ESP: Emerging Solutions in Pain

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Release Date: September 02, 2008
Expiration Date: September 02, 2011

Program Overview

Opioids can be a successful treatment for chronic, nonmalignant pain, even for long-term use, but are not well tolerated by some patients. Treatment failures occur for various reasons, among them opioid-related adverse events, analgesic tolerance, hyperalgesia, comorbid mental disorders, opioid misuse to seek reward, and addiction. In addition, recent research indicates that individual genetic variations may influence opioid metabolism causing a myriad of inter-individual responses to medications. Assessing a patient's suitability for opioid therapy can increase chances for successful outcomes and alert clinicians to the need to change therapeutic course if opioid therapy becomes ineffective or harmful. Patients should be evaluated for risk of addiction or misuse, the presence of mental disorders, and the type, duration, and severity of pain. The treatment regimen, whether pharmacologic, non-pharmacologic, or both, should be individualized accordingly. Assessment should take place before initiation of opioid therapy and continue as a monitoring activity throughout the course of treatment.

Intended Audience

This activity is designed for physicians, pharmacists, physician assistants, nurses, and other health care professionals with an interest in enhancing their clinical skills in pain management.

Educational Objectives

• Describe when and why opioids are a necessary therapeutic component of moderate-to-severe pain management and recognize which patients may benefit most from treatment of chronic pain with opioid analgesics
• Recognize the importance of using a risk-benefit analysis when prescribing opioid therapy
• Identify how opioid type, route of delivery, and monitoring measures can affect clinical outcomes
• Recognize opioids' limitations, when opioid therapy has failed, and when to discontinue opioids and/or initiate alternative
  therapy(ies)

General Information

This activity is eligible for credit through September 2, 2011. After this date, this activity will expire and no further credit will be awarded.

Expected time to complete this activity as designed: 60 minutes

There are no fees for participating in this activity. All participants must complete the Activity Evaluation Form. Participants must receive a minimum score of 70% on the self-assessment portion of the form to qualify for CE credit. Certificates may be printed immediately after successfully completing the online self-assessment and evaluation.

Faculty Biography

Dr. Lynn Webster is board certified in anesthesiology and pain medicine and is also certified in addiction medicine. In his private practice, he treats chronic pain patients, many of whom have complex diagnoses. He also detoxes opioid-addicted patients. This dual role lends Dr. Webster a valuable perspective. He is dedicated to treating patients in pain while simultaneously working to minimize the potential for abuse and addiction.Dr. Webster is co-founder and medical director of Lifetree Clinical Research. His research interests are diverse. He has been keenly interested in developing safer and more effective therapies for chronic pain and addiction.

Dr. Webster earned his doctorate of medicine from the University of Nebraska Medical Center and completed his residency in the University of Utah Medical Center's Department of Anesthesiology. He lectures extensively on the subject of preventing opioid abuse and criminal diversion in chronic pain patients, and he has authored over 100 scientific abstracts, journal articles and the recently published book Avoiding Opioid Abuse While Managing Pain: A Guide for Practitioners. This book was written for clinicians who prescribe opioids as a guide to sort out the clinical, regulatory, and ethical issues associated with the prescribing of opioid analgesics. It includes step-by-step protocols for assessing patients for the risk of opioid abuse as well as for legally protecting the opioid prescriber.

He is the co-founder of LifeSource, a non-profit foundation established in 2006 to educate physicians, patients, and communities on health issues (with an emphasis on pain-related, scientific and social issues), as well as fund and conduct research that will discover new solutions and hope for improved life. LifeSource's first project is entitled "Zero Unintentional Deaths." The campaign was developed to educate physicians, chronic pain sufferers and all communities about the increasingly serious issue of unintentional overdose deaths relating to methadone and other prescription medications. It aims to eliminate unintentional overdoses from prescription medication.

Dr. Webster is currently on the Board of Directors for the American Academy of Pain Medicine and the National Pain Foundation. He was also instrumental in launching the Utah chapter of the American Academy of Pain Medicine. This organization seeks to achieve high medical standards, improve access to pain care and educate all interested parties about the many pain-related scientific and social issues.

Accreditation

CME CREDIT
Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of MediCom Worldwide, Inc. and Medical Learning Solutions. MediCom Worldwide, Inc. is accredited by the ACCME to provide continuing medical education for physicians.
Designation Statement: MediCom Worldwide, Inc. designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CPE CREDIT
MediCom Worldwide, Inc. is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is acceptable for 1.0 contact hour(s) of Continuing Education Credit. Universal Activity Number: 0827-9999-08-216-H01-P Knowledge-based CPE activity.

NURSING CREDIT
Accreditation Statement: This activity has been planned and implemented through the joint sponsorship of MediCom Worldwide, Inc. and Medical Learning Solutions. 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: 08-216-212

Disclosure

In accordance with the Accreditation Council for Continuing Medical Education (ACCME), ACPE and California Board of Nursing, MediCom Worldwide, Inc. requires that all program planners, faculty, and providers who are in a position to control the content of a CE activity are required to disclose any relevant financial relationships they may have or have had within the last 12 months with the commercial supporter or the manufacturer(s) of any commercial device(s) discussed in this educational activity. Accordingly the following disclosures were made.

Faculty Disclosure

Dr. Lynn Webster has received honoraria as a consultant from Advanced Bionics Corporation; Cephalon, Inc.; Covidien AG; Elan Pharmaceuticals, Inc.; Elite Pharmaceuticals, Inc.; Medtronic, Inc.; MEDACorp; and ZARS Pharma. He has received grant support related to research activities from Abbott Laboratories; Advanced Bionics; Alpharma Inc.; Ameritox, Ltd.; Array BioPharma Inc.; AstraZeneca PLC; Boehringer Ingelheim Pharmaceuticals, Inc.; Cervelo Pharmaceuticals Inc.; CoMentis, Inc.; DURECT Corporation; Elan; Elite; Forest Laboratories, Inc.; GlaxoSmithKline; Jazz Pharmaceuticals, Inc.; King Pharmaceuticals, Inc.; Medtronic; Merck & Co., Inc.; Nektar Therapeutics; NeurogesX; Pain Therapeutics, Inc.; Purdue Pharma L.P.; QRxPharma Ltd.; Respironics, Inc.; Takeda Pharmaceuticals North America, Inc.; TorreyPines Therapeutics; Wyeth; and ZARS. In addition he has received honoraria related to formal advisory activities from Alpharma; Ameritox; Cortex Pharmaceuticals, Inc.; King; Nektar; Nervo; Neuromed Pharmaceuticals Inc.; Purdue; and QRxPharma.

Planner and Provider Financial Disclosure

The individuals listed below reported the following for this activity:
MediCom Worldwide, Inc. – Joan Meyer, executive director; Ruth Widmer, medical editor and Alan Vogenberg, RPh, FASCP, clinical reviewer have nothing to disclose.

Medical Learning Solutions – Sheri Gavinski, president and Bronwyn Boyes, director have nothing to disclose.

Jeffrey Gudin, MD, was the clinical reviewer for this activity and disclosed that he has received honoraria related to speakers’ bureau activities from Cephalon, Inc.; Endo Pharmaceuticals; King Pharmaceuticals, Inc. and Pfizer Inc. He has received grant support related to research activities from Cephalon; Neuromed Pharmaceuticals Ltd.; and Pfizer.

Conflict of Interest Resolution

To identify and resolve conflicts of interest, the educational content was fully peer reviewed by a member of the MediCom Worldwide, Inc. Clinical Content Review Committee. The resulting activity was found to provide educational content that is current, evidence based, and commercially balanced.

Off-Label/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. Webster indicated that his presentation would not include the discussion of unlabeled uses of commercial products or investigational products not yet approved by the FDA for any use in the United States.

Hardware/Software 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, 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™.

This activity is supported by an independent educational grant from

©2008 MediCom Worldwide, Inc., 101 Washington St., Morrisville, PA 19067.

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