Understanding Cirrhosis and Liver Disease
Cirrhosis is a common chronic condition with high rates of morbidity and mortality. Primary care physicians play a key role in early identification of risk factors, in the management of patients to improve quality and length of life, and in preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications, and aid in selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for optimal medical management and to provide better outcomes for individuals with liver cirrhosis.
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This activity is designed to meet the educational needs of physicians — including family physicians — coders and other health care professionals interested in cirrhosis and liver disease.
At the end of this educational activity, participants should be able to:
- List common causes for cirrhosis of the liver.
- Describe major complications of cirrhosis including ascites, esophageal varices, portal hypertension and secondary hyperaldosteronism.
- Identify optimal timing for referral of an individual with cirrhosis to a specialist and state the importance of a multidisciplinary management approach.
- Describe how hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease and non-alcoholic fatty liver disease (NAFLD) impact the progression of cirrhosis and list applicable vaccine recommendations.
- Discuss the current guidelines for diagnostic workup and management of HCV infection.
John Rice, MD
Assistant Professor of Medicine
Director, Hepatology; Medical Director, Liver and Pancreas Center
University of Wisconsin School of Medicine and Public Health
About the presenter
Dr. John Rice is a faculty member of the Division of Gastroenterology and Hepatology in the Department of Medicine at the University of Wisconsin (UW) School of Medicine. He serves as the medical director of the Liver and Pancreas Center at the UW Health Digestive Health Center and section chief of Hepatology in the Division of Gastroenterology and Hepatology. He is a member of the American Liver Foundation Advisory Board, the American Society of Transplantation, and the American Association for the Study of Liver Disease (AASLD). Dr. Rice has received honors such as the Clinical Excellence Award from the Department of Medicine and the American Liver Foundation Academic Debate Award, and he was inducted into the Alpha Omega Alpha honorary society. He is a reviewer for the journals Liver Transplantation, Hepatology, and Transplantation. He routinely presents lectures to third- and fourth-year medical students on liver disease and pathology, acute liver injury and liver failure, and he has engaged in didactic teaching and mentoring of gastroenterology fellows. Dr. Rice serves as co-director of the gastroenterology and hepatology fourth-year clerkship for medical students and serves on education committees for the gastroenterology and hepatology fellowship program. He has served on a Veterans Affairs clinical guidelines board to devise treatment guidelines for HCV as well as on a Hepatitis C Special Interest Group of the AASLD.
Sarah Chart, RN
Eden Prairie, MN
Rebecca Gleason, RN, CCM
Eden Prairie, MN
Kevin Heath, MD, MHL, FACP
Medical Director, Clinical Performance
Disclosures of relevant financial relationships
In accordance with the ACCME Standards for Commercial SupportSM, OptumHealth Education (OHE) requires all those involved in the development of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or his/her spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest. OHE ensures that the content is independent of commercial bias.
Ms. Chart and Ms. Gleason have indicated that they are employees of and own stock in UnitedHealth Group.
The remaining activity faculty or planners have no financial relationships to disclose.
Method for calculating CE credit
CE credit was calculated by the complexity of content.
In support of improving patient care, OptumHealth Education 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 health care team.
Credit Designation Statements
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.
OptumHealth Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Academy of Family Physicians
This Enduring Material activity, Understanding Cirrhosis and Liver Disease, has been reviewed and is acceptable for up to 1.00 Elective credit(s) by the American Academy of Family Physicians. AAFP certification begins January 29, 2019. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.
This program meets AAPC guidelines for 1.0 CEU. Can be used for Core A, CANPC and CHONC with successful completion of post-test for continuing education units.
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization with which they wish to obtain credit.
- 1.00 AAPC - Coders
- 1.00 AMA - Physicians
- 1.00 Attendance - General Attendance
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