Fundamentals of Liver Disease - Non-Alcoholic Fatty Liver Disease (NAFLD) & Non-Alcoholic Steatohepatitis 2.0

5 (10 votes)

There is currently an anticipated shortage of trained providers capable of diagnosing and treating different liver diseases. As a result of this increased demand and limited specialists in the field, more and more front line providers are faced with these patients and do not have the experience or resources that will allow them to manage them appropriately.

The overall goal is to improve patient care by increasing learner competence and confidence in both proper patient identification and assessment and increasing learner performance in therapeutic options and on-treatment management strategies for patients. Patient outcomes will be improved as a result of the improvements in more providers understanding these key components in the management and care of patients with liver diseases.

Key topic areas:
NAFLD: Diagnosis and Identification of Those at Risk of Disease Progression
Pathogenesis of Non-alcoholic Steatohepatitis
Non-Invasive Determination of Advanced Disease in NAFLD
Lifestyle Interventions: Setting Goals and Recommendations
Comorbidities in NAFLD: Cardiovascular Disease, Sleep Apnea, and Chronic Kidney Disease
Bariatric Surgery: Is the Cure for NASH in the OR?
Managing NASH Cirrhosis and Assessment for Liver Transplant
Current Pharmacological Treatment Options for Non-Alcoholic Steatohepatitis (NASH)
Emerging Treatments for Non-Alcoholic Steatohepatitis

Release date: June 15, 2020
Expiration date: June 14, 2023
Time to complete each module: 30 minutes

CREDITS OFFERED

Continuing Medical Education (CME): For a maximum of 4.50 AMA PRA Category 1 Credits™ 
Continuing Education (CE): For a maximum of 4.50 Contact Hour
You may only earn one Continuing Education Credit type- either CE or CME

Maintenance of Certification (MOC): For a maximum of 4.50 MOC Points

COMPONENTS
Online presentations comprised of PowerPoint slides and accompanying audio, online pre- and post-tests and evaluations:
-9 online, narrated modules 15 to 20 minutes in length 
-Pre- and post-test questions for each module
-Evaluation for CE or CME credit offering 

DIRECTIONS
Click "Activate" to register for the enduring material. Review all section tabs before you begin. Select module of interest. Complete necessary components to claim either CE or CME, and MOC.

COPYRIGHT
All faculty in this activity have given their permission for publication ©2020 AASLD. 

CONTACT INFORMATION
For questions on CME and  MOC content or LiverLearning®, contact online_education@aasld.org
For questions on CE credit for this enduring material, contact Certificate@AmedcoEmail.com

Learning Objective:
• Identify patients with liver disease, specifically NASH/NAFLD
• Apply diagnostic tests appropriately
• Discuss important counseling
• Recognize treatment/referral priorities
• Identify first line therapies for NASH/NAFLD
• Refer to specialist in a timely and appropriate fashion

This curriculum was developed for Primary Care Providers and any other healthcare provider interested in liver disease.

Hepatologists
Gastroenterologists
Nurses
Nurse Practitioners
Pharmacists
Physician Assistants
Transplant Coordinators
Surgeons
Fellows/Trainees
Primary Care Physicians
Other healthcare providers

CREDITS OFFERED 
Continuing Medical Education (CME): For a maximum of 4.50 AMA PRA Category 1 Credits™ 
Maintenance of Certification (MOC): For a maximum of 4.50 MOC Points
Continuing Education (CE): For a maximum of 4.50 Contact Hours

ACCREDITATION AND DESIGNATION STATEMENTS Continuing Medical Education (CME) 
The American Association for the Study of Liver Diseases (AASLD) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AASLD designates this enduring activity for a maximum of 4.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Maintenance of Certification (MOC) Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 4.50 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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Continuing Education (Nursing Contact Hours)  In support of improving patient care, this activity has been planned and implemented by Amedco LLC and the American Association for the Study of Liver Diseases.  Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Credit Designation Statement – Amedco LLC designates this enduring material activity for a maximum of 4.50 contact hours for nurses. Learners should claim only the credit commensurate with the extent of their participation in the activity.

CLAIMING CME CREDITS Physicians and other health care professionals for a maximum of 4.50 AMA PRA Category 1 Credits™ for this enduring continuing medical education material must completed by June 14, 2023

CLAIMING ABIM MOC POINTS  Physicians seeking ABIM MOC credit must complete the enduring material by June 14, 2023. Requests for MOC after this date will not be honored. MOC Points will be reported to the ABIM by the end of each month through July 2023 for individuals who successfully complete MOC.

CLAIMING CE CREDITS Nurses for a maximum of 4.50 contact hours for this enduring continuing education material must be completed by June 14, 2023

HOW TO EARN AND CLAIM MOC POINTS For each module that you wish to claim MOC points for you must:

             o    Complete the pre-test

             o    Watch video presentation

             o    Complete the post-test and pass with a score of 70% or higher (Participants have unlimited attempts to earn the passing score.)

             o    Claim CME credits (ABIM Rule: MOC points must be equivalent to the amount of CME credits claimed for the activity.)

MOC completions are collected on the 15th of each month and submitted to the ABIM by the last day of the month. Points are not submitted automatically and will not display immediately on your ABIM MOC Profile.

MOC points are available for ABIM board certified physicians only.

DISCLOSURE OF CONFLICTS OF INTEREST
AASLD requires all individuals who are in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Disclosures are collected prior to the start of the educational activity. Any potential conflicts of interest that exist are resolved prior to implementation of the activity. All disclosures are made available and communicated to the leaner prior the activity beginning.

The enduring material organizers, faculty, reviewers and staff have reported the following disclosures:

Mary E. Rinella, MD, FAASLD
Faculty
Consulting: AbbVie, NuSirt, NGM Biopharmaceuticals, Novartis, Gilead, Intercept, Genfit, Enanta, BMS, Immuron, CymaBay, Merck, Viking, Madrigal, Genesis, Metacrine, Allergan, Thetis, Fractyl, 3vBio, Coherus, Terns, Boehringer Ingelheim and Takeda
Editorial Board: Hepatology, Clinical Liver Disease (guest associate editor), Seminars in Liver Disease (associate editor in 2017)

Arun J. Sanyal, MD, MBBS
Faculty
Consulting: Novartis, Merck, BMS, Boehringer Ingelheim, Nitto Denko, Tobira, Intercept, Genfit, Aredelyx, Akarna, Syntlogic, Fractyl, Pfizer, Jannsen, Exalenz, Novo Nordisk, Nordic Bioscience, Lilly
Grant/research support: Intercept, Gilead, Tobira, Novartis, Astra Zeneca, Merck, BMS
Stock Options: Genfit
President of Sanyal Bio

Leon A. Adams, MBBS, FRACP, PhD
Faculty
Patents regarding Hepascore
Employer has a licensing agreement with Quest Diagnostics regarding its commercialization

Brent Neuschwander-Tetri, MD
Faculty
Consulting: Allergan, Allysta, Arrowhead, ARTham, Axcella, Blade, Boehringer-Ingelheim, Bristol-Myers Squibb, Conatus, Consynance, Cymabay, Durect, Enanta, Ferring, Fortress, Gelesis, Genfit, Gilead, High Tide, Histolndex, Intercept, Lipocine, Llama, Madrigal, Medimmune, Merck, Metacrine, Mundipharma, NGM, pH-Pharma, Prometheus and Siemens
Grants/research support: Allergan, BMS, Cirius, Cymabay, Enanta, Galectin, Genfit, Gilead, Intercept, Madrigal, NGM and Prometheus

Kathleen E. Corey, MD, MPH, MMSc
Faculty
Nothing to disclose

Philippe Mathurin
Faculty
Financial Interests: MSD, Abbvie, Gilead Sciences, Bristol-Myers Squibb, Verlyx, Intercept, Janssen-Cilag and Bayer Healthcare pharmaceutical companies

Kymberly D. Watt, MD

Faculty
Co-investigator for industry studies supported by Conatus, Intercept Pharmaceuticals and Gilead

Dawn M. Torres, MD
Faculty
Nothing to disclose

Raj Vuppalanchi, MD, FAASLD
Faculty
Data Safety Monitoring Board for Industry or Commercial Enterprise: Enanta, Enyio and LabCorp/Covance
Served as PI for multicenter clinical trials: Intercept, Gilead, Zydus Discovery, Novo Nordisk and Eli Lilly

Sanjeeva Arora, MD
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Nothing to disclose 

Lauren A. Beste, MD
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Nothing to disclose

Amanda J. Chaney, DNP, APRN, FNP-BC
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Royalities: Springer Publishing-Author

Guadalupe Garcia-Tsao, MD, FAASLD
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Advisory Board: Intercept, Conatus
Scientific Consultant/Advisor to Industry or Commercial Enterprises, including Development of Education Presentations: Conatus, Galectin
Research Grants: Intercept

Leslie Hayes
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Nothing to disclose

Minhhuyen Nguyen, MD
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Nothing to disclose

Vicki Shah, PA
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Scientific Consultant/Advisory to Industry or Commercial Enterprise, including Development of educational Presentations: Gilead, Intercept, AbbVie Advisory Board, Gilead Advisory Board

Raj Vuppalanchi, MD, FAASLD
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Data Safety Monitoring Board for Industry or Commercial Enterprise: Enanta, Enyio and LabCorp/Covance
Served as PI for multicenter clinical trials: Intercept, Gilead, Zydus Discovery, Novo Nordisk and Eli Lilly

Susan Zapatka, MSN
Fundamentals of Liver Disease Committee/Organizer/Reviewer
Nothing to disclose

Dominique Clayton
AASLD Staff
Nothing to disclose

Denise Seise
AASLD Staff
Nothing to disclose

Sheryl Morgan
Amedco LLC Staff
Nothing to disclose

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of AASLD. 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 on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Acknowledgement of Commercial Support:
No commercial support was received for this enduring material activity.

Key:

Complete
Failed
Available
Locked
Module 1: NAFLD - Diagnosis and Identification of Those at Risk of Disease Progression
Module 1 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 1: NAFLD - Diagnosis and Identification of Those at Risk of Disease Progression
Open to view video.
Open to view video.
Module 1 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 2: Pathogenesis of Non-alcoholic Steatohepatitis
Module 2 Pre-Test
4 Questions  |  1 attempt  |  0/4 points to pass
4 Questions  |  1 attempt  |  0/4 points to pass
Module 2: Pathogenesis of Non-alcoholic Steatohepatitis
Open to view video.
Open to view video.
Module 2 Post-Test
4 Questions  |  Unlimited attempts  |  3/4 points to pass
4 Questions  |  Unlimited attempts  |  3/4 points to pass
Module 3: Non-Invasive Determination of Advanced Disease in NAFLD
Module 3 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 3: Non-Invasive Determination of Advanced Disease in NAFLD
Open to view video.
Open to view video.
Module 3 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 4: Lifestyle Interventions: Setting Goals and Recommendations
Module 4 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 4: Lifestyle Interventions: Setting Goals and Recommendations
Open to view video.
Open to view video.
Module 4 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 5: Comorbidities in NAFLD: Cardiovascular Disease, Sleep Apnea, and Chronic Kidney Disease
Module 5 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 5: Comorbidities in NAFLD: Cardiovascular Disease, Sleep Apnea, and Chronic Kidney Disease
Open to view video.
Open to view video.
Module 5 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 6: Bariatric Surgery: Is the Cure for NASH in the OR?
Module 6 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 6: Bariatric Surgery: Is the Cure for NASH in the OR?
Open to view video.
Open to view video.
Module 6 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 7: Managing NASH Cirrhosis and Assessment for Liver Transplant
Module 7 Pre-Test
4 Questions  |  1 attempt  |  0/4 points to pass
4 Questions  |  1 attempt  |  0/4 points to pass
Module 7: Managing NASH Cirrhosis and Assessment for Liver Transplant
Open to view video.
Open to view video.
Module 7 Post-Test
4 Questions  |  Unlimited attempts  |  3/4 points to pass
4 Questions  |  Unlimited attempts  |  3/4 points to pass
Module 8: Current Pharmacological Treatment Options for Non-Alcoholic Steatohepatitis (NASH)
Module 8 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 8: Current Pharmacological Treatment Options for Non-Alcoholic Steatohepatitis (NASH)
Open to view video.
Open to view video.
Module 8 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 9: Emerging Treatments for Non-Alcoholic Steatohepatitis
Module 9 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 9: Emerging Treatments for Non-Alcoholic Steatohepatitis
Open to view video.
Open to view video.
Module 9 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Claim Credits & Final Evaluation
Evaluation (Complete to claim CE or CME credit)
7 Questions
7 Questions Please complete the following evaluation form to share your feedback on this activity.
Claim your continuing education credit
Up to 4.50 medical credits available  |  Certificate available
Up to 4.50 medical credits available  |  Certificate available
Acknowledgement of MOC Submission
Please review and agree to the terms to continue.
Please review and agree to the terms to continue.
MOC Points
Up to 4.50 medical credits available  |  Certificate available
Up to 4.50 medical credits available  |  Certificate available