Asthma can affect patients at all stages of life, and although the disease characteristics are the same, diagnosis, outcomes, and treatment strategies differ depending on the individual patient. This interactive case-based activity provides examples of 3 patients with persistent asthma and very different disease histories/lifestyles. The first is a 3-year-old patient with the classic atopic march of childhood, including persistent asthma that has resulted in multiple trips to the emergency room and considered very frightening by his mother. The second case features a teenager who refuses to quit smoking despite her ongoing asthma. Compliance issues with such an unwilling patient are discussed along with this case. The third case features an adult who had childhood asthma that has reappeared along with a recent move to a new climate and other allergen exposures . Appropriate management of all 3 of these patients is discussed in both written and interactive formats, featuring thought-leader pop-ups that provide background information about the diagnosis and management of asthma.

This activity has been designed to meet the educational needs of primary care physicians, pediatricians, and ancillary health care professionals who treat patients with asthma.

1. Describe the 3 appropriate controller therapies in infants and preschoolers requiring step 2 therapy.
2. Name 2 external triggers that may exacerbate asthma symptoms and describe the role of implementing environmental controls in a comprehensive asthma management plan.
3. Describe how current or a history of smoking may affect treatment response compared with nonsmokers.

Lawrence DuBuske, MD
Consultant in Allergy
Brigham and Women’s Hospital
Harvard Medical School
Boston, Massachusetts

Andrew Liu, MD
Associate Professor
National Jewish Health and Research Center
University of Colorado at Denver
School of Medicine
Denver, Colorado

Gailen Marshall, Jr, MD, PhD
Professor of Medicine and Pediatrics
Vice Chair for Faculty Development
Director
Division of Clinical Immunology and Allergy
The University of Mississippi Medical Center
Jackson, Mississippi

David Rosenstreich, MD
Professor, Department of Medicine
Albert Einstein College of Medicine
Director
Division of Allergy and Immunology
Montefiore Medical Center
Bronx, New York

Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Med Learning Group is also accredited by the ACCME and serves as co-sponsor for this educational activity.

Albert Einstein College of Medicine designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was planned and produced in accordance with the ACCME Essentials.

For CME questions, please contact:  Center for Continuing Medical Education, Albert Einstein College of Medicine at 718-920-6674.

Contact this CME provider at Albert Einstein College of Medicine for privacy and confidentiality policy statement information at www.mecme.org/site/privacy.php

There are no fees for participating and receiving CME credit for this activity. During the period November 19, 2009 through November 18, 2010, participants must:

1. Read the educational objectives and faculty disclosures
2. Study all parts of the educational activity
3. Complete the posttest by recording the best answer to each question in the answer key and complete the evaluation form.
4. Submit the evaluation form online via iQueue.

To participate in this activity, please view the presentation and take the posttest. Fill in the answer sheet and evaluation form and submit online via iQueue.  CME credit will be awarded if a score of 70% or better is achieved. You will receive your certificate instantly.

Disclosure Policy Statement:

The “Conflict of Interest Disclosure Policy” of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present.


Disclosure of Conflicts of Interest:

Lawrence DuBuske, MD
Consultant in Allergy
Brigham and Women’s Hospital
Harvard Medical School
Boston, Massachusetts

Disclosure: Lawrence DuBuske, MD, is a consultant for Allergy Therapeutics, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals, Schering-Plough, and Sepracor. He receives grant/research funding from Alcon, Allergy Therapeutics, Genentech, Novartis Pharmaceuticals, Schering-Plough, and Wyeth Pharmaceuticals. Dr. DuBuske is on the speakers’ bureaus for Alcon, Genentech, GlaxoSmithKline, Merck & Co., Inc., Novartis Pharmaceuticals, Schering-Plough, and Sepracor.

Andrew Liu, MD
Associate Professor
National Jewish Health and Research Center
University of Colorado at Denver, School of Medicine
Denver, Colorado

Disclosure: Andrew Liu, MD, is a consultant for AstraZeneca, GlaxoSmithKline, and Phadia. He receives grant/research funding from Novartis Pharmaceuticals. Dr. Liu is on the speakers’ bureaus for Aerocrine, AstraZeneca, GlaxoSmithKline, Merck & Co., Inc., and Phadia.

Gailen Marshall, Jr, MD, PhD
Professor of Medicine and Pediatrics
Vice Chair for Faculty Development
Director, Division of Clinical Immunology and Allergy
The University of Mississippi Medical Center
Jackson, Mississippi

Disclosure: Gailen Marshall, Jr, MD, PhD, has nothing to disclose.

David Rosenstreich, MD
Professor, Department of Medicine
Albert Einstein College of Medicine
Director, Division of Allergy and Immunology
Montefiore Medical Center
Bronx, New York

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Mildred Shields Adighiuzor of Albert Einstein College of Medicine, Center for Continuing Medical Education has nothing to disclose.

Tara Hun-Dorris, MMC, ELS, of THD Editorial, Inc., is a consultant for Victory Pharma, Inc.

Kelly Kraines of Med Learning Group has nothing to disclose.

Christopher Cahill of Med Learning Group has nothing to disclose.

The Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States. 

The Center for Continuing Medical Education of Albert Einstein College of Medicine makes every effort to develop CME activities that are scientifically based. This activity is designed for health care professionals for educational purposes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.