Family Medicine: An Evidence-Based Approach to Patient Care

Day 1

Irritable Bowel Syndrome.

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Appraise possible etiologies for Irritable Bowel Syndrome.
2. Select and utilize diagnostic criteria to identify IBS, based on the current medical evidence and expert recommendations.
3. Use the current medical literature to assess and screen for other conditions that can present with similar IBS symptoms.
4. Detect “red flag” signs and symptoms that should make one question the diagnosis of IBS.
5. Formulate an EBM diagnostic evaluation for patients with signs and symptoms of IBS.
6. Use the current medical literature to develop an EBM treatment plan for Irritable Bowel Syndrome.

Dyspepsia.

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Appraise symptoms and common etiologies for dyspepsia.
2. Use EBM to detect “alarm symptoms” that are suspicious for GI malignancy.
3. Apply current medical evidence and expert guidelines to construct a diagnostic evaluation for Dyspepsia.
4. Determine appropriate treatment for Dyspepsia based on current medical evidence and the likely etiology.

Chronic Obstructive Pulmonary Disease (COPD): Evaluation and Treatment.

Upon completion of this session, using the ACCP GOLD guidelines, the AACVPR practice guidelines and the evidence-based reports from Clinical Evidence, the participant should be able to: ^{EBM, GL, COMP}

1. Appraise patient specific data to determine if they meet diagnostic criteria for COPD.
2. Analyze the role of cigarette smoking in the etiology and natural history of COPD.
3. Formulate a treatment plan for the stages of COPD.
4. Recommend the follow-up required to assess the therapeutic efficacy of the treatment options.

Treating Patients with Type 2 Diabetes Mellitus.

Upon completion of this session, using the American Diabetes Association, the European Association for the Study of Diabetes Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Evaluate the therapeutic goals in treating type 2 diabetes and their impact on morbidity and mortality.
2. Recommend the approach for choosing an oral hypoglycemic agent to treat type 2 diabetes.
3. Specify the clinical situations that would require the use of insulin to treat type 2 diabetes and the probable dosage form and average amounts required for control of A1c.

Develop the therapeutic options for preventing diabetic complications.

Day 2

Evaluation and Treatment of Hypertensive Patients.

Upon completion of this session, using the most recent JNC Guidelines, the Cochrane Abstract Database and the evidence-based reports from Clinical Evidence, the participant should be able to: ^{EBM, GL, COMP}

1. Employ the non-pharmacologic treatment options to manage hypertension.
2. Specify the pharmacologic treatment options for patients with compelling indications based upon JNC Guidelines.
3. Formulate the therapeutic goal for controlling blood pressure in different patient populations and the combination of medications that can achieve that goal.
4. Distinguish the side effect risks for each class of antihypertensive medications.

Migraine Headaches – Update on Diagnosis and Treatment.

Upon completion of this session, using the International Headache Society and U.S. Headache Consortium Guidelines and the National Guideline Clearinghouse and the evidence-based reports from Clinical Evidence, the participant should be able to: ^{EBM, GL, COMP}

1. Construct the approach for evaluating a patient with possible migraine headaches.
2. Assess the advantages of supportive therapy and lifestyle changes in treating migraine headaches compared to pharmacologic therapy.
3. Appraise the pharmacologic options for treating the acute pain of a migraine headache.
4. Recommend a prophylactic therapy regimen for patients with recurrent migraine headaches.

Dementia.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Detect symptoms consistent with the diagnosis of dementia.
2. Distinguish dementia from treatable conditions that have similar presentations.
3. Construct a diagnostic plan utilizing EBM and Expert Guidelines.
4. Differentiate the common Dementia syndromes and distinguish the characteristics between them.
5. Use EBM to design a treatment plan for dementia.

Hyperlipidemia and CV Disease Prevention – A Review of the Literature and Recent AHA Guidelines.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Create a diagnostic and treatment plan for patients based on the current evidence and AHA Guidelines.
2. Explain similarities and differences between the most recent and previous guidelines.
3. Identify areas of strength and weakness in the recent AHA Guidelines.
4. Utilize the most recent cholesterol guidelines at the point of care.

Day 3

Adult Health Screening and Immunizations – Evidence-Based Approach.

Upon completion of this session, using the USPSTF and Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Apply the evidence-based recommendations for preventive screening tests for adults.
2. Determine the immunizations required for adults.
3. Appraise the side effects of adult immunizations.
4. Select the contraindications for each adult immunization and their alternative therapy.
5. Plan when screening tests can be discontinued in adults.

Anemia – A Finding, Not Yet a Diagnosis.

Upon completion of this session, using the Cochrane Abstract Database and AAFP Guidelines, the participant should be able to: ^{GL, COMP}

1. Distinguish the etiologies for the common anemias.
2. Construct the diagnostic evaluation to determine the etiology of each anemia.
3. Develop the therapeutic options for each identified anemia.
4. Formulate the appropriate follow-up evaluations for assessing the treatment efficacy.

Carpal Tunnel Syndrome.

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Apply an evidence-based approach to the identification of Carpal Tunnel Syndrome.
2. Detect clues that can help identify likely etiologies for Carpal Tunnel Syndrome.
3. Construct a differential diagnosis for Carpal Tunnel Syndrome.
4. Determine which patients would benefit from nerve conduction studies.
5. Discriminate the severity of Carpal Tunnel Syndrome.
6. Use EBM to select an appropriate treatment plan for Carpal Tunnel Syndrome

Evaluation and Treatment of Respiratory Infections Commonly Seen in Primary Care.

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Formulate appropriate evaluation strategies for patients who present with respiratory conditions.
2. Identify history and exam findings that help differentiate common respiratory conditions.
3. Determine situations when antibiotics are appropriate for the treatment sinus infections.
4. Utilize severity index tools in the evaluation of pneumonia.
5. Utilize EBM to determine appropriate treatment for common respiratory conditions.
6. Discuss some of the controversies in the treatment of common respiratory infections seen in primary care.

Day 4

Ischemic Heart Disease in Women.

Upon completion of this session, using the American College of Cardiology, the American Heart Association, the USPSTF Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Differentiate the symptoms that women with coronary artery disease (CAD) exhibit in contrast to those experienced by men.
2. Recommend the evidence-based interventions to prevent CAD in women.
3. Formulate the recommendations to treat the risk factors for CAD in women.
4. Specify the treatment required for women with proven CAD.

Venous Thromboembolism (VTE): Diagnosis and Treatment.

Upon completion of this session, using the ACCP and ATS Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Determine the diagnostic testing for evaluating a patient for possible VTE.
2. Apply the algorithm for diagnosing a pulmonary embolism in multiple clinical settings.
3. Differentiate the advantages and disadvantages of outpatient treatment compared to inpatient treatment for venous thromboembolism (VTE).
4. Order the frequency of monitoring and the adjustments needed for warfarin therapy in the treatment of VTE.

The Science Behind Marijuana Pharmacology.

Upon completion of this session, the participant should be able to: ^COMP

1. Understand the central mechanism of action for the most common cannabinoids
2. Define and understand the role of the Endocannabinoid system.
3. Describe the pharmacological effects on the human body through a system-based approach
4. Discuss toxicity levels of THC and impact on overall health
5. Understand the mechanism behind tolerance and dependence
6. Discuss Drug to Drug Interactions
7. Discuss therapeutic uses of cannabis preparations based on different levels of evidence

Federal and State Laws Regarding Medical Marijuana.

Upon completion of this session, the participant should be able to: ^COMP

1. Understand why federal policy generally prohibits medical marijuana and hinders research
2. Discuss early attempts by states to legalize marijuana
3. Discuss and analyze the evolution of marijuana distribution and use
4. Discuss the pros and cons of marijuana legalization

Evaluate current federal and state law as it pertains to medical marijuana.

Day 5

Prescribing Medical Marijuana (dosing, strains and delivery systems).           

Upon completion of this session, the participant should be able to: ^COMP

1. Review and solidify understanding of cannabis pharmacology
2. Differentiate between strains and routes of delivery for medical marijuana therapy
3. Understand and recommend dosing regiments for medical marijuana
4. Discuss dosing for short-term and long-term health benefits of medical marijuana
5. Discuss the controversies and side-effects of medical marijuana use

Future Studies.  

Upon completion of this session, the participant should be able to: ^COMP

1. Review and solidify current medical uses for medical marijuana
2. Discuss the therapeutic potential of cannabis
3. Define roadblocks and controversy to cannabis research
4. Apply current medical knowledge to advance marijuana research. 

Osteoporosis: Treatment and Prevention.

Upon completion of this session, using the USPSTF, NOF Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Debate the importance of the risk factors for an osteoporosis fracture.
2. Employ the diagnostic testing for patients at risk with osteoporosis.
3. Select the therapeutic medication to treat osteoporosis based upon the indications and side effects.
4. Assess the therapeutic role of repeating the DXA scan in patients treated for osteoporosis.

Contraceptive Options – Helping Women Make an Informed Choice.

Upon completion of this session, using the ACOG Practice Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Appraise the pharmacologic differences in oral contraceptives and their role in contraceptive efficacy.
2. Formulate the treatment options for contraception other than oral contraceptives.
3. Specify the relative and absolute contraindications to oral contraceptives.
4. Relate the circumstances that would be eligible for emergency contraception and the appropriate emergency contraception method for each situation.