This series of bite-sized episodes will take you through the latest information regarding disrupted nighttime sleep and its relationship to cardiovascular risk, plus patient/clinician preferences regarding the treatment of narcolepsy with sodium oxybates.
Can We Talk? Optimizing Patient Buy-In to the Management of Narcolepsy
Can We Talk? Optimizing Patient Buy-In to the Management of Narcolepsy
Welcome to CME on ReachMD. This episode is part of our MinuteCME curriculum.
Prior to beginning the activity, please be sure to review the faculty and commercial support disclosure statements as well as the learning objectives.
This is CME on ReachMD, and I’m Dr. Michael Thorpy. Here with me today is Dr. Anne Marie Morse.
Anne, if you have a patient that comes into your office who’s recently been diagnosed with narcolepsy and she’s hesitant about taking the medication that you’re recommending because she’s read about some stuff on the internet about how it could possible cause some potential adverse effects, how do you counsel this patient and provide accurate information for them?
So one of the first things that I would do in this particular situation is applaud the patient for putting themselves in that driver’s seat in their own journey. Although many physicians sometimes become frustrated by patients who come in with, “I have done my research on the internet,” I tend to take the approach of, “You are clearly an active person in your own medical journey.” An educated, engaged, active patient is one that is driven to have the best outcomes.
So first and foremost, it's really important for us to have a discussion of what are the things that were of concern? When we’re able to look at those factors, we also need to balance the concerns or potential risks that come along with any potential medication with what is the burden of the symptoms that you’re experiencing. With that, we then need to develop a progress plan. What does “great” look like, and what are the things or the guardrails that we need to stay in the lanes of? So when we’re creating this progress plan, we need to understand and incorporate where those concerns may come from. We also need to make sure we’re providing additional education, especially if those concerns are not based in fact and are based in myth, and redirect to resources that may be more holistic in regards to all of the information that would be useful.
When we are able to have this type of conversation that is really transparent and reinforcing the empowerment and activation of the patient in that journey, we generally are also identifying that this is a strategy that is going to lead to a greater degree of adherence, because it’s returning the control to the patient and personalizing it to what their preferences are but also what their fears are and making sure that we’re keeping them in a safe journey that is going to lead to a more optimal outcome.
Anne, I wonder if you could talk to us a little bit more about the importance of adherence. There are people in different situations, for example, the mother that might have a baby at night, the student who goes away to college and has issues with regards to taking their medications, or a high school student who can’t take medication during the daytime. Talk a little bit about those situations and how personalized medicine would make a difference in terms of their management.
Those are all really great examples of factors that can very clearly impact adherence. And in fact, all of those examples can even be present in the same person over time. And so this is where personalizing the therapy for the person in front of you at the time if life that they’re in becomes so critically important, because you’re right that it’s difficult for a student in school to have to go to the nurse all the time to take their medication; or the college student being able to get on a consistent enough schedule to take the medication from day to day or night to night; or that mom who’s going to be woken up frequently in the night by a baby and may be concerned about taking something. So it is important to be able to frame the conversation around medication in regards to what are the needs for the person in front of you at the time that you’re treating them and then really trying to fit the medication profile into the person’s lifestyle, rather than the other way around.
That it’s important to discuss this with the patient, as you have mentioned, Anne, that we’ve got to involve the patient in that discussion and point them in the right direction. Maybe that also involves pointing them to better sources of information on the internet. But involving the patient in a discussion about the various agents and seeking an agreement with the patient as to what’s going to work for her best or him best and then, you know, the importance of their taking their medication on a regular basis as well. So involving the patient is very important in the correct management.
Well, this was a brief but great discussion. Unfortunately, our time is up. Thanks for tuning in.
You have been listening to CME on ReachMD. This activity is provided by Prova Education and is part of our MinuteCME curriculum.
To receive your free CME credit, or to download this activity, go to ReachMD.com/Prova. Thank you for listening.
In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative (GLC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company. GLC mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs.
Michael J. Thorpy, MD
Director, Sleep‐Wake Disorders Center
Montefiore Medical Center
Professor of Neurology, Albert Einstein College of Medicine
Consulting/Advisory Board: Alkermes, Avadel Pharmaceuticals, Axsome, Balance Therapeutics, Eisai Pharmaceuticals, Harmony Biosciences, LLC, Idorsia Pharmaceuticals, Jazz Pharmaceuticals, NLS Pharmaceuticals, Suven Life Sciences Ltd., Takeda Pharmaceutical Co., Ltd, XW Pharma
Clete A. Kushida, MD, PhD
Professor, Division Chief
Medical Director, Sleep Medicine
Stanford University School of Medicine
Consulting Fees: XW Pharma
Research: Avadel Pharmaceuticals
Ann Marie Morse, DO
Director, Child Neurology and Pediatric Sleep Medicine
Geisinger Medical Center
Janet Weis Children’s Hospital
Consulting Fees: Alkermes, Avadel Pharmaceuticals, Jazz Pharmaceuticals, Harm Reduction Therapeutics, Takeda Pharmaceutical Co.
Research: Geisinger Health Plan, Jazz Pharmaceuticals, NIH, UCB,
Other: Damm Good Sleep, LLC
Franz H. Messerli, MD
Professor of Medicine
University of Bern
No relevant relationships reported.
- Jennifer Brutsche has nothing to disclose.
- Cindy Davidson has nothing to disclose.
- Elizabeth Lurwick has nothing to disclose.
- Andrea Mathis has nothing to disclose.
- Tim Person has nothing to disclose.
- Robert Schneider, MSW, has nothing to disclose.
- Peer Review, if applicable, Brian P. McDonough, MD, FAAFP, has nothing to disclose.
After participating in this educational activity, participants should be better able to:
- Evaluate the efficacy and safety of available sodium oxybate therapies in improving outcomes for patients with narcolepsy
- Describe the quality-of-life impact and potential cardiovascular effects of disrupted nighttime sleep on patients with narcolepsy
- Compare and contrast various federal and medical society guidelines, as well as clinical trial data, as to what constitutes appropriate sodium intake
- Define the counseling processes by which patients and clinicians can communicate about goals of treatment and implement shared decision-making as to the therapeutic management approach
This activity is designed to meet the educational needs of sleep medicine specialists, psychiatrists, and neurologists.
In support of improving patient care, Global Learning Collaborative (GLC) 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.
Global Learning Collaborative (GLC) designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Global Learning Collaborative (GLC) designates this activity for 1.0 nursing contact hour. Nurses should claim only the credit commensurate with the extent of their participation in the activity.
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This activity is supported by an independent educational grant from Avadel Pharmaceuticals.
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