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Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10:113-130. Abstract
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Sullivan MD, Howe CQ. Opioid therapy for chronic pain in the US -- promises and perils. Pain. 2013;154:S94-S100. Abstract
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Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the opioid risk tool. Pain Med. 2005;6:432-442. Abstract
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Passik SD, Kirsh KL, Casper D. Addiction-related assessment tools and pain management. Pain Med. 2008;(suppl 9):S145-S166.
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Meltzer EC, Rybin D, Saitz R, et al. Identifying prescription opioid use disorder in primary care: diagnostic characteristics of the Current Opioid Misuse Measure (COMM). Pain. 2011;152:397-402. Abstract
Brennan MJ. Update on prescription extended-release opioids and appropriate patient selection. J Multidiscip Health. 2013;6:265-280.
Fine PG, Portenoy RK. Establishing "best practices" for opioid rotation: conclusions of an expert panel. J Pain Symptom Manage. 2009;38:418-425. Abstract
Knotkova H, Fine PG, Portenoy RK. Opioid rotation: the science and the limitations of the equianalgesic dose table. J Pain Symptom Manage. 2009;38:426-439. Abstract
Pasternak GW. Multiple opiate receptors: deja vu all over again. Neuropharmacology. 2004;47(suppl 1):312-323. Abstract
Periyakoil V. End of life online curriculum. Pain control: opioid conversion module. http://endoflife.stanford.edu/M11_pain_control/intro_m01.html. 2008.
Shaheen PE, Walsh D, Lasheen W, et al. Opioid equianalgesic tables: are they all equally dangerous? J Pain Symptom Manage. 2009;38:409-417. Abstract
Webster LR, Fine PG. Review and critique of opioid rotation practices and associated risks of toxicity. Pain Med. 2012;13:562-570. Abstract
Haffey F, Brady RR, Maxwell S. A comparison of the reliability of smartphone apps for opioid conversion. Drug Saf. 2013;36:111-117. Abstract
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Gourlay D, Heit HA. Commentary. Clin Chem. 2009;55:1769.
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CME / ABIM MOC / CE

Opioid Prescribing: Safe Practice, Changing Lives - 2018 Update

Authors: Katherine Galluzzi, DO; Randall Hudspeth, PhD, MBA, MS, APRN-CNP
CME / ABIM MOC / CE Released: 3/28/2018; Reviewed and Renewed: 5/9/2019
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 8/31/2019, 11:59 PM EST

Target Audience and Goal Statement

This activity is intended for primary care clinicians, nurses, and other healthcare professionals who are involved in the management of chronic pain.

The goal of this activity is to improve the safe prescribing of opioid analgesics for chronic pain in the primary care setting.

Upon completion of this activity, participants will have increased knowledge regarding the:

Accurate assessment of patients with pain for consideration of an opioid trial
Establishment of realistic goals for pain management and restoration of function
Safe and judicious initiation of opioid treatment, maximizing efficacy while minimizing risks
Monitoring and reevaluation of treatment and safe discontinuation when appropriate
Counseling of patients and caregivers about use, misuse, abuse, diversion, and overdose
Education of patients about the safe storage and disposal of opioids
General and specific information about opioids, with a focus on the opioids most commonly used in practice

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education 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.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

Katherine Galluzzi, DO

Department of Geriatrics, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania

Disclosures

Disclosure: Katherine Galluzzi, DO, has disclosed no relevant financial relationships.

Dr Galluzzi does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Galluzzi does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Randall Hudspeth, PhD, MBA, MS, APRN-CNP

Advanced Practice Pain Management and Palliative Care, Boise, Idaho

Disclosures

Disclosure:Randall Hudspeth, PhD, MBA, MS, APRN-CNP, has disclosed no relevant financial relationships.

Dr Hudspeth does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Hudspeth does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor

Catherine Friederich Murray, BS

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Catherine Friederich Murray, BS, has disclosed no relevant financial relationships.

CO*RE Planning Committee

David Bazzo, MD

University of California, San Diego
San Diego, California

Ron Crossno, MD

Kindred At Home
Rockdale, Texas

Katherine Galluzzi, DO

Department of Geriatrics
Philadelphia College of Osteopathic Medicine
Philadelphia, Pennsylvania

Carol Havens, MD

Director of Physician Education and Development
Kaiser Permanente, Northern California
Sacramento, California

Randall Hudspeth, PhD, MBA, MS, APRN-CNP

Advanced Practice Pain Management and Palliative Care
Boise, Idaho

Cathy Judd, PA-C

Parkland Health
Dallas, Texas

Ed Salsitz, MD

Mt. Sinai Beth Israel
New York, New York

Seddon Savage, MD

Dartmouth College
Hanover, New Hampshire

Barb St. Marie, ANP

University of Iowa
Iowa City, Iowa

Disclosures

All Planning Committee Members have disclosed no relevant financial relationships.

Independent Content Reviewer

Roberto Cardarelli, DO, MHA, MPH

Disclosures

Disclosure: Roberto Cardarelli, DO, MHA, MPH, has disclosed no relevant financial relationships.

CME Reviewer/Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Lead Nurse Planner, Medscape, LLC

Disclosures

Disclosure: Amy Bernard, MS, BSN, RN-BC, has disclosed no relevant financial relationships.

Reviewers

Cynthia Kear, MDiv

California Academy of Family Physicians

Disclosures

Disclosure: Cynthia Kear, MDiv, has disclosed no relevant financial relationships.

Robin Heyden

Heyden Ty

Disclosures

Disclosure: Robin Heyden has disclosed no relevant financial relationships.

AAFP Member Reviewer

Charles Vega, MD, FAAFP

Health Sciences Clinical Professor of Family Medicine, University of California, Irvine, California

Disclosures

Disclosure: Charles Vega, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Served as a speaker or a member of a speakers bureau for: Shire Pharmaceuticals

Accreditation Statements

In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

This Enduring Material activity, Opioid Prescribing: Safe Practice, Changing Lives - 2018 Update, has been reviewed and is acceptable for up to 2.00 Prescribed credit(s) by the American Academy of Family Physicians. AAFP certification begins 03/28/2018. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

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For Nurses

Awarded 2.0 contact hour(s) of continuing nursing education for RNs and APNs; 2.0 contact hours are in the area of pharmacology.

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For Pharmacists

Medscape, LLC designates this continuing education activity for 2.0 contact hour(s) (0.20 CEUs) (Universal Activity Number JA0007105-0000-19-190-H05-P).

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For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

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 75% on the post-test.

Follow these steps to earn CME/CE credit*:

Read the target audience, learning objectives, and author disclosures.
Study the educational content online or printed out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

From Medscape Education Neurology & Neurosurgery

CME / ABIM MOC / CE

Opioid Prescribing: Safe Practice, Changing Lives - 2018 Update

Authors: Katherine Galluzzi, DO; Randall Hudspeth, PhD, MBA, MS, APRN-CNPFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC / CE Released: 3/28/2018; Reviewed and Renewed: 5/9/2019

Valid for credit through: 8/31/2019, 11:59 PM EST

processing....

Contents of This CME Activity

All sections of this activity are required for credit.

Assessing Patients and Initiating Opioid Therapy

How do you know if opioid therapy is appropriate for your patient?
Katherine Galluzzi, DO; Randall Hudspeth, PhD, MBA, APRN-CNP/CNS

Managing and Monitoring Therapy

What steps should you follow to ensure safe use and optimal outcomes?
Katherine Galluzzi, DO; Randall Hudspeth, PhD, MBA, APRN-CNP/CNS

Take-Home Points and General Drug Information

A summary of the key clinical points
Katherine Galluzzi, DO; Randall Hudspeth, PhD, MBA, APRN-CNP/CNS

Clinical Case Challenge

Please answer the following questions to assess your performance. Answering these questions again after the activity will allow you to see what you learned and to compare your answers with those of your peers.

Page 1 of 7

CME / ABIM MOC / CE Information

Additional Resources

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This educational activity is supported by an independent educational grant from the Extended-Release/Long-Acting (ER/LA) Opioid Analgesic REMS Program Companies. Please see this document 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 and Drug Administration.

Disclaimer

The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Faculty

Katherine Galluzzi, DO

Randall Hudspeth, PhD, MBA, MS, APRN-CNP

Editor

Catherine Friederich Murray, BS

CO*RE Planning Committee

David Bazzo, MD

Ron Crossno, MD

Katherine Galluzzi, DO

Carol Havens, MD

Randall Hudspeth, PhD, MBA, MS, APRN-CNP

Cathy Judd, PA-C

Ed Salsitz, MD

Seddon Savage, MD

Barb St. Marie, ANP

Independent Content Reviewer

Roberto Cardarelli, DO, MHA, MPH

CME Reviewer/Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Reviewers

Cynthia Kear, MDiv

Robin Heyden

AAFP Member Reviewer

Charles Vega, MD, FAAFP

CME / ABIM MOC / CE

Opioid Prescribing: Safe Practice, Changing Lives - 2018 Update

Target Audience and Goal Statement

Disclosures

Faculty

Katherine Galluzzi, DO

Randall Hudspeth, PhD, MBA, MS, APRN-CNP

Editor

Catherine Friederich Murray, BS

CO*RE Planning Committee

David Bazzo, MD

Ron Crossno, MD

Katherine Galluzzi, DO

Carol Havens, MD

Randall Hudspeth, PhD, MBA, MS, APRN-CNP

Cathy Judd, PA-C

Ed Salsitz, MD

Seddon Savage, MD

Barb St. Marie, ANP

Independent Content Reviewer

Roberto Cardarelli, DO, MHA, MPH

CME Reviewer/Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Reviewers

Cynthia Kear, MDiv

Robin Heyden

AAFP Member Reviewer

Charles Vega, MD, FAAFP

Accreditation Statements

For Physicians

For Nurses

For Pharmacists

Instructions for Participation and Credit

Opioid Prescribing: Safe Practice, Changing Lives - 2018 Update

Contents of This CME Activity

Assessing Patients and Initiating Opioid Therapy

Managing and Monitoring Therapy

Take-Home Points and General Drug Information

Clinical Case Challenge