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ForwardStone Management for APPs (2017)
Member only benefit! Renal stone disease is one of the most common urologic problems seen in clinical practice. The majority of patients can reduce their risk of recurrent stone disease with adherence to dietary changes specific to stone disease and their metabolic workup. Studies have shown improved patient adherence to these dietary recommendations when regular review of their diet is performed with trained personnel. In some cases, patients require additional needs such as added medications(s) to optimize their urine to avoid future stone formation. This will aid in decreasing morbidity and cost of stone incidences years.
The purpose of this activity is to educate Advanced Practice Providers on dietary counseling of patients with renal stone disease to more effectively advise patients and follow up with them on their medical management. During this process the patients will require review by urologists if they develop new stones or symptoms of obstruction which can be effectively triaged by the APPs. Advanced Practice Providers will be able to do initial work up, set up for surgery if indicated, and complete follow up imaging and metabolic work up with patients following surgery.
Target Audience
- Physician Assistants
- Advanced Practice Nurses
Learning Objectives
After completion of this activity, participants should be able to:
- Complete a thorough initial consultation for patients with stones.
- Determine the need to treat or observe stone.
- Explain surgical options to appropriate candidates.
- Interpret metabolic work ups and develop a dietary plan specific for each patient.
- Identify and treat those patients with lithogenic risk factors.
- Explain Medical Expulsive Therapy (MET).
Faculty
The content of this enduring material was developed by
Timothy C. Brand, MD with contributions from
Ashleigh M. Decker, PA-C.
Faculty Disclosures
Timothy Charles Brand, MD: Nothing to disclose
Ashleigh Decker, PA-C: Nothing to disclose
Planner Disclosures
Education Council
Christopher Lee Amling, MD: Janssen: Meeting Participant or Lecturer
Gopal Badlani, MD: Lithotripsy Group: Piedmont stone & Physician Discovery: Investment Interest; Society of University Urologist: Leadership Position; NIDDK: Leadership Position
Timothy Charles Brand, MD: Nothing to disclose
Peter Robert Carroll, MD: NIH: Scientific Study or Trial; Department of Defense: Scientific Study or Trial; Myriad Genetics: Scientific Study or Trial; Genomic Health: Scientific Study or Trial; Abbott Pharmaceuticals: Scientific Study or Trial; AUA Update: Leadership Position; Astra Zeneca: Meeting Participant or Lecturer; Genome Dx: Consultant or Advisor; Intuitive: Meeting Participant or Lecturer; Genomic Health: Consultant or Advisor; Takeda Pharmaceutical Company: Meeting Participant or Lecturer; Teva Pharmaceutical Industries: Meeting Participant or Lecturer; Janssen Pharmaceutical Companies: Meeting Participant or Lecturer; Intuitive Surgical Inc.: Meeting Participant or Lecturer
Sam S. Chang, MD: Janssen: Consultant or Advisor, Meeting Participant or Lecturer; Astellas: Consultant or Advisor; Dendreon: Consultant or Advisor; NIH: Scientific Study or Trial; Cold Genesys, Inc.: Scientific Study or Trial; Cepheid: Scientific Study or Trial
Pat Fox Fulgham, MD: Urology Clinics of North Texas: Investment Interest
Bruce R. Gilbert, MD, PhD: Bayer Healthcare Pharmaceuticals Inc.: Scientific Study or Trial; Auxilium: Scientific Study or Trial; Clarus Pharmaceutcals: Scientific Study or Trial; Eli Lilly: Scientific Study or Trial; Warner Chilcott: Scientific Study or Trial
Christina Hernandez (AUA Staff): Nothing to disclose
Douglas A. Husmann, MD: Nothing to disclose
Wes Kassouf, MD: Nothing to disclose
Louis Koncz, PA-C: Nothing to disclose
Cheryl Taylore Lee, MD: Adolor: Scientific Study or Trial; Tengion, Inc.: Consultant or Advisor, Scientific Study or Trial; Endo Pharmaceuticals: Consultant or Advisor, Scientific Study or Trial; Photocure: Consultant or Advisor; CVI: Consultant or Advisor
Thomas Sean Lendvay, MD: Spi Surgical Inc.: Consultant or Advisor, Owner, Product Development; MIMIC Technologies Inc.: Other
Vinata B. Lokeshwar, PhD: Nothing to disclose
Elspeth Marguerita McDougall, MD: Nothing to disclose
John Patrick Mulhall, MD: Association of Peyronie's Disease Advocates (APDA): Leadership Position; Pfizer: Scientific Study or Trial; Vivus: Consultant or Advisor, Scientific Study or Trial; Nexmed: Consultant or Advisor; Absorption Pharmaceuticals: Consultant or Advisor; AMS: Consultant or Advisor, Scientific Study or Trial; Meda: Consultant or Advisor; Lilly: Consultant or Advisor; Alliance for Fertility Preservation: Leadership Position
J. Kellogg Parsons, MD: AMS: Meeting Participant or Lecturer; Sophiris: Consultant or Advisor; Watson: Consultant or Advisor
Lee Richstone, MD: Wundercare LLC: Consultant or Advisor
Marianne D. Sadar, PhD: ESSA Pharma Inc.: Leadership Position, Consultant or Advisor, Investment Interest
Karl-Dietrich Sievert, MD, PhD: AMS: Meeting Participant or Lecturer; Karl Storz: Meeting Participant or Lecturer; Photocure: Scientific Study or Trial; Medtronics: Meeting Participant or Lecturer, Scientific Study or Trial; Allergen: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Neotract: Meeting Participant or Lecturer
Sheila Stark, PhD (AUA Staff): Nothing to disclose
William Donald Steers, MD: National Institutes of Health: Consultant or Advisor, Meeting Participant or Lecturer; Allergan: Scientific Study or Trial; New England Research Institute (NERI): Consultant or Advisor, Scientific Study or Trial
Chandru P. Sundaram, MD: Cook Medical Inc.: Scientific Study or Trial; North Central Section of the AUA: Leadership Position; Journal of Endourology and Videourology: Leadership Position; Society of Urological Robotic Surgeons: Leadership Position
Ashutosh Kumar Tewari, MD: Intuitive Surgical: Scientific Study or Trial; Kalyani Prostate Cancer Institute: Leadership Position; Global Prostate Cancer Foundation: Leadership Position; Peter Georgescu Foundation Award: Leadership Position; Chris Lange Foundation: Other; Peter Kalikow Foundation: Other; Craig Effron Foundation: Other; Tim O'Neill Foundation: Other; Patent for a Catheter-less device and approach: Other; NIH RO1 Funding-PI: Other
Paul Jacob Turek, MD: MandalMed: Leadership Position; Medical Board of California: Consultant or Advisor; BioQuiddity, Inc.: Consultant or Advisor, Investment Interest;HealthLoop.com: Consultant or Advisor, Investment Interest; Doximity, Inc.: Consultant or Advisor, Investment Interest; Fertility Planit, Inc.: Consultant or Advisor, Investment Interest
Alan J. Wein, MD, PHD (HON): Allergan: Consultant or Advisor, Meeting Participant or Lecturer; Medtronic: Consultant or Advisor, Meeting Participant or Lecturer; Ferring Pharmaceuticals: Consultant or Advisor, Meeting Participant or Lecturer; Pfizer; Consultant or Advisor, Meeting Participant or Lecturer; Astellas: Consultant or Advisor, Meeting Participant or Lecturer; Merck: Consultant or Advisor; opko: Consultant or Advisor; theravida: Consultant or Advisor
APN/PA Education Committee
Jeffrey A. Albaugh, PhD, APRN-BC, CUCNS: Sexual Medicine Society of North America: Leadership Position, Meeting Participant or Lecturer; Society of Urologic Nurses & Associates: Leadership Position, Meeting Participant or Lecturer; Prostate Net: Meeting Participant or Lecturer; Jannetti Publications Inc.: Other; Actient Pharmaceuticals LLC:Consultant or Advisor, Meeting Participant or Lecturer; Astellas Pharma: Consultant or Advisor; Medivation: Consultant or Advisor
Roxelyn Baumgartner, RN, APN-BC: Nothing to disclose
Ashleigh Decker, PA-C: Nothing to disclose
Todd James Doran, MS, PA-C: Urological Association of Physician Assistants: Leadership Position; Physician Assistant Education Association: Leadership Position
Susan M. Flick, CNP: Pfizer: Other
Peggy Francis, DNP, RN, MSN, CS, FNP-BC, CUNP: Warner Chilcott: Meeting Participant or Lecturer
Gina Fries, RPA-C: Astellas Pharma US: Scientific Study or Trial
Raymond Matthew Galocy, ANP-C: Nothing to disclose
Michele Huebner, PA-C: Urological Association of Physician Assistants: Leadership Position
Louis Koncz, PA-C: Nothing to disclose
Ralph Raphael Madeb, MD: Nothing to disclose
Thomas P. McBride, PA-C: Adirondack Society of Physician Assistants: Leadership Position, Meeting Participant or Lecturer; Dendreon Corporation: Investment Interest; SeekingAlpha.com: Health Publishing
Heather Schultz, NP: Nothing to disclose
Allen D. Seftel, MD: Auxilium: Consultant or Advisor, Scientific Study or Trial; Journal of Urology: Leadership Position; Abbott: Consultant or Advisor; Lilly: Consultant or Advisor, Scientific Study or Trial; Journal of Sexual Medicine: Leadership Position; American Geriatrics Society: Leadership Position; Urology Care Foundation: Leadership Position; Mid-Atlantic Section of AUA: Leadership Position; AUA NPP committee: Leadership Position; International Journal of Impotence Research: Leadership Position; Patient Pocket, LLC: Owner, Product Development.
Meredith Vaccaro (AUA Staff): Nothing to disclose
Method of Participation
Learners will participate in this interactive online educational activity by reading through slides and case studies, answering multiple choice questions, examining patient tools and resources and completing the posttest and evaluation. To claim CME credit for this enduring material, learners must complete the posttest, passing with 80% accuracy and submit the program evaluation.
Estimated time to complete this activity: 1.0 hour
Renew Date: August, 2017
Original Release Date: October, 2014
Expiration Date: August, 2020
AUA Disclosure Policy
All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) participating in an educational activity provided by the AUA are required to disclose to the provider any relevant financial relationships with any commercial interest. The AUA must determine if the individual’s relationships may influence the educational content and resolve any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.
Resolution of Identified Conflict of Interest
All disclosures will be reviewed by the program/course directors or editors for identification of conflicts of interest. Peer reviewers, working with the program directors and/or editors, will document the mechanism(s) for management and resolution of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to resolve conflict of interest:
- Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or Education Content Review Committee or its subgroup
- Limit content to evidence with no recommendations
- Introduction of a debate format with an unbiased moderator (point-counterpoint)
- Inclusion of moderated panel discussion
- Publication of a parallel or rebuttal article for an article that is felt to be biased
- Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
- Divestiture of the relationship by faculty
Accreditation Statement
The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation
The American Urological Association designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Evidence-Based Content
It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.
Off-label or Unapproved Use of Drugs or Devices
It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias. The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the product prescribing information for full disclosure of approved uses.
Disclaimer
The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.
Reproduction Permission
Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the American Urological Association.
AUA Privacy and Confidentiality Policy
www.auanet.org/education/confidentiality-statement.cfm
Contact Information
American Urological Association
Office of Education
1000 Corporate Blvd
Linthicum, MD 21090
Toll Free (U.S. only): 1-866-RING AUA (1-866-746-4282)
Phone: 410-689-3700
Fax: 410-689-3800
CME Information
For all inquiries regarding CME credit email: cme@AUAnet.org
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Non-Physician Participation