evaluation process reveal a high level (97%) of attendee satisfaction with the program design/content overall (Outcome Level 2 – Satisfaction).

PROGRAM OVERVIEW

A continuing education program titled Optimizing Treatment of Parkinson’s Throughout the Disease Course was presented at three live symposia:

November 14, 2011 - St. Paul, MN November 15, 2011 – Rochester, MN November 15, 2011 – La Crosse, WI

This CE activity presented the growing evidence that supports effective management of Parkinson’s disease through an individualized, patient-focused approach. Such approaches are crucial to minimize disability, improve health-related quality of life, and achieve therapeutic success. Pharmacists and physicians received 1.5 hours of credit for their participation in this educational activity. Accreditation for physicians was provided by the National Association of Managed Care (NAMCP), and pharmacy credit was provided by ProCE, Inc., an accredited provider of continuing pharmacy education.

Learning Objectives

At the conclusion of this program, participants should be able to:

Outline features of PD that impact health-related quality of life.

Discuss motor complications associated with levodopa and therapeutic options for management

Compare and contrast the efficacy and safety of dopamine agonists, levodopa, and monoamine oxidase inhibitors

Outcome Methodology

Outcome levels are defined in this report according to the Expanded CME Framework described by Moore and colleagues. Please see Addendum A for a description of each outcome level.

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Participants

(Outcome Level 1 – Participation)

Target audience: Medical directors, neurologists, and pharmacists Total attendees: 105 La Crosse, WI (45) Rochester, MN (18) St. Paul, MN (42) Evaluations Submitted: 75 Audience demographics: 69 Pharmacists 6 Physicians

Faculty

Jack J. Chen, PharmD, FCCP, BCPS, CGP Associate Professor of Neurology Movement Disorders Clinic Loma Linda University Schools of Medicine and Pharmacy Loma Linda, California Michael Rezak, MD, PhD Neurosciences Institute Central DuPage Hospital Winfield, Illinois

Pharmacists92%

Physicians8%

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PROGRAM EVALUATION SUMMARY

To receive credit, attendees were required to complete an online evaluation. 75 of 105 attendees submitted evaluations. Achievement and Impact of Learning Objectives (Outcome Level 3A – Learning: Declarative Knowledge)

The following learning objective was achieved (n=75): Outline features of PD that impact health-related quality of life The following learning objective was achieved (n=75): Discuss motor complications associated with levodopa and therapeutic options for management.

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The following learning objective was achieved (n=75): Compare and contrast the efficacy and safety of dopamine agonists, levodopa, and monoamine oxidase inhibitors. Impact of Program on Clinical Practice Please describe specifically what you learned today that you will apply to your practice. (Outcome Level 4 – Competence)

Address incontinence issues of Parkinson’s

Being better armed to tackle questions regarding quality of life and support the nonmotor symptoms of the disease

Better monitoring of SE profiles

Drug therapy (correct) can make a difference

Early signs of Parkinson’s

Effectiveness of deep brain stimulation and use MAOB inhibitor and dopamine agonist as primary Rx, delaying L-dopa as long as possible

Hold off on levodopa as long as possible

How DBS dramatically improved the quality of life of patients

How drugs are used

I gained a better understanding of the challenges clinicians face when prescribing carbidopa/levodopa and subsequent dose adjustments

I learned about olfactory dysfunction, as well as many of the nonmotor-related symptoms of PD

Learned pros and cons of each drug class and appropriate situations to suggest each

Learned well the appropriate use of levodopa & other drugs

Medication options to treat Parkinson's

Pharmacy retail

Priority of the approach to treating nonmotor effects of Parkinson’s with medications

Research

Stress the importance of trying to delay levodopa therapy

The better understanding of patients with Parkinson’s

The nonmotor complications of the disease

Treatment of side effects of medications used to treat PD

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I intend to make a change in my practice based on the information provided. (Outcome Level 4 – Competence; n=75)

How do you plan to implement what you learned today in your practice? (Outcome Level 4 – Competence)

Add to list

An inservice (learning opportunity) for the providers at my healthcare facility would be appropriate after learning so much at this program

Better evaluation of potential patients at risk, with earlier treatment when possible

Better understanding of the drug regimen

By identifying the PD patients and providing them with more consulting information

During patient consultation or specific recommendations requested from providers

Engage patients and caregivers in conversation

Help direct patients to new advances in the treatment of Parkinson's

Help with balancing side effects and drug effectiveness

Making new recommendations

Reinforce to patients that nonpharmaceutical treatments may be an option for them

Sharing information learned with patients

Suggestions to physicians

Will alter sequence of meds used

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Effectiveness of Speaker and Overall Program Speaker Effectiveness (n=75) (Outcome Level 2 – Satisfaction)

Learning Materials Appropriate and Effective (n=75) (Outcome Level 2 – Satisfaction)

0%

10%

20%

30%

40%

50%

60%

70%

Poor Fair Good Very Good Excellent

0% 0%

20%

48%

32%

0% 0%

20%

36%

44%

0% 0%

8%

44% 48%

0% 0%

8%

60%

32%

Organization

Delivery

Content

Audio‐Visual

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Learning Activities Appropriate and Effective (n=75) (Outcome Level 2 – Satisfaction) Program Fair, Balanced and Lacked Commercial Bias (n=75) (Outcome Level 2 – Satisfaction)

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Comments Regarding Speakers

Both speakers did a superb job

Both speakers were good

Both were very knowledgeable in presenting the topic

Dr. Rezak’s presentation was especially informative

Dr. Chen presented very well, and Dr. Rezak showed an extensive knowledge base and experience regarding subject

Dr. Rezak did an excellent presentation

Enjoyed both speakers and appreciated their 1st hand experience with patients

Excellent

Fine

Good presentation by Dr. Rezak

I enjoyed the second phase with Dr. Rezak more

I really enjoyed the diagrams and videos. It helped with the being able to visualize especially how the surgeries helped patients. Asking questions to the audience also helped me learn.

I thought Dr. Chen was hard to follow. Dr. Rezak did a great presentation.

I would have preferred having an overview of disease and pathophysiology prior to pharmacological presentation

Interesting material from both, Dr. Rezak's material was more interesting

Jack Chen was not as effective a speaker compared to Dr. Rezak. Dr. Rezak's delivery was extremely enlightening, thorough and I did not want to fall asleep.

Dr. Rezak was excellent

Really appreciated the insight of clinicians who see this type of patient daily

Dr. Rezak had good information content

Session began somewhat slow, but pace improved

The non-neurological side effects of the disease and the medications

They were excellent speakers with current info on Parkinson’s treatment

Very good presentation by both speakers

Additional Participant Comments

Brain stimulation still seems quite frightening; my patient had much poorer response

Good program, thanks for the invitation

Good work

It was a very interesting and informative class

Very clear and informative

Suggestions for Future CE Programming

Infectious disease, pain management, and heart failure and treatment options

It is needed to provide medical professionals with the CE needed for their licensing

Thoughtful sequence for meds in DM

Wading through all the ACE inhibitors

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Addendum A – Outcome Levels

Moore DE Jr, Green JS, Gallis HA. Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. J Contin Educ Health Prof. 2009;29:1-15.

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Addendum B – Evaluation Form