CME Articles

Accreditation Statement
The Dannemiller Memorial Educational Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation of Credit

Physicians
The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses
The Dannemiller Memorial Educational Foundation is an approved provider of the California Board of Registered Nursing. Provider approved by the California Board of Registered Nursing, Provider Number 4229, for 1.2 contact hours.

RNs outside of California must verify with their licensing agency for approval of this course.

Target Audience
The educational program is intended for pain management physicians and nurses.

Needs Assessment
The last decade has seen a great increase in the range of opioid agents and formulations available for the treatment of chronic pain as reflected in a review of the existing medical literature on opioid agents and formulations currently available. Opioids remain a cornerstone of pharmacotherapy. In addition to severity of pain, coexisting disease, response to previous therapy, the drug’s pharmacokinetics and available formulations influence the choice of an opioid agent. Short half-life drugs, such as morphine, hydromorphone, fentanyl, oxycodone, and oxymorphone, are generally favored initially because they are easier to titrate than long half-life agents. Long-acting controlled-release opioid preparations can lessen the inconvenience of around-the-clock administration with a short duration of action. In recent years several new formulations have been developed including controlled-release morphine suppositories and suspensions; controlled-release tablets of oxycodone, hydromorphone, and codeine; and transdermal fentanyl, a patch that allows 3-day dosing and avoids the first-pass effect of the liver. Among the important advances in the last decade in the treatment of chronic pain is the realization that the goals of care and the best means of achieving them differ not only among individuals but often for a single patient throughout a long course of care. Physicians must not only be knowledgeable but also flexible in their approach to managing chronic pain. An understanding of the range of opioid agents and the formulations available can allow physicians to maintain the best possible quality of life for their patients with chronic pain.

Method Of Participation
The activity should take approximately 1 hour to complete. You should read the objectives and other CME information, proceed through the educational offering, and take the link to the registration for credit and post-test. The evaluation on the post-test site provides you with the opportunity to comment on the extent in which the educational needs were met, the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and your views on future educational needs. To receive credit for this CME/CPE/CE activity, follow the instructions provided on the site. This credit is available through February 28, 2007. No credit will be given after this date.

*In the event you are unable to print the certificate, please submit the post-test and then email editor@dannemiller.com and a certificate will be mailed to you within two weeks.

Evaluation
The activity evaluation form provides each participant the opportunity to comment on the extent to which educational objectives were met, the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and specific views on future needs. This form is part of the registration form.

Educational Content
This issue of the Pain Report, for which CME/CE credit will be awarded, consists of three articles dealing with long-acting opioids, guidelines for use and treatment disparities.

Faculty Disclosure
Dr. Goli has nothing to disclose.
Dr. Finley discloses that she is a speaker for Purdue Pharma.

Unlabeled Use/Investigational Uses of Products
It is the policy of the Dannemiller Memorial Educational Foundation that faculty disclose any unlabeled or investigational drugs discussed in his/her presentation.

Methadone is not currently approved for use in the treatment of neuropathic pain.

Objectives

1. Enhance the knowledge and skills of healthcare professionals in selecting and using long-acting opioids for chronic pain.
2. Discuss the effect of race/ethnicity and social characteristics on physicians’ decisions to prescribe opioids.
3. Review consensus statements, guidelines and policies on the treatment of Chronic NonMalignant Pain with long-acting opioids.