Targeting Breakthrough Pain: A Patient Case Report

Please Log In or Register to continue.

Release Date: June 14, 2013
Expiration Date: June 14, 2014

Expected time to complete this activity as designed: 60 minutes
There are no fees for participating in or receiving credit for this online activity.

Program Overview

One of the greatest challenges faced by health care professionals today is the need to balance the time required to remain up-to-date concerning new data and research with the demands of day-to-day patient and practice management. During this satellite symposium held in conjunction with the 38th ONS Annual Conference, a panel of leading clinical experts in pain management will focus on the critical components that define breakthrough pain, as well as current approaches to effectively managing chronic pain patients who are at risk of suffering, or do suffer, with breakthrough pain episodes in the oncology setting.

Target Audience

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

Learning Objectives

Upon completion of this educational activity, participants should be able to:
  • Formulate effective assessment techniques to assist in the diagnosis of breakthrough pain
  • Define key principles of prescribing opioid analgesics for persistent and breakthrough pain, including protocols for proper patient selection in determining treatment options
  • Identify and incorporate opportunities within the clinical practice setting to incorporate assessment, management, and ongoing evaluation of breakthrough pain in chronic pain patients


Program Overview, Introductions – Kevin E. Brigle, PhD, NP

Formulating Effective Assessment and Management Strategies for Breakthrough Pain – John F. Peppin, DO, FACP

Patient-centered Treatment – April Hazard Vallerand, PhD, RN, FAAN

Instructions for Participation and Credit

This activity is eligible for credit through June 14, 2014. 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

Kevin E. Brigle, PhD, NPModerator
Adjunct Assistant Professor
Adult Health Nursing, School of Nursing
Virginia Commonwealth University
Richmond, Virginia

Dr. Kevin Brigle earned his PhD in molecular microbiology from Virginia Tech in Blacksburg, Virginia. Following completion of his dissertation, he took a position as a postdoctoral fellow and later as a laboratory director in the Division of Hematology and Oncology at Virginia Commonwealth University in Richmond, Virginia. While consulting on a NIH funded grant in the School of Nursing, he enrolled in the nurse practitioner program. Following one year of practice as an acute care nurse practitioner in the Department of Internal Medicine, he came to his current position as an oncology nurse practitioner in the Hematological Malignancies Clinic at the Massey Cancer Center in the Virginia Commonwealth University Health System. He is also an adjunct assistant professor, Adult Health Nursing, School of Nursing, Virginia Commonwealth University.

Dr. Brigle is a member of various professional associations including the American Association for Advancement of Science, American Association of Clinical Oncologists, American Association of Nurse Practitioners, American Nurses Association, and the Oncology Nursing Society. He has authored several book chapters and articles in peer-reviewed publications.

John F. Peppin, DO, FACP
Associate Medical Director
Hospice of the Bluegrass
Palliative Care Center of the Bluegrass
Lexington, Kentucky

Dr. John Peppin completed his medical degree at the University of Osteopathic Medicine and Health Sciences, Des Moines, Iowa. He continued his postgraduate education with an internal medicine residency at the University of Wisconsin, Marshfield Clinic/St. Joseph’s Hospital. Dr. Peppin is currently associate medical director, Hospice of the Bluegrass and the Palliative Care Center of the Bluegrass, Lexington, Kentucky. He is also CEO, president and founder, Iowa Pain Management Clinic, Des Moines, Iowa.

Dr. Peppin is board certified by the American Board of Internal Medicine, American Board of Psychiatry and Neurology, American Board of Pain Medicine, and the American Board of Hospice and Palliative Care Medicine. Additionally, he is a certified Education in Palliative and End-of-Life Care (EPEC) trainer. He serves on numerous professional committees and is an editor and peer reviewer for numerous journals. Dr. Peppin has published articles in the fields of pain management, palliative care and bioethics, has edited numerous books, and has given numerous lectures at conferences on topics in pain and palliative medicine, bioethics, end-of-life care, and internal medicine.

April Hazard Vallerand, PhD, RN, FAAN
Associate Professor
College of Nursing
Wayne State University
Detroit, Michigan

Dr. April Hazard Vallerand received her bachelor’s degree in nursing from Mount St. Mary’s College and her master of science degree in nursing from California State University. She received her PhD in nursing from the University of Pennsylvania and completed a three-year postdoctoral fellowship in psychosocial oncology at the University of Pennsylvania School of Nursing. She is currently an associate professor in the College of Nursing at Wayne State University, Detroit.

Dr. Vallerand is a fellow in the American Academy of Nursing and is the principal investigator on the study Improving Functional Status in African Americans with Cancer Pain, funded by the National Cancer Institute. She lectures nationally on the management of pain, and has published numerous articles on pain and pain control. She has also authored five books on pharmacology for nurses and other health care professionals, including Davis’s Drug Guide for Nurses. Dr. Vallerand’s research interests are focused on the improvement and maintenance of functional status in patients with chronic pain and the identification and reduction of pain-related disparities


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 1.0 contact hour. Program Number: 13-361-325


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. Kevin Brigle has received honoraria related to speakers’ bureau activities from Celgene Corporation, Millennium: The Takeda Oncology Company, Onyx, and Seattle Genetics, Inc.

Dr. John Peppin has received honoraria as a consultant from AIT Laboratories, Insys Therapeutics, Inc., Salix Pharmaceuticals, Inc., and Zogenix, Inc.

Dr. April Vallerand has received honoraria related to speakers’ bureau activities from Pfizer, Inc. and as a consultant from Teva Pharmaceuticals.

Planning Committee Disclosures

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

Peer Reviewer Disclosure

In accordance with MediCom Worldwide, Inc. policy, all content is independently peer reviewed 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.

Drs. Brigle, Peppin, and Vallerand have indicated that they do 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.

Drs. Brigle, Peppin, and Vallerand 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.

Hardware/Software/Internet Requirements

MediCom Worldwide, Inc. requires Internet Explorer® version 9.0 or higher, the latest version of Google Chrome, or the latest version of Safari, a computer running 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 include Adobe® Flash® Player, Adobe® Acrobat®, Windows Media® Player, and/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

Provided by MediCom Worldwide, Inc.

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

©2013 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.

Please Log In or Register to continue.