CTS Accredited Webinars

PAH: Improving Outcomes & CTEPH: Updated Guideline

Presenters: Dr. Sanjay Mehta and Dr. Andrew Hirsch
Moderator: Dr. John Granton

Date: Thursday, November 12, 2020
Time: 4:00 pm – 5:00 pm EDT

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Medical Expert, Scholar

Pulmonary Arterial Hypertension (PAH): Improving Clinical Outcomes
Presenter: Sanjay Mehta, MDCM, FRCPC, Western University, London ON

Although Pulmonary Hypertension (PH) is increasingly common in our aging population with multiple co-morbid illnesses, one of the most important sub-types, Pulmonary Arterial Hypertension (PAH) remains uncommon, but serious, progressive, and often fatal. PAH is diagnosed by ruling out other common causes of PH as well as definitive right-heart catheterization.

Optimal management of PAH consists of: (i) baseline assessment of PAH severity in a PH expert centre, using a panel of multiple parameters (eg. clinical, functional, hemodynamic), and resulting risk stratification in each individual patient to estimate the future risk of adverse clinical outcomes including death, (ii) appropriate supportive measures (eg. nutritional, exercise, O2, diuretics), (iii) most appropriate initial medical therapy (eg. double oral PH-targeted medications, IV/SC prostanoid infusion therapy), (iv) regular reassessment to assess clinical response and updated risk stratification, and (v) appropriate modification of therapy, including potentially triple PH-targeted medical therapy and consideration of lung transplantation.

At the end of the session, participants will be able to;

Identify, investigate, and accurately diagnose patients with PAH
Choose optimal therapy for PAH
Follow and assess clinical risk status of PAH patients

Dr. Sanjay Mehta graduated from McGill Medical School in 1988 and completed further training in Internal Medicine and Respirology at McGill. He also pursued Respirology and PH research at McGill and Harvard. He is currently a Professor of Medicine and Consultant Respirologist at Western University, London, ON and Director at Southwest Ontario PH Clinic, London Health Sciences Center. He is also the Founding Board Member and Past-Chair Board of Directors at Eternal PHriend of PHA Canada.

Dr Mehta has been looking after PH patients for 30 years, since he was a resident at McGill in 1989, and as a PH specialist in London since 1996. He has also participated in many clinical PH research studies. He is very active in the education of physicians and healthcare providers about PH, including many Canadian and international PH guidelines.

Diagnosis of Thromboembolic Pulmonary Hypertension (CTEPH): A Canadian Thoracic Society Clinical Practice Update
Presenter: Andrew Hirsch, MD, Jewish General Hospital, Montreal, QC

Chronic Thrombo-embolic Pulmonary Hypertension (CTEPH) remains an important and relatively common cause of pulmonary hypertension. In September 2019, the Canadian Thoracic Society published a clinical practice guideline update concentrating on important diagnostic questions regarding the diagnostic evaluation of this condition. Recommendations regarding screening for CTEPH, initial testing for CTEPH, and diagnosis of CTEPH will be reviewed. A Canadian assessment of CTEPH in patients with Pulmonary Hypertension will be presented.

At the end of the session, participants will be able to;

Explain the role of screening for CTEPH following an acute pulmonary embolism
Identify the appropriate initial tests to rule out CTEPH in patients with Pulmonary hypertension
Discuss the role of CT pulmonary angiography in patients with suspected CTEPH

Dr. Andrew Hirsch is Chief of the Division of Respiratory Medicine at the Jewish General Hospital in Montreal and active clinically and in a variety of research endeavours in pulmonary vascular disease and thrombosis medicine. He obtained his MD, and Internal Medicine training at McGill University in Montreal, and completed his Pulmonary Training at UCSD in San Diego.

His specific interests include all aspects of pulmonary embolic disease both acute and chronic including prevention, diagnosis, treatment, and natural history. He is an active member of the pulmonary vascular center at the JGH, and director of the CTEPH program where we provide a full array of diagnostic and therapeutic services including balloon pulmonary angioplasty and pulmonary thrombo-endarterectomy. He is also active in the thrombosis center where he sees a large number of patients both in the outpatient clinic and the in-patient consult service with a variety of thrombotic disorders.

Moderator: John Granton, MD, FRCPC, University of Toronto, Toronto, ON

Dr. John Granton is a Professor of Medicine, in the Faculty of Medicine at the University of Toronto. He specializes in pulmonary hypertension and critical care. His research interests include pulmonary hypertension, pulmonary embolic disease, exercise physiology, and heart-lung interactions. He is the Head of Respirology at the University Health Network and Sinai Health System. He is the Past-President of the Canadian Thoracic Society.

This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program (MOC) of The Royal College of Physicians and Surgeons of Canada and approved by the Canadian Thoracic Society. You may claim a maximum of 1 hour (credits are automatically calculated).

This session is developed by the Canadian Thoracic Society with an independent educational grant from Janssen and is planned to achieve scientific integrity, objectivity and balance.

Past Webinars

A Role for Digital Health in the Behaviour Change Challenges Associated with the Management of Chronic Lung Disease in Canada

September 29, 2020 Webinar: Dr. Kouri’s presentation.

The session will first describe the current state of chronic lung disease management in Canada, with a focus on the challenges of behaviour change and how patient attitudes, values, and beliefs influence this. We will then review how important barriers to behaviour change are identified and discuss different strategies to overcome them, linking this to behaviour change theory. Next, the role of digital health as a tool to help overcome barriers to behaviour change in the management of chronic lung disease in Canada will be presented. We will review how digital health can augment the provision of virtual care, support patient self-assessment and goal setting, and provide real-time individualized behaviour change interventions and reinforcement, as well as important feedback to both patients and their providers.

At the end of the session, participants will be able to;

Describe the current state of digital health in the management of chronic lung disease in Canada
Discuss the challenges of behaviour change associated with the management of chronic lung disease
Understand how digital health can help overcome behaviour change challenges to enhance management of chronic lung disease

CanMEDs Competencies addressed:
Communicator, Health Advocate, Leader, Scholar

Presenter:
Andrew Kouri, MD, FRCPC, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON

Originally from Montreal, Dr. Kouri undertook his medical studies at McGill University, after which he completed residency training in General Internal Medicine and Adult Respirology at the University of Toronto. Since finishing his clinical training, he has been working towards obtaining his PhD in Clinical Epidemiology and Health Services Research at UofT. Both his research and clinical work focus on patients with chronic airways disease (asthma and COPD), and he is currently studying ways in which mobile digital health tools can be better designed and implemented for older patients with airways disease.

Moderator:
Samir Gupta, MD, FRCPC, University of Toronto, Toronto, ON

This session is developed by the Canadian Thoracic Society with an independent educational grant from BreatheSuite and is planned to achieve scientific integrity, objectivity and balance.

Are all inhaled corticosteroids (ICS) created equally?

June 17, 2020 Webinar: Dr. Cockcroft’s Presentation

Presenter: Donald Cockcroft, MD, FRCPC, University of Saskatchewan, Saskatoon, SK
Moderator: Andréanne Côté, MD, FRCPC, Quebec Heart and Lung Institute, Université Laval, Quebec City, QC

The presentation will review the history of inhaled corticosteroid (ICS) use in asthma from early use of cortisone acetate powder in the 1950s to the first commercial ICS MDI (BDP) in the 1970s, up to more recently introduced ICS. It will concentrate on the evolution of ICS structural features as it relates to potency and therapeutic index.

Learning Objectives
At the end of this presentation, attendees will be able to:

Summarize data supporting older and modern ICS medications in asthma and how steroids evolved since the 1970s.
Re-evaluate the concept of ICS dose equivalence – what evidence supports low, med, high dose ICS?
Discuss the unique structural features of older and modern ICS, the concept of steroid potency, therapeutic index, and its clinical impact.

Presenter:
Donald Cockcroft, MD, FRCPC, University of Saskatchewan, Saskatoon, SK

Dr. Donald Cockcroft trained with Freddy Hargreave (1975-1977) in respirology and allergy research predominantly asthma. He has worked in academic respiratory medicine at the University of Saskatchewan for 43 years with clinical practice and research focussing on asthma. His area of research interest is mainly bronchoprovocation with allergen, methacholine, mannitol and other stimuli.

Moderator:
Andréanne Côté, MD, FRCPC, Quebec Heart and Lung Institute, Université Laval, Quebec City, QC

This session is developed by the Canadian Thoracic Society with an independent educational grant from GSK and is planned to achieve scientific integrity, objectivity and balance.

PF-ILD in the Canadian Landscape: Sharing Best Practices in Management

June 2, 2020 Webinar: Dr. Kolb’s Presentation

Presenter: Martin Kolb, MD, PhD, McMaster University, Hamilton, ON
Moderator: Maggie Larché, MD, MRCP(UK), PhD, McMaster University, Hamilton, ON

IPF is a progressive disease with high morbidity and mortality. The past years have brought significant improvements in the pharmacological therapy of IPF, but disease progression nevertheless occurs in most patients, albeit at a slower rate. This means that symptomatic treatment of patients with IPF (and other fibrotic lung disorders) remains a major element of patient care.

Learning Objectives
At the end of this presentation, attendees will be able to:

Explain the unmet clinical need around PF-ILD;
Evaluate emerging evidence in PF-ILD treatments, specifically connective tissue disease-related ILDs (CTD-ILD);
Discuss best practice approaches for collaborative care in the diagnosis and monitoring of CTD‑ILD.
Discuss the possible impact of Covid-19 on PF-ILD

CanMEDs Competencies addressed:
Health Advocate, Medical Expert, Professional, Scholar

Presenter:
Martin Kolb, MD, PhD, Professor, Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON

Dr. Martin Kolb is the Moran Campbell Chair and Professor in respiratory medicine and Director of the Division of Respirology, McMaster University. His major research interests are fibrotic lung disease, with a particular interest in the role of growth factors and matrix abnormalities in disease progression. He leads activities in biomarker development for lung fibrosis and is a principal investigator and steering committee member in numerous ILD clinical trials. Professor Kolb has authored over 130 peer-reviewed publications on different basic science and clinical topics. He is the Chief-Editor of the European Respiratory Journal (2018-2023).

Moderator:
Maggie Larché, MD, MRCP(UK), PhD, Associate Professor, Departments of Medicine and Pediatrics, Divisions of Rheumatology, and Clinical Immunology and Allergy, McMaster University, Hamilton, ON

This session was developed by the Canadian Thoracic Society with an independent educational grant from Boehringer Ingelheim and was planned to achieve scientific integrity, objectivity and balance.