Speaker Michael J. Brennan, MD The Pain Center of Fairfield Physical Medicine and Rehabilitation Senior Attending Physician Department of Medicine, Section of Pain Management & Rehabilitation Bridgeport Hospital Bridgeport, CT Associate Director, Chronic Pain and Recovery Center Silver Hill Hospital New Canaan, CT
Series Chair Charles E. Argoff, MD Professor of Neurology Albany Medical College Director, Comprehensive Pain Program Albany Medical Center Albany, NY
AMA PRA Category 1 Credit™ Medium
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Opioid prescriptions have increased dramatically in the last decade, and opioid abuse and misuse has become a major public health concern. In 2012 the FDA approved a classwide risk management program, known as a Risk Evaluation and Mitigation Strategy (REMS), for all extended-release or long-acting (ER/LA) opioid analgesics. As part of this program, continuing education is being made available to prescribing clinicians to enhance their management of patients with chronic pain.
This REMS-compliant training module (Module 4 of 6) discusses using the Patient Counseling Document (PCD), including the “dos” and “don’ts,” combining opioids with other CNS depressants, and specific instructions; dangers of combining opioids with other CNS depressants; medication guides; strategies to include the PCD in practice; opioid adherence; and tampering with formulations. Subsequent REMS-compliant training modules will address the remainder of the FDA Blueprint.
. Target Audience
This educational activity is designed to meet the needs of all health care professionals who prescribe ER/LA opioid analgesics, including physicians, nurses, NPs, PAs, pharmacists, dentists, and pain specialists.
Upon completion of this educational activity, the participant should be able to:
List the key points that should be discussed with patients and caregivers when counseling them about the safe use of ER/LA opioid analgesics.
Explain why an oral ER/LA opioid analgesic should not be broken, chewed, or crushed and why patches should not be cut or torn prior to use.
Inform patients about other agents and substances that when used with ER/LA opioid analgesics can cause overdose and death.
Counsel patients and caregivers on the risk factors, signs, and symptoms of overdose and opioid-induced respiratory depression, gastrointestinal obstruction, and allergic reactions.
Instruct patients about proper storage and disposal of ER/LA opioid analgesics.
Michael J. Brennan, MD, discloses the following relationships with commercial interests:
Advisory Board: Purdue, Teva, Covidien/Mallinckrodt, Endo Pharmaceuticals, Insys, Millenium Labs
Consultant: Purdue, Teva, Covidien/Mallinckrodt, Insys, Millenium Labs
Shareholder: Zalicua, PEIXUA
Speakers Bureau: Purdue, Teva, Mallinckrodt, Endo Pharmaceuticals, Insys, J&J, Pfizer, Lilly, Depomed
Charles Argoff, MD, discloses the following relationships with commercial interests:
Advisory Board: Teva, Daiichi Sankyo, Pfizer, Nektar, Purdue, Depomed, Xenoport
Consultant: Teva, Daiichi Sankyo, Pfizer, Nektar, Purdue, Depomed, Xenoport
Grant Recipient: Endo Pharmaceuticals, Forest Labs, Lilly
Speakers Bureau: Janssen, Allergan, Depomed, Xenoport
Rick Ricer, MD, Physician Reviewer, University of Cincinnati, has no conflicts of interest to disclose.
Susan P. Tyler, MEd, CCMEP, FACEHP, University of Cincinnati, has no conflicts of interest to disclose.
Gena Dolson, MS, MCM Education Senior Medical Writer, has no conflicts of interest to disclose.
Kathleen Hines, MCM Education Editorial Director, has no conflicts of interest to disclose.
The University of Cincinnati requires all faculty to disclose any planned discussion of an investigational and/or off-label use of a pharmaceutical product or device within their presentation. Participants should note that the use of products outside FDA-approved labeling should be considered experimental and are advised to consult current prescribing information for approved indications.
In this educational activity, the faculty reports his presentation will not contain reference to investigational and/or off-label uses.
This activity has been planned and implemented in accordance with the Essentials Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Cincinnati and MCM Education. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.
The University of Cincinnati designates this Enduring Material Activity for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Release date: April 7, 2014
Last review date: April 7, 2014
Expiration date: April 15, 2015 Commercial Support Statements
This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies. Please see
http://ce.er-la-opioidrems.com/IwgCEUI/rems/pdf/List_of_RPC_Companies.pdf for a listing of the member companies. This activity is intended to be fully compliant with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration. Instructions
* Link to and Log into program on QuantiaMD.com
* Complete the pre-activity assessment.
* Review the educational activity
* Complete the post-activity assessment and score a minimum of 75% (you are allowed two retakes).
* Complete the evaluation
* View, print, or save a CME certificate verifying your
credit/participation in this activity Computer Requirements: Minimum System Requirements: • Pentium III, 600 MHz or Equivalent Processor • 512 MB of RAM • Windows XP, Vista, or 7 • Mac OS X • 800x600 Monitor Resolution • 16-bit Color • 16 bit Sound Card with Speakers
There is no charge for CME credit.
The opinions or views expressed in this CME activity are those of the presenters and do not necessarily reflect the opinions or recommendations of the University of Cincinnati, MCM Education, or the commercial supporter(s). Participants should critically appraise the information presented and are encouraged to consult appropriate resources for information surrounding any product, device, or procedure mentioned.