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Overview

Using Implementation Science to Improve Multidisciplinary Diagnostic and Treatment Pathways for Patients With PAH

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Activity URL:

https://www.achlcme.org/detail/5402/Using-Implementation-Science-to-Improve-Multidisciplina...

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Using Implementation Science to Improve Multidisciplinary Diagnostic and Treatment Pathways for Patients With PAH
Format
Interactive Practice Guide
Time to Complete
1.50 hr(s).
Release Date
June 30, 2025
Expires On
June 30, 2026

Multidisciplinary care is vital in the diagnosis, risk assessment, and treatment of patients with pulmonary arterial hypertension (PAH) and, although multiple therapies are available for PAH, patient outcomes remain suboptimal due to delayed diagnosis, underutilization of risk assessment tools, and undertreatment. To address these challenges and meet the needs of patients, evolving multidisciplinary approaches to PAH management offer recommended strategies for screening high-risk patients, diagnosis, initial and ongoing risk assessment, and treatment to support personalized care. However, for more patients to realize the benefits of this approach, comprehensive education is needed to ensure multidisciplinary team members, including those from cardiology, pulmonology, internal medicine, and pharmacy, among others, are prepared to perform integrated care functions. This interactive practice guide interweaves education and practical guidance for easy integration of the latest evidence into routine clinical practices, processes, and workflows.

This activity is intended for pulmonologists, cardiologists, primary care physicians, hospitalists, geriatricians, internal medicine physicians, pharmacists, and other members of the multidisciplinary teams treating at-risk patient populations.

Pulmonary arterial hypertension (PAH), or group 1 pulmonary hypertension, is a progressive disease with a 7-year survival rate of approximately 50% despite available treatments, and the reasons underlying the mortality rate are multifactorial. Retrospective analyses of practice patterns indicate patients with risk factors for PAH are not consistently screened for the disease, and patients with PAH are not diagnosed in a timely fashion. In addition, survey data show that clinical care of patients after diagnosis is suboptimal; risk assessment, which is vital for guiding treatment decisions in PAH, is not done by many clinicians at diagnosis or during therapy. Moreover, outcomes data suggest patients with PAH may not be receiving optimal therapy; a recent claims analysis found that more than 90% of patients were initiated on monotherapy despite evidence from clinical trials and treatment guidelines supporting combination therapy as the initial intervention for most patients. Finally, the recent approvals of a fixed-dose combination of macitentan and tadalafil, and the novel activin signaling inhibitor sotatercept, add an extra layer of complexity to the already challenging PAH treatment paradigm. Within this context of gaps observed in screening, diagnosis, risk assessment, and treatment, this educational activity will assist both individual clinicians and multidisciplinary teams apply the latest evidence for optimal management of patients with PAH.

Upon completion of this activity, learners will be able to:
• Integrate evidence-based approaches in the screening and diagnosis of PAH
• Implement treatment algorithms and clinical trial evidence in practice to optimize initial treatment selection and ongoing treatment modifications in PAH
• Establish MDT roles and workflows for monitoring therapy, facilitating access, and providing whole-person care for patients with PAH

Pharmacy Learning Objectives
Upon completion of this activity, pharmacists will be able to:
• Implement treatment algorithms and clinical trial evidence in practice to optimize initial treatment selection and ongoing treatment modifications in PAH
• Establish MDT roles and workflows for monitoring therapy, facilitating access, and providing whole-person care for patients with PAH

Diagnostic Standards
• Clinical classification
• Diagnostic criteria and testing
• Investigational markers and novel imaging modalities 

PAH Risk Assessment and Treatment Algorithms
• Risk assessment to inform treatment strategies 
- Treatment goals, escalation of treatment according to ongoing risk assessment
• Treatment guidelines
- Use of upfront combination therapy
• Latest clinical evidence
- Available therapies (MOAs, dosing/administration, safety and efficacy)
- Application of latest clinical and real-world evidence
• Challenges in treatment of PAH

Developing an Action Plan: Practical Strategies for Multidisciplinary Clinical Teams
• Establishing diagnostic and treatment protocols
• Expediting access to treatment 
• Patient management 
• Multidisciplinary team strategies

Provided by the Academy for Continued Healthcare Learning (ACHL).

Supported by an educational grant from Merck & Co., Inc.

John Ryan, MD, MB, BCH, BAO
Professor of Medicine
Director, Cardiology Fellowship
Chief, General Cardiology
University of Utah
Salt Lake City, UT

Aaron B. Waxman, MD, PhD
Associate Professor, Internal Medicine, Pulmonary Critical Care
Harvard Medical School
Executive Director, Center for Pulmonary Heart Disease
Pulmonary Critical Care
Brigham and Women’s Hospital
Boston, MA

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

The following financial relationships have been provided:

John Ryan, MD, MB, BCH, BAO (Chair)
Advisory Board: Gossamer Bio, Johnson & Johnson, Kiniksa Pharmaceuticals, Liquidia Technologies Inc., Merck, United Therapeutics 
Speakers Bureau: Gossamer Bio, Johnson & Johnson, Kiniksa Pharmaceuticals, Liquidia Technologies Inc., Merck, United Therapeutics 

Aaron B. Waxman, MD, PhD (Chair)
Advisory Board: Acceleron/Merck, INSMED, OrphAI, Pulmivant, Tectonics, United Therapeutics 
Data Safety Monitoring Board: INSMED

Grants/Research Support: Acceleron/Merck, OrphAI, Pulmivant, Tectonics, United Therapeutics 

ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Discussion of scientific information on unapproved uses (SIUU), off-label, investigational, or experimental drug/device use: imatinib, seralutinib, CS1, MK5475, dehydroepiandrosterone, and cibotercept are not approved for the treatment of PAH.

This activity will take approximately 90 minutes to complete. To receive credit, learners are required to complete the pretest, view the online activity, and complete the posttest and evaluation. To receive credit, 75% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

For questions, contact McKenna Reinhard at mreinhard@achlcme.org.

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Academy for Continued Healthcare Learning designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician assistants, nurse practitioners, and nurses may participate in this educational activity and earn a certificate of completion as AAPA, AANP, and ANCC accept AMA PRA Category 1 Credits™ through their reciprocity agreements.

The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 

This activity has been approved for 1.5 contact hour.
ACPE Universal Activity Number: 0396-0000-25-005-H01-P

Activity Type: Application

Partial credit may not be awarded for CPE credit; participation in the complete activity is required to receive credit. CPE credit will be submitted to CPE Monitor® on the first business day of each month.

Completion of this activity, including the pretest, posttest, and follow-up assessments, qualifies as a medium weight MIPS improvement activity under MACRA and can be claimed as completion of IA_PSPA 28 of an Accredited Safety or Quality Improvement Program in the Quality Payment Program. Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website. You will receive additional information after completing the activity and receiving your certificate via email.

McKenna Reinhard
mreinhard@achlcme.org
(773)714-0705 ext. 121
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