Preventing Hepatic Encephalopathy in Patients With Cirrhosis: Rural Medicine Perspectives
  • CME

Gain expert perspectives on managing patients at risk for recurrent HE and selecting effective oral therapies for patients with a history of HE.
Terry D. Box, MD
Physicians: maximum of 0.75 AMA PRA Category 1 Credits
Released: March 17, 2020 Expiration: March 16, 2021
Multimedia Preventing Hepatic Encephalopathy in Patients With Cirrhosis: Rural Medicine Perspectives
This program is divided into short segments. After reviewing all segments, click the Claim Credit button to complete the CME/CE posttest and evaluation.
Part 1: Risk Factors (10 minutes)
Learn who is at risk and what you can do about it.
Launch Part 1: Risk Factors (10 minutes)
Part 2: Hepatic Encephalopathy (8 minutes)
Avoid common pitfalls in diagnosis.
Launch Part 2: Hepatic Encephalopathy (8 minutes)
Part 3: Management of Overt Hepatic Encephalopathy (8 minutes)
Learn a simple 4-pronged approach to management.
Launch Part 3: Management of Overt Hepatic Encephalopathy (8 minutes)
Part 4: Prevention of Recurrent Hepatic Encephalopathy (4 minutes)
Current best practice for minimizing risk of recurrence in patients with HE.
Launch Part 4: Prevention of Recurrent Hepatic Encephalopathy (4 minutes)
Part 5: Prevention of Readmission (4 minutes)
Learn the factors associated with readmissions in patients with HE and how to minimize the risk.
Launch Part 5: Prevention of Readmission (4 minutes)
Part 6: Telehealth for Care of Patients With Liver Disease (3 minutes)
Current models and utility of telehealth care for patients with liver disease.
Launch Part 6: Telehealth for Care of Patients With Liver Disease (3 minutes)
Part 7: Questions and Answers (8 minutes)
Listen as faculty answer common questions from clinicians.
Launch Part 7: Questions and Answers (8 minutes)

Learning Objectives

Upon completion of this activity, participants should be able to:
  • Identify individuals at risk for HE
  • Monitor and effectively manage patients at risk for recurrent HE
  • Consider the mechanisms of actions, administration, effectiveness, and adverse events of oral therapies that can be used in patients with a history of HE


Provided by Clinical Care Options, LLC

Clinical Care Options, LLC
12001 Sunrise Valley Drive
Suite 300
Reston, VA

Sophia Kelley

Produced in collaboration with
National Rural Health Association Logo
Supported by educational grants from
Mallinckrodt Pharmaceuticals
Salix Pharmaceuticals

Information on this Educational Activity

Clinical Care Options, LLC (CCO) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any relevant conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to CCO policy. CCO is committed to providing its learners with high-quality CME/CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME/CE activity:


Terry D. Box, MD

Associate Professor of Medicine
Department of Internal Medicine
Division for Gastroenterology, Hepatology, Nutrition
University of Utah School of Medicine
Salt Lake City, Utah

Terry D. Box, MD, has disclosed that he has received consulting fees from Gilead Sciences, Intercept, and Targeted Oncology and fees for non-CME/CE services from Chronic Liver Disease Foundation, Gilead Sciences, and Intercept.


Zachary Schwartz, MSc

Scientific Director

Zachary Schwartz, MSc, has no relevant conflicts of interest to report.
Kiran D. Mir-Hudgeons, PhD

Manager, Editorial Operations

Kiran Mir-Hudgeons, PhD, has no relevant conflicts of interest to report.
Anne Roc, PhD
Director, Scientific Services
Anne Roc, PhD, has no relevant conflicts of interest to report.
David C. Howard

Editorial Contributor

David C. Howard has no relevant conflicts of interest to report.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Target Audience

This program is intended for physicians, nurses, physician assistants, nurse practitioners, and other healthcare providers who care for patients with or at risk of recurrent HE.


The goal of this activity is to improve rural clinicians’ knowledge of HE and increase their competence in delivering care aimed at preventing recurrent HE in patients with cirrhosis.


Joint Accreditation Statement

In support of improving patient care, Clinical Care Options, LLC (CCO) 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.

Physician Continuing Medical Education

Credit Designation

CCO designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Program Medium

This program has been made available online.

Instructions for Credit

Participation in this self-study activity should be completed in approximately 0.75 hours. To successfully complete this activity and receive credit, participants must follow these steps during the period from March 17, 2020, through March 16, 2021:

1. Register online at
2. Read the target audience, learning objectives, and faculty disclosures.
3. Study the educational activity online or printed out.
4. Submit answers to the posttest questions and evaluation questions online.

You must receive a test score of at least 65% and respond to all evaluation questions to receive a certificate. After submitting the evaluation, you may access your online certificate by selecting the certificate link on the posttest confirmation page. Records of all CME/CE activities completed can be found on the "CME/CE Manager" page. There are no costs/fees for this activity.

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