EPI patient care & the importance of follow-up

MELISSA: Being able to properly manage EPI starts with really great communication between patients and providers and encouraging patients to open up about what's really going on. One of my favorite approaches is saying, you know what, everybody poops, everybody passes gas. And if I have kind of that blank stare from my patients, and I try to make it, like, a little bit more approachable.

MELISSA: I'm like, you know, like, farting. And that usually gets, like, a giggle out of people. And so now you feel a little bit more relaxed. That's the point. I want to make my patients feel comfortable and open up about these what could be very uncomfortable symptoms.

MELISSA: When talking to my patients, I'll start by asking questions like, what have you heard about EPI? Or what is your understanding of what the pancreas does?

Melissa: And then from there, I can continue building on that understanding and assess how things are going with their treatment plan, as well as how well they understand their condition.

CAMILLE: Sounds like your patients are very fortunate. My care team is great. The best thing they taught me was to watch the floating stools, what looked like oily stools, which could be signs of malabsorption and may mean my pancreas isn't producing enough enzymes to break down food.

MELISSA: That's a great example of how we as healthcare professionals need to be there for our patients. I believe it's more important to understand the function rather than the label by saying, look for oily or floating stools instead of saying, look for or be aware of malabsorption. You know, and this can help us better educate our patients so that we can diagnose them faster.

MELISSA: Communication is so important, and not just between patients and providers, but even within the provider and the care team itself, right? I find that using our practice's healthcare portal and following up seven days after starting treatment can help create an open and honest communication.

MELISSA: I might not always be the one seeing my patients appointment after appointment, but making sure that everyone's on the same page and knows what the treatment plan is, is so helpful.

CAMILLE: Right.

MELISSA: And so I do tell my patients, and I lovingly call it, to keep a food and poop log. I want to know what they're eating and how that relates to their bowel movements.

CAMILLE: Almost like a snapshot of what they've eaten.

MELISSA: Exactly. Then they bring that back a week after or so and as a care team we look at that and we are able to decide, you know what, I think we need to make some adjustments.

MELISSA: I know starting a new medication can be a little bit daunting, especially when it's brand new and, and it's a lifestyle change to have to take it. The key is to not overwhelm patients with too much information at once, though. When setting treatment expectations with my patients after they've been diagnosed with EPI and prescribed CREON, the top three things I want them to remember are, number one, you must take CREON with food. Number two, communicate with your providers. And finally, keep track of what you're eating to be able to identify whether you're on the right dose.

CAMILLE: I agree. Over time, I worked with my doctor to get the right dose with CREON. And it's been managing my EPI ever since.

SAFETY VOICE OVER:

Indication

CREON^® (pancrelipase) delayed-release capsules are indicated for the treatment of exocrine pancreatic insufficiency in adult and pediatric patients.

Important Safety Information

• Fibrosing colonopathy has been reported following treatment with pancreatic enzyme products. Do not exceed the recommended dosage of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day) or 4,000 lipase units/g fat ingested/day in adult and pediatric patients greater than 12 months of age without further investigation.
• To avoid irritation of oral mucosa, care should be taken to ensure that CREON is not crushed, chewed, or retained in the mouth. CREON should always be taken with food.
• Pancreatic enzyme products contain purines that may increase blood uric acid levels. High dosages have been associated with hyperuricosuria and hyperuricemia. Consider monitoring blood uric acid levels in patients with gout, renal impairment, or hyperuricemia during treatment with CREON.
• There is theoretical risk of viral transmission with all pancreatic enzyme products, including CREON.
• Severe hypersensitivity reactions including anaphylaxis, asthma, hives, and pruritus have been reported with pancreatic enzyme products. Monitor patients with a known hypersensitivity reaction to proteins of porcine origin for hypersensitivity reactions during treatment with CREON.
• Adverse reactions that occurred in at least 2 cystic fibrosis patients (greater than or equal to 4%) receiving CREON were vomiting, dizziness, and cough.
• Adverse reactions that occurred in at least 1 chronic pancreatitis or pancreatectomy patient (greater than or equal to 4%) receiving CREON were hyperglycemia, hypoglycemia, abdominal pain, abnormal feces, flatulence, frequent bowel movements, and nasopharyngitis.

Please see the accompanying full Prescribing Information, including Medication Guide or visit https://www.rxabbvie.com/pdf/creon_pi.pdf