Physicians: .25 AMA PRA Category ICreditsTM
Family Physicians: .25 Prescribed credits
Nurse Practitioners: .25 Contact hours
Release Date: May 1, 2013
Expiration Date: May 1, 2014
Estimated Completion Time: 15 minutes
There is no fee for this activity.
To Receive Credit
In order to receive your certificate of participation, you should read the information about this activity, including the disclosure statements, review the entire activity, take the post-test, and complete the evaluation form. You may then follow the directions to print your certificate of participation. To begin, click the CME icon at the end of the article.
Upon successful completion of this educational program, the reader should be able to:
1. Discuss the significance of this article as it relates to your clinical practice.
2. Be able to apply this knowledge to your patient's diagnosis, treatment and management.
Alan Ehrlich, MD - Assistant Clinical Professor in Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Senior Deputy Editor, DynaMed, Ipswich, Massachusetts, USA
Michael Fleming, MD, FAAFP - Assistant Clinical Professor of Family Medicine and Comprehensive Care, LSU Health Science Center School of Medicine, Shreveport, Louisiana, USA; Assistant Clinical Professor of Family Medicine, Department of Family and Community Medicine, Tulane University Medical School, New Orleans, Louisiana, USA; Chief Medical Officer, Amedisys, Inc. & Antidote Education Company
Dr. Ehrlich, Dr. Fleming, DynaMed Editorial Team members, and the staff of Antidote Education Company have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.
No commercial support has been received for this activity.
ACCME: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Antidote EducationCompany and EBSCO Publishing. Antidote is accredited by the ACCME to provide continuing medical education for physicians. Antidote Education Company designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AAFP: Enduring Material activity, DynaMed EBM Focus, has been reviewed and is acceptable for up to 13 Prescribed credits by the American Academy of Family Physicians. AAFP certification begins March 7, 2012. Term of approval is for one year from this date with the option of yearly renewal. Each EBM Focus is worth .25 Prescribed credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AANP: This program is approved for 0.25 contact hour of continuing education by the American Academy of Nurse Practitioners.
Program ID: 1210393I
Last week 661 journal articles were evaluated via DynaMed's Systematic Literature Surveillance and summaries of 200 articles were added to DynaMed content.
Based on criteria for selecting "articles most likely to change clinical practice," one article of significant interest was selected by the DynaMed Editorial Team.
Behavioral Intervention May Promote Weight Loss in Overweight and Obese Adults with Serious Mental Illness
Reference: N Engl J Med 2013 Apr 25;368(17):1594, (level 2 [mid-level] evidence)
Obesity is highly prevalent in patients with serious mental illness, a population in which physical activity tends to be low and unhealthy diets are common. The need for psychotropic medications can compound the problem, since many of these drugs induce weight gain by increasing appetite. Short-term behavioral interventions have previously shown some efficacy for limiting weight gain in this population in small trials (Cochrane Library 2007 Issue 1:CD005148), but large scale trials have been lacking. A recent trial evaluated an 18-month targeted behavioral program for weight loss in 291 adults with serious mental illness.
Patients receiving outpatient psychiatric rehabilitation at 10 centers (mean age 45 years) were randomized to 1 of 2 interventions. In the behavioral weight loss group, patients received tailored group and individual weight management sessions, and group exercise sessions, with goals of improved diet and increased aerobic activity. The control group received standard nutritional and exercise information at baseline and was given the option of general health classes on topics unrelated to weight. Healthy, reduced-calorie foods were available to all participants at breakfast and lunch at the rehabilitation centers. At baseline, the mean body mass index was 36.3 kg/m2 and mean weight was 102.7 kg (225.9 lbs). Diagnoses included schizophrenia or schizoaffective disorder in 58%, bipolar disorder in 22%, and major depression in 12%. About 90% were taking antipsychotic drugs, and 22% were taking clozapine or olanzapine, the 2 atypical antipsychotics associated with the most weight gain.
Follow-up data at 18 months were available for 96% of the participants. The median number of sessions attended in the behavioral intervention group was 2.5 per month. The rates of absenteeism for at least 30 consecutive days were about 25% over the first 6 months and about 50% during months 7-18. The behavioral intervention was associated with greater rates of achieving ≥ 5% weight loss (37.8% vs. 22.7%, p = 0.009, NNT 7), and ≥ 10% weight loss (18.5% vs. 7%, p = 0.007, NNT 9). At 18 months, the mean weight loss was 3.4 kg (7.5 lbs) in the intervention group vs. 0.2 kg (0.4 lbs) in controls (p = 0.002).
For more information, see the Schizophrenia, Bipolar disorder, and Obesity in adults topics in DynaMed.
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Society of Teachers of Family Medicine (STFM) 46th Annual Spring Conference, May 1-5, 2013
Editor-in-Chief Brian Alper, MD, MSPH, FAAFP, will be attending the Society of Teachers of Family Medicine (STFM) 46th Annual Spring Conference, held at the Baltimore Marriott Waterfront Hotel in Baltimore, Maryland. Representatives will be available to discuss peer review, mobile access, and free trial information.
Visit the Society of Teachers of Family Medicine website to learn more about the event and for registration information.
American Congress of Obstetricians and Gynecologists (ACOG) 61st Annual Clinical Meeting, May 4-8, 2013
Andrea Chisholm, MD, FACOG, editor for DynaMed and Paula Hillard, MD, editor for PEMSoft will be attending the American Congress of Obstetricians and Gynecologists (ACOG) 61st Annual Clinical Meeting May 4-8, 2013, held at the Ernest N. Morial Convention Center in New Orleans, Louisiana. Please contact DynaMedCommunity@ebscohost.com if you would like to meet with them to learn more about peer review opportunities.
Visit the American Congress of Obstetricians and Gynecologists website to learn more about the event and for registration information.
Annual Meeting and Exhibition of the Medical Library Association (MLA), May 3-8, 2013
Editor-in-Chief Brian Alper, MD, MSPH, FAAFP, will be presenting at the 2013 Annual Meeting and Exhibition of the Medical Library Association, held at the John B. Hynes Veterans Memorial Convention Center. The topic of the presentation is “The Pace of Change in Practice-Driving Medical Knowledge in New Models of Publishing” and will be presented from 1:30pm to 3:00pm on May 5th. Representatives will be available at the DynaMed booth (216) to discuss peer review, mobile access, and free trial information.
Visit the Medical Library Association website to learn more about the event and for registration information.
If you would like to meet with a DynaMed representative at any of our conferences, please contact us at DynaMedCommunity@ebscohost.com.