1. 1 Secondary hyperparathyroidism (SHPT): Assessing the educational support requirements for nurses across Europe A joint EDTNA/ERCA & Amgen (Europe) GmbH Project Andrey Gurevich, MD PhD European Development Medical Director Amgen (Europe) GmbH MN-IHQ-AMG-355-2013-July-NP

2. 2 Who is Amgen? Neupogen ® launched Expansion to Europe Expansion to new therapeutic areas (bone) 1990s Tomorrow Ultra rapid DNA sequencing Inducible Pluripotent stem cells Gene therapy Personalized medicines 2000-Today Strong growth in product portfolio Acquisitions Global expansion New modalities CV and Neuroscience research efforts 1980 Amgen established Gene for erythropoietin cloned 1983 First major therapy, EPOGEN ®, approved by FDA 1989

3. 3 SHPT as a complication of chronic kidney disease (CKD) ●Adding to the burden of CKD, is the development of SHPT ●A common complication manifested due to elevated parathyroid hormone (PTH) levels, as well as calcium and phosphate disturbances ●A vicious cycle of decreased renal function, vitamin D deficiency and impaired mineral metabolism ●SHPT arises in most patients during the progression of CKD ●Associated manifestations include: renal osteodystrophy, extraskeletal calcification and CVD disease, resulting in increased mortality ●The aim of treatment in secondary hyperparathyroidism is to manage levels of phosphate, PTH and calcium, and in turn reduce the associated clinically important complications Melanie S et al. J Manag Care Pharm 2007; 13(5): 397-411.

4. 4 The key role of nurses in managing patients with SHPT Nurses provide care that meets a wide variety of physical, social and psychological needs for their CKD and SHPT patients Patients feed back to nurses on their physical and social condition Education and support

5. 5 Determining what educational support is needed ●The EDTNA/ERCA is developing a Nephrology Nurse Education Survey, in association with Amgen (Europe) GmbH, via an unrestricted grant ●The survey aims to understand the professional educational needs of the nephrology nurse in the management of SHPT ●The results will help to provide recommendations on how to improve the focus and quality of education given to nurses in this area ●Activities, such as an advisory board, have already been undertaken to enhance understanding in this area

6. 6 Survey overview ●Selected centres across Europe, starting in Autumn 2013 ●Strictly confidential and non-promotional online survey covering the following topics: Background and nephrology experience General knowledge of SHPT Laboratory values and reaching targets Therapies and adherence Patient management and side effects General training and education

7. 7 A sample question How often do you typically ask your patients about side effects that might be associated with their secondary hyperparathyroidism therapy? A.Annually B.About once every 3-12 months C.About once every 1-2 months D.Every month E.Every visit

8. 8 A sample question What, in your experience, do you find to be the most challenging aspect of Secondary Hyperparathyroidism management? Select all that apply Explaining the disease and treatment to the patient at the point of diagnosis Patient counselling and on-going support Conducting regular testing, deciding upon regularity and nature of tests required for each patient (either alone or with a consultant physician) … etc … Other

9. 9 A sample question What format of educational support would you find most valuable in helping you to support patients with Secondary Hyperparathyroidism? Select all that apply Educational training meetings Online educational training meetings Distance learning materials (hard copy packs) Online interactive distance learning modules Practical toolkits … etc… Newsletter and case study series written by nurses and experts

10. 10 The results Results of the survey will be published and used as a springboard for future educational themes, materials and learning goals!

11. 11 Thank you!