Effective Strategies in Managing Breakthrough Pain for Nurses

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Release Date: September 28, 2012
Expiration Date: September 28, 2013

Expected time to complete this activity as designed: 2 hours
There are no fees for participating in or receiving credit for this online activity.

Program Overview

In this 6-part program, Dr. Gudin, Dr. Webster and Dr. Brennan focus on appropriate and individualized assessment for breakthrough pain, proper patient selection and appropriate pharmacological treatments for breakthrough pain and risk mitigation in a real-world setting.

Target Audience

This activity is designed for nurses who have an interest in enhancing their clinical skills in pain management.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

  • Define and differentiate characteristics of breakthrough cancer pain
  • Formulate effective assessment techniques to assist in the diagnosis of breakthrough cancer pain
  • Define key principles of prescribing opioid analgesics for breakthrough pain including protocols for proper patient selection in determining treatment options
  • Integrate knowledge regarding risk stratification into treatment planning strategies of patients prescribed opioid therapy


Activity 1
Module 1: Effective Assessment of Breakthrough Pain – Jeffrey A. Gudin, MD
Module 2: Case Study – Assessment – Jeffrey A. Gudin, MD
Activity 2
Module 1: Individualized Approaches to the Treatment of Breakthrough Pain– Jeffrey A. Gudin, MD – Moderator, and Lynn R. Webster, MD, FACP, FASAM
Module 2: Case Study – Treatment – Jeffrey A. Gudin, MD
Activity 3
Module 1: Risk Management Strategies in Breakthrough Pain – Jeffrey A. Gudin, MD – Moderator, and Michael J. Brennan, MD
Module 2: Case Study – Risk – Jeffrey A. Gudin, MD

Instructions for Participation and Credit

This activity is eligible for credit through September 28, 2013. After this date, this activity will expire and no further credit will be awarded.
1. Read the target audience, learning objectives, and faculty disclosures.
2. You may be asked to complete a short pre-test before accessing the educational content. This must be completed in order to move forward in the activity.
3. Complete the educational content as designed.
4. Complete the post-test. To receive a certificate, you must receive a passing score of 70%.
5. Complete the activity evaluation survey to provide feedback and information useful for future programming.
6. Certificates may be printed immediately after successfully completing the post-test and activity evaluation.

Faculty Biographies

Jeffrey A. Gudin, MD
Pain Management Center
Englewood Hospital and Medical Center
Englewood, New Jersey

Dr. Jeffrey A. Gudin received his medical degree from Albany Medical College in Albany, New York. Following a transitional internship in surgery, medicine, and anesthesiology at St. Barnabas Medical Center in Livingston, New Jersey, he completed a residency in anesthesiology at Yale University School of Medicine. He continued his training with an extended postdoctoral fellowship in pain medicine at the Yale Center for Pain Management, where he was actively involved in research and teaching. He is currently director of the Pain Management Center at Englewood Hospital and Medical Center in New Jersey, an affiliate of the Mount Sinai School of Medicine. Dr. Gudin is board certified in pain medicine and anesthesiology, and is board eligible in addiction medicine.

An active speaker in the field of pain management, Dr. Gudin has been interviewed on various television news channels, including CBS, and other national news networks. Dr. Gudin has also been quoted in The New York Times and various regional newspapers in New Jersey and Connecticut. His clinical and research focus includes pain management, regional anesthesia, and preemptive analgesia, as well as increasing clinician awareness of pain assessment and management.

Lynn R. Webster, MD, FACPM, FASAM
Medical Director
Co-Founder, LifeSource
Salt Lake City, Utah

Dr. Lynn Webster earned his medical degree from the University of Nebraska and completed his residency in the University of Utah’s Department of Anesthesiology. He is medical director at CRILifetree in Salt Lake City, Utah and is also the co-founder of LifeSource, a non-profit foundation established in 2006 to provide education about pain-related issues as well as fund and conduct research. LifeSource’s first project, “Zero Unintentional Deaths,” was developed to educate physicians, chronic pain sufferers, and all communities about unintentional overdose deaths relating to methadone and other prescription medications.

Dr. Webster is board certified in anesthesiology and pain medicine with additional certification in addiction medicine; he is currently on the Board of Directors and serves as treasurer for the American Academy of Pain Medicine. He is past president of the Utah Academy of Pain Medicine and an active national spokesman for improving access to pain therapies.

Dr. Webster lectures extensively on the subject of preventing opioid abuse and criminal diversion in chronic pain patients. He has authored over 100 scientific abstracts, journal articles and recently published the book, Avoiding Opioid Abuse While Managing Pain: A Guide for Practitioners.

Michael J. Brennan, MD
The Pain Center of Fairfield
Fairfield, Connecticut
Senior Attending Physician
Department of Medicine
Bridgeport Hospital
Bridgeport, Connecticut

Dr. Michael J. Brennan received his medical degree at the State University of New York Downstate Medical Center, and completed a residency in physical medicine and rehabilitation at the New York Hospital-Cornell University Medical Center, where he served as chief resident. While at New York Hospital, Dr. Brennan also served as chief resident at the International Center for the Disabled in New York City. Dr. Brennan is a board certified physiatrist in private practice in Fairfield, Connecticut.

After completing his residency, Dr. Brennan was appointed to the faculty of New York Hospital and Cornell Medical College in the Department of Physical Medicine and Rehabilitation. He served as acting chief of the rehabilitation service in the Department of Neurology at Memorial Sloan-Kettering Cancer Center. After leaving Sloan-Kettering, Dr. Brennan became the medical director of the Rehabilitation Center of Fairfield County and Ahlbin Centers for Rehabilitation Medicine and chief of the section of physical medicine at Bridgeport Hospital in Bridgeport, Connecticut. He is currently a senior attending physician in the Department of Medicine at Bridgeport Hospital and consulting physician at St. Vincent’s Hospital in Bridgeport, Connecticut.

Dr. Brennan has special interests of the management of pain as well as disability in patients suffering from the acute and long-term effects of musculoskeletal diseases, neurological disorders, and cancer and various cancer treatments. He has published over 30 scholarly articles, abstracts and textbook chapters on the treatment of cancer and noncancer related disabilities including lymphedema and pain. He is a reviewer for several medical journals and has served as guest editor for the Journal of Musculoskeletal Rehabilitation and as online editor for Pain.com. Recently, Dr. Brennan was awarded the Dr. Elizabeth Narcessian Memorial Award from Kessler Institute, recognizing his commitment to the treatment of patients suffering from chronic pain.


Accreditation Statement: MediCom Worldwide, Inc., 101 Washington Street, Morrisville, PA 19067 is approved by the California Board of Registered Nursing, Provider Number CEP11380. MediCom designates this CNE activity for 2.0 contact hours. Program Number: 12-326-291


As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE) and California State Board of Registered Nursing, MediCom Worldwide, Inc. requires everyone who is a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest. Accordingly, the following disclosures were made.

Faculty Disclosures

Dr. Jeffrey Gudin has received honoraria related to speakers’ bureau activities from Pfizer Inc., Purdue Pharma L.P., and Teva Pharmaceuticals.

Dr. Lynn Webster has received honoraria related to formal advisory activities and as a consultant from American Academy of Pain Management, American Board of Pain Medicine, Boston Scientific Corporation, Covidien, Iroko Pharmaceuticals, LLC, Medtronic, Inc., Nektar, Pfizer Inc., and Salix Pharmaceuticals, Inc.

Dr. Michael Brennan has received honoraria related to speakers' bureau activities from Eli Lilly and Company, Endo Pharmaceuticals, Forest Laboratories, Inc., Merck & Co., Inc., Pfizer Inc., Purdue Pharma L.P., and Teva Pharmaceuticals, as well as formal advisory activities from Endo, Johnson & Johnson, Pfizer, Purdue, and Teva. He has received consultant fees from Endo, J & J, Purdue, and Teva.

Planning Committee Disclosures

The individuals listed below from MediCom Worldwide, Inc. reported the following for this activity: Joan Meyer, RN, MHA, executive director, and Bronwyn Boyes, PharmD, director, have no relevant financial relationships.

Peer Reviewer Disclosure

In accordance with MediCom Worldwide, Inc. policy, all content is reviewed by external independent peer reviewers for balance, objectivity and commercial bias. The peer reviewers have no relevant financial relationships to disclose.

Off-Label Disclosures/Investigational Disclosures

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Dr. Gudin has indicated that he does not intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.

Dr. Gudin and Dr. Webster have indicated that they do not intend to discuss investigational drugs, mechanical devices, biologics or diagnostics not approved by the FDA for use in the US.

Dr. Webster and Dr. Brennan have indicated that they do intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.

Dr. Brennan has indicated that he does intend to discuss investigational drugs, mechanical devices, biologics or diagnostics not approved by the FDA for use in the US.

Hardware/Software/Internet Requirements

MediCom Worldwide, Inc. requires Internet Explorer® version 7.0 or higher, or Firefox 3.0 or higher, a computer running Windows® XP, Windows® Vista, Windows® 7, or Mac OS X, 512MB of RAM or greater, 1.5 GHZ or faster processor, and a screen resolution of 1024x768 or higher. Certain educational activities may require additional software to view. These activities will be marked with the information and/or links to the required software. That software may be Adobe® Flash® Player, Adobe® Acrobat®, Windows Media® Player or Microsoft® Silverlight™.

If you have any questions or concerns regarding this activity, please contact MediCom Worldwide, Inc. at 1-800-408-4242 or email us at info@emergingsolutionsinpain.com.

Provided by MediCom Worldwide, Inc.

This activity is supported by an educational grant from Teva Pharmaceuticals.

©2012 MediCom Worldwide, Inc., 101 Washington St., Morrisville, PA 19067, 800-408-4242.
No portion of this material may be copied or duplicated without the expressed permission of MediCom Worldwide, Inc.

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