Name
*
First Name
Last Name
Email
*
example@example.com
What best describes your title?
*
MD
RN
PharmD
PA
NP
Other
Other
How many patients do you currently see each month with GERD?
Less than 5
5-15
16-25
26-35
36 or more
N/A
How many years have you been in practice?
1. By what primary mechanism does vonoprazan differ from proton pump inhibitors (PPIs) in its acid-suppressive effect, and which GERD patient phenotype is most likely to derive particular benefit from this distinction?
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Irreversible inhibition of H+/K+-ATPase with meal-dependent activation; patients with poor CYP2C19 metabolism
Reversible, potassium-competitive inhibition of H+/K+-ATPase without acid-dependent activation; patients with nocturnal acid breakthrough despite optimized PPI therapy
Irreversible, noncompetitive inhibition of H+/K+-ATPase with food-timing independence; patients with Barrett's esophagus but controlled symptoms
Competitive inhibition of histamine H2 receptors with rapid tachyphylaxis; patients with mild, intermittent NERD
2. A 52-year-old man with Los Angeles Grade C erosive esophagitis has persistent symptoms and incomplete mucosal healing after an adequate trial of twice-daily PPI therapy. Based on phase 3 data and comparative evidence, which management strategy best aligns with an evidence-based, vonoprazan-inclusive GERD algorithm?
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Continue the current PPI regimen unchanged, as escalation beyond twice-daily dosing offers no additional benefit
Switch to vonoprazan as maintenance therapy only after a repeat endoscopy confirms complete healing on the current PPI
Transition from PPI to vonoprazan for active healing and maintenance, given superiority data in Grade C/D disease and PPI-refractory GERD
Discontinue acid suppression and manage expectantly, as long-term PPI and PCAB therapy are contraindicated in severe erosive disease
3. A gastroenterologist initiates vonoprazan for a patient with PPI-refractory GERD and severe erosive esophagitis. Which approach best supports continuity of care and minimizes the risk that a primary care clinician will inadvertently switch the patient back to a PPI?
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Assume the primary care team will recognize vonoprazan as superior therapy and avoid changing it without consultation
Document the medication change in the endoscopy report only, without specific explanation of rationale or maintenance plan
Provide explicit, written and verbal communication to the PCP/APP detailing the indication for vonoprazan, expected duration, and request not to substitute a PPI without GI input
Ask the patient to manage all future GERD prescriptions independently
Learning Objectives
Rows
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Good
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Distinguish the mechanism of action and key pharmacokinetic properties of a PCAB from PPIs, and identify the GERD patient phenotypes most likely to derive differential benefit from potassium-competitive acid blockade
Apply Phase 3 clinical trial evidence and supporting comparative data to integrate PCAB therapy appropriately into a stepwise treatment algorithm for erosive and non-erosive GERD, including decision points for first-line use, PPI transition, and maintenance
Effectively communicate treatment rationale and co-management expectations to PCPs and APPs when initiating PCAB therapy, in order to prevent inadvertent therapeutic substitution and support continuity of care
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Do you feel this activity was fair balanced and free of commercial bias?
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This educational activity will result in a change in my role as a healthcare team member.
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Based on your participation in this activity, choose the statement(s) that applies to how your role as a healthcare team member will change:
I gained new strategies/skills/information that my team can apply to practice
I plan to implement new strategies/skills/information in my practice
I will be more competent in my team’s management of patient care
I will improve my communication with the healthcare team
What factors beyond clinical care that effect the health of your patients does your team experience?
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