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CME: Current and Emerging Strategies in the Treatment of Chronic Pain

 


Program Description / Statement of Need:

In this online CME self-learning program:

Chronic pain is a serious medical condition found in a diverse range of patient populations.  Because of the etiologically heterogeneous nature of this condition, many treatment modalities exist, some of which apply to a broader range of patient populations than do others.  For several reasons that are both patient- and provider-specific and include concern over medication dependence, stigma to narcotic use, and the inherent difficulty in measuring the subjective phenomenon of pain itself, chronic pain is frequently undertreated.

 

Opioids are the mainstay of pharmacologic care for most forms of chronic pain; however, other classes of drugs are also used in specific types of pain, such as neuralgia, referred pain secondary to psychiatric disease, and others.  These alternative treatments not only have lower risk for dependence, but also may be better options to control these types of pain, and therefore provide better outcomes. 

 

Opioids are available in many dosage forms with novel routes of administration, adding a layer of complexity to their prescription.  There are also many products combining opioids with other medications providing an additional set of therapeutic options.  These dual products may either contain synergistic combinations of medications for added efficacy or agonist-antagonist combinations meant to reduce abuse potential or side effects.  Yet another, emerging trend in chronic pain management is opioid rotation.  Also, new treatments like pain rehabilitation and strategies to improve compliance and understanding of medical therapy may permit treatment with lower doses of opioids. 

 

Healthcare professionals must navigate an array of regulations specifically aimed at the prescription of controlled substances when managing chronic pain, and the uninformed may skirt or traverse the law, whether intentionally or not, when they prescribe analgesics.  Only about 0.1% of practices of physicians practicing patient care are ever charged with offenses stemming from the prescription of opioids.  However, a plurality – just over 39% – are general practitioners, suggesting that education about analgesia prescribing is warranted in this population.  Dentistry is also increasingly becoming a targeted health discipline for those with substance abuse disorders.  Because extended-release medications are the most likely to be abused due to increased potency, additional education should be provided and caution used when prescribing them.  The FDA is seeking ways to make these medications safer but, in the mean time, stronger caution may be needed on the part of prescribers.  These long-acting opiates, particularly methadone, are responsible for at least 37% of poisoning deaths in the US between 1999 and 2006.  Moreover, in over a quarter of U.S. states, more people die from opioid overdoses than car crashes.  These statistics illustrate just some of the dangers associated with these medications’ use and emphasize the need for more education about prescribing them.  Another drug of concern is acetaminophen which, because it is sometimes present in multiple medications a patient is taking, prescription and non-, has become the leading cause of acute liver failure in the U.S.  Taken in aggregate, these factors suggest that a gap exists between best practices and actual medical practice.  This should be addressed through education of medical professionals who can then adjust their practices to better serve their patients. 

 

This program has been designed to bring healthcare professionals’ knowledge of the strategies for management of chronic pain up to date.


 

Target Audience:

This activity has been designed to meet the educational needs of Physicians, Pharmacists, Nurses, Physician Assistants, Nurse Practitioners, and other health care professionals who are interested in managing patients with Chronic Pain.



Program Objectives:

By the end of the session the participant will be able to:

    • Describe challenges to the successful management of chronic pain.
    • Apply existing diagnostic recommendations and criteria to practice in the management of chronic pain.
    • Develop strategies to minimize adverse effects associated with chronic pain treatment in different patient populations.
    • Develop a monitoring plan aimed at streamlining therapeutic titration of chronic pain treatment in different patient populations.


    Accreditation:

    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

     

    Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.



    Release Date: January 02, 2012
    Expiration Date: December 29, 2014

    Faculty: Richard Greene PharmD


    Faculty Disclosure and Resolution of COI:
     As an provider of continuing medical education, it is the policy of the ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is our policy to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.
    Richard B. Greene, PharmD does not have any relevant conflicts of interest or financial relationships.
    Disclosures of Educational Planners: Charles Turck, PharmD has no relevant financial disclosures.
    Commercial Support Disclosure: This program is supported by an educational grant from Purdue Pharma L. P.

     

    Viewing Instructions:

     

    PC

    Windows 2000 or above
    Internet Explorer 5.5
    Adobe Acrobat Reader*

    MAC
    Mac OS 10.2.8
    Safari
    Adobe Acrobat Reader*
    Internet Explorer is not supported on the Macintosh

     

    *Required to view Printable PDF Version

     

    Privacy Policy

     

    Instructions:
    -Read the learning objectives and faculty disclosures above

    -Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.

    -View the on-line program. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.

    -Take the post-test

    -Complete the program evaluation and CME registration. A CE certificate will be emailed to you.


    Perform Pre-Test (optional)
    Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


    Download the Presentation (optional)


     

    View the online program

     

    Perform Post-Test


    Complete the Symposium Evaluation and Request CE Certificate



This program is supported by an educational grant from Purdue Pharma L. P.

 


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