Friday, January 27, 2023
This activity is intended for primary care providers including physicians, pharmacists, and nurses who are involved in the care of patients with chronic pain.
The goal of this activity is to improve the recognition and management of various types of chronic pain in patients presenting to primary care.
Upon completion of this activity, participants will be able to:
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Medscape, LLC designates this enduring material for a maximum of 2.25
AMA PRA Category 1 Credit(s)™
. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page. To receive
AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.
Follow these steps to earn CME/CE credit*:
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CME Released: 9/16/2011
Valid for credit through: 9/16/2012
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Editor's note: This activity is part of a set of resources for Improving the Assessment of Pain, a Performance Improvement (PI) CME initiative on Medscape Education. PI CME offers physicians the opportunity to earn up to 20 AMA PRA Category 1 credits by evaluating their practice in a specific clinical area, identifying opportunities for improvement and implementing change, and measuring the results. The first step is a self-assessment. To learn more about PI CME, click here.
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Tom is a 57-year-old married man with 2 adult children. He is executive vice president of an advertising firm. At his recent annual visit, he is found to be slightly hypertensive (138/92 mm Hg), mildly diabetic (glycated hemoglobin [A1c] level, 7.2%), and to have gained 12 lbs in the last year. During the course of the physical examination, he complains that he has been struggling with insomnia and has needed to take over-the-counter sleep aids at least 1-2 nights per week for a few months. He and his doctor joke about their respective golf handicaps, and Tom admits that he has not been able to play golf in the past few months because of nagging intermittent low back pain.
The primary care provider (PCP) addresses the immediate medical concerns of hypertension, diabetes, and weight gain, and recommends specific lifestyle modifications including exercising, choosing a healthier diet to stabilize blood sugar levels and promote weight loss, and reducing his alcohol consumption. The PCP also sends Tom for blood tests and a cardiac stress test, and prescribes a mild antihypertensive and a sleep aid.
When Tom returns in 6 weeks for his follow-up visit, he has made some progress: He has lost 4 lb, reports walking a mile or so 2-3 times per week, and is within his target blood glucose level. All of his test results (cholesterol, stress test) are within normal limits. His blood pressure is down to 125/86 mm Hg. However, he is feeling increasingly fatigued and complains of loss of concentration at work and reduced libido, most of which he attributes to his chronic low back pain (CLBP). Tom is given a standard depression screener to complete and is found to be mildly depressed. He complains about the added stress of his medical problems and admits that he recently missed a few days of work because he "hurt too much to get out of bed." The PCP notices that Tom is having a difficult time sitting comfortably during the consultation.
