You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.


Advances in the Management of Opioid-Induced Constipation in Cancer-Related Pain

  • Authors: Charles E. Argoff, MD; Barton T. Bobb, MSN, FNP-BC, ACHPN
  • CE Released: 6/26/2018
  • Valid for credit through: 6/26/2019
Start Activity

Target Audience and Goal Statement

This activity is developed for multi-disciplinary physician specialists, oncology advanced practitioners (NPs, DrNPs, PAs), clinical nurse specialists, and investigators dedicated to evidence-based research and care for patients with cancer-related pain.

The goal of this online activity is to contribute to positive change through advances in education and clinical behaviors for oncology advanced practitioners managing cancer patients, by teaching evidence-based interventions for the prevention and management of opioid-induced constipation (OIC). OIC is a serious adverse effect of cancer pain management with a negative impact on patients’ activity and quality of life that may limit a patient’s ability to actively participate in treatment and rehabilitation, and thus, compromising the effectiveness of the comprehensive treatment plan.

Although OIC resulting from treatment of malignant pain often can be unrecognized, underassessed, and ineffectively managed, oncology advanced practitioners have a responsibility to recognize that OIC is a frequent consequence of pain medication and can be a major source of distress for cancer patients. If not prevented or treated, the consequences of OIC can be far reaching, including decreased quality of life, poor adherence and/or discontinuation of therapy, and increased healthcare utilization and costs. As a member of the cancer care team, oncology advanced practitioners need to be vigilant in both preventing or treating OIC, applying pain guidelines as directives to effective treatment. Therefore, oncology advanced practitioners have an important mandate to treat cancer pain in an optimal way, working closely with physicians, surgeons, families, and palliative caregivers to care for cancer patients throughout all stages of treatment. Knowledge of and approaches to managing OIC are integral to successful cancer pain management and ultimately, will impact the success of treatment outcomes.

Upon completion of this activity, participants will be able to:

  1. Summarize current National Comprehensive Cancer Network guidelines for opiate use in chronic malignant pain
  2. Identify how opioid analgesia affects the gastrointestinal tract and creates risk for OIC
  3. Review the epidemiology, evaluation, and clinical impact of OIC
  4. Make recommendations for pharmacologic and nonpharmacologic strategies to managing OIC
  5. Assess current pharmacologic treatment in managing OIC
  6. Provide care and collaborative decision making, as part of a multi-disciplinary team, including oncology advanced practitioners and clinical nurse specialists, in managing patients with OIC employing a multimodal range of non-pharmacological and pharmacological approaches

Activity Co-Chairs

  • Charles E. Argoff, MD

    Professor of Neurology, Albany Medical College; Director, Comprehensive Pain Program, Albany Medical Center, Albany, New York


    Disclosure: Charles E. Argoff, MD, has disclosed the following relevant financial relationships:
    Received grant/research support from Gruenenthal, Vertex.
    Served as a consultant for Amgen, BDSI, Braeburn, Depomed, Egalet, Kaleo, Lilly, Nektar, Nevro, Novartis, Pfizer, Teva.
    Owns stock in Depomed, Pfizer.
    Received honoraria from: Allergan, Amgen, BDSI, Depomed, Jazz, Novartis, Teva.

  • Barton T. Bobb, MSN, FNP-BC, ACHPN

    Palliative Nurse Practitioner, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia


    Disclosure: Barton T. Bobb, MSN, FNP-BC, ACHPN, has no conflicts of interest to report.

The content managers reported no relationships with commercial interests whose products or services may be mentioned in this activity.

Letters & Sciences has no financial relationships to disclose.

Accreditation Statements

    For Nurses

  • Letters & Sciences is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission (ANCC) on Accreditation. Letters & Sciences is accredited by the ANCC with distinction.

    This activity is designated for 1.0 contact hours. The audience is advised that the educational content contained herein was developed by and reflects the opinions of the presenters and faculty, and does not necessarily reflect the opinions or recommendations of the CE provider or the grantor. Accredited status does not imply endorsement by the provider of any commercial products discussed/displayed in conjunction with the educational activity.

    Contact Provider

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. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page and must receive a minimum score of 80% on the post-test.

Follow these steps to earn CNE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. 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.


Advances in the Management of Opioid-Induced Constipation in Cancer-Related Pain

Authors: Charles E. Argoff, MD; Barton T. Bobb, MSN, FNP-BC, ACHPNFaculty and Disclosures

CE Released: 6/26/2018

Valid for credit through: 6/26/2019


Before you begin, please answer the questions in this brief questionnaire.

  • Print