College of Psychiatric and Neurologic Pharmacists

Content

The articles selected by CPNP Recertification Committee for the BCPP Recertification Literature Analysis are based on a 7-year curriculum. This curriculum is developed using the Board of Pharmaceutical Specialties' Content Outline for the Psychiatric Pharmacy Specialty Certification Examination as a guideline. Since CPNP became the sole BCPP recertification provider in 2008, the articles are chosen to cover the three content domains - Domain I: Clinical and Therapeutic Management; Domain II: Education and Dissemination of Information; and, Domain III: Clinical Administration.  This course is a knowledge-based educational program designed for pharmacists to acquire factual knowledge.

The CPNP BCPP Recertification Literature Analysis includes:

• The home-study manual containing the required readings needed to prepare for the online assessment.
• For pharmacists, 10.0 contact hours of ACPE credit and 10.0 contact hours of recertification credit achieved by successfully completing the online CPNP recertification examination.

2010 Literature Analysis Articles

• Antidepressant Efficacy  0284-0000-10-022-H04-P (2 hours)

  Andrea Cipriani, Toshiaki A Furukawa, Georgia Salanti, John R Geddes, Julian P T Higgins, Rachel Churchill, Norio Watanabe, Atsuo Nakagawa, Ichiro M Omori, Hugh McGuire, Michele Tansella, Corrado Barbui. Comparative Efficacy and Acceptability of 12 New Generation Antidepressants: A Multiple Treatments Meta- Analysis.Lancet 2009: 373:746-758.

  Learning Objectives

  1. Identify the study methodology used for this meta-analysis comparing new generation antidepressants.
  2. Evaluate clinical differences between antidepressants for efficacy and acceptability.
  3. Develop (given a patient case) a pharmacotherapy recommendation based on the results of clinical differences in antidepressant efficacy and acceptability.
  4. Describe the authors’ recommendations for the study design of future antidepressant trials.

  Erick H. Turner, M.D., Annette M. Matthews, M.D., Eftihia Linardatos, Robert A. Tell, Robert Rosenthal, Ph.D.Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy. New England Journal of Medicine 2008; 358:252-60.

  Learning Objectives

  1. Describe the requirements of the FDA registry and results database.
  2. Identify the prevalence of publication bias in antidepressant efficacy trials.
  3. Assess how accurately published literature conveys data on drug efficacy to the medical community, including effect size calculation and statistical analysis.
  4. Identify differences between methods and results reported by study sponsors and those submitted for regulatory review.

• Cardiac Death Related to Antipsychotics  0284-0000-10-023-H05-P (1 hour)

  Ray WA et al. Atypical Antipsychotic Drugs and the Risk of Sudden Cardiac Death.  New England Journal of Medicine 2009; 360:225-35.

  Learning Objectives

  1. Discuss the design, methods, statistical analyses, results, and limitations of the Ray et al. study. (Domain II)
  2. Differentiate among the rates of sudden cardiac death among the various patient populations discussed in the study: (1) patients currently receiving antipsychotics (atypical and typical); (2) patients formerly receiving antipsychotics and (3) nonusers of antipsychotic medications.
  3. Evaluate the effects of dose on the risk for sudden cardiac death in users of antipsychotic medications.
  4. Describe the limitations and potential confounding factors that may have influenced the results of the study and the compensatory actions the researchers took to address these factors.  (Domain II)

• Childhood Anxiety  0284-0000-10-024-H01-P (1 hour)

  Segool NK, Carlson JS. Efficacy of Cognitive-Behavioral and Pharmacological Treatments for Children with Social Anxiety. Depression and Anxiety. 2008; 25:6200-631.

  Learning Objectives

  1. Describe the relative efficacy of cognitive-behavioral therapy (CBT) and SSRI (Selective Serotonin Reuptake Inhibitor) pharmacotherapy for various symptom dimensions of social anxiety in children.
  2. Identify impairments associated with untreated social anxiety in children.
  3. Summarize design elements and limitations of the results of this meta-analysis.
  4. Apply the results of this meta-analysis to the treatment of childhood social anxiety using CBT or SSRI pharmacotherapy.

• Generalized Anxiety Disorder   0284-0000-10-025-H01-P  (1.5 hours)

  The International Psychopharmacology Algorithm Project: Generalized Anxiety Disorder Algorithm Notes and References. Updated November 16, 2006. Available at: http://www.ipap.org/pdf/gad/en/IPAP_GADnotes_en.pdf  Accessed June 15, 2009.

  Learning Objectives

  1. Compare DSM-IV-TR and ICD-10 diagnostic criteria for generalized anxiety disorder (GAD), and given a case example, evaluate whether the patient meets DSM-IV-TR criteria for GAD.
  2. Apply the IPAP algorithm to develop a pharmacotherapy plan, including dosing and duration of therapy, for a patient with GAD at all stages of treatment.
  3. Describe the limitations of the current evidence for managing a patient with GAD concurrent with other disorders (e.g., sleep, depressive, bipolar, anxiety, substance abuse).
  4. Discuss the limitations of the current evidence for managing a patient with GAD in a special population (e.g. children, elderly, pregnancy).
  5. Formulate a plan to resolve potential drug-related problems involving activation and discontinuation syndromes in patients with GAD.
  6. Develop a plan to resolve potential drug-related problems involving adverse effects in patients with GAD.
  7. Propose a plan to resolve potential drug-related problems involving drug-interactions in patients with GAD.
  8. Describe a plan to resolve potential drug-related problems involving non-adherence in patients with GAD.

• Jitteriness/Anxiety Syndrome 0284-0000-030-H04-P (1 hour)

  Lindsey Sinclair, David Christmas, Sean Hood, John Potokar, Andrea Robertson, Andrew Isaac, Shrikant Srivastava, David Nutt, Simon Davies Antidepressant-induced jitteriness/anxiety syndrome:  systematic review. The British Journal of Psychiatry 2009; 194: 483-492

  Learning Objectives

  1. Discuss the incidence of and symptoms consistent with jitteriness/anxiety syndrome
  2. Identify the medications and psychiatric disorders associated with jitteriness/anxiety syndrome
  3. Describe the time course of antidepressant-induced jitteriness/anxiety syndrome and its relationship to therapeutic response to antidepressants
  4. Develop management strategies for antidepressant-induced jitteriness/anxiety syndrome

• Medication Adherence    0284-0000-029-H04-P  (1 hour)

  Julius RJ, Novitsky MA, Dubin WR.  Medication adherence: a review of the literature and implications for clinical practice.  Journal of Psychiatric Practice 2009;15:34-44.

  Learning Objectives

  1. Identify the frequency and impact of medication nonadherence in the psychiatric patient population
  2. Describe medication adherence measurements and their limitations.
  3. Classify the risk factors for medication nonadherence in the psychiatric population
  4. Apply strategic interventions to improve medication adherence

• Medication Reconciliation   0284-0000-10-026-H05-P (1 hour)

  Boockvar KS, LaCorte HC, Giambanco V, Bridman B, Siu A.  Medication Reconciliation for Reducing Drug-Discrepancy Adverse Events. American Journal of Geriatric Pharmacother. 2006; 4: 236-43

  Learning Objectives

  1. Explain the effect of pharmacist-led medication reconciliation on drug-discrepancy adverse drug events (ADEs) in nursing home patients.
  2. Classify the physician response to medication reconciliation discrepancies.
  3. Discuss the common discrepancy types and medication classes affected through reconciliation in this study.
  4. Describe the study methodology used to evaluate medication reconciliation and possible application in other settings.

  This article was chosen to cover Domain 3 (Clinical Administration) topics.

• Schizophrenia (1 hour)  0284-0000-10-027-H04-P (.5 hour)

  Siow-An Chong, Yuen Yeng Ong, Mythily Subramaniam, Edimansyah Abdin, Christine Marx, Alastair Campbell. An Assessment of the Understanding and Motivations of Patients with Schizophrenia about Participating in a Clinical Trial. Contemporary Clinical Trials 2009; 30:  446-450

  Learning Objectives

  1. Summarize the components and purpose of the presented Prospective Preference Approach (PPA).
  2. Compare patients’ levels of comprehension about key elements of a randomized placebo-controlled trial before and after an educational module in patients with schizophrenia.
  3. Identify patients’ reasons for and concerns about volunteering for the proposed trial.

• Substance Abuse   0284-0000-10-028-H04-P (1 hour)

  Kaloyanides KB, McCabe SE, Cranford JA, Teter CJ. Prevalence of Illicit Use and Abuse of Prescription Stimulants, Alcohol, and Other Drugs Among College Students:  Relationship with Age at Initiation of Prescription Stimulants. Pharmacotherapy 2007; 27: 666-74

  Learning Objectives

  1. Distinguish between the instruments used to assess alcohol and drug abuse and the criteria for a positive screening test result.
  2. Describe the correlation between age at initiation of prescription stimulant use to the development of illicit use/abuse of prescription stimulants and alcohol.
  3. Compare the prevalence rates of illicit drug and alcohol abuse among the five subgroups studied.
  4. Identify the study limitations and the possible biases identified by the authors.

Requirements

To satisfactorily complete the BCPP Recertification Literature Analysis and receive 10.0 hours of Recertification and ACPE credit, candidates must meet the following requirements:

• Abide by a confidentiality and honesty statement requiring individual completion of the Recertification education.
• Complete an online assessment by the deadline of August 25, 2010.
• Meet the minimum passing score for the examinations as determined by a panel of experts.

Registration

If you wish to purchase Recertification programming, an online payment option is provided. Alternatively, you may print off the registration form and submit the form and payment via fax to CPNP at 402-476-1677.

Statements of Credit

Pharmacists can obtain 10.0 contact hours of ACPE credit and 10.0 hours of recertification credit by successfully completing the online CPNP Literature Analysis examination. The ACPE numbers for this course are 0284-0000-10-022-H04-P, 0284-0000-10-023-H05-P, 0284-0000-10-024-H01-P, 0284-0000-10-025-H01-P, 0284-0000-030-H04-P, 0284-0000-029-H04-P, 0284-0000-10-026-H05-P, 0284-0000-10-027-H04-P, and 0284-0000-10-028-H04-P. This course expires August 25, 2010.

ACPE Statements of Credit will be available online at www.cpnp.org within 6 weeks after the examination deadline. Notification of statement availability will be provided to each registrant via email. A letter confirming BCPP recertification programming successfully completed each year is mailed to each registrant in December. This is followed by CPNP’s report to BPS. BPS updates its records no later than the end of the first quarter of the following year. Visit the CPNP Transcript Center for a detailed listing of all Recertification programming completed (requires log-in into the CPNP website).