Chronic Pain Management: Biopsychosocial Considerations and Evidence-Based Best Practices
- Credit Type
- CME
- Credit Amount
- 1
- Release Date
- 03/01/2011
- Expiration Date
- 02/29/2012
- Activity Type
- Monograph
Jointly sponsored by Purdue University College of Pharmacy, and Asante Communications, LLC.
This activity is supported by an educational grant from Lilly USA, LLC.
ACTIVITY GOAL
The goal of this activity is to improve the assessment, treatment, and ongoing management of patients with chronic pain.
INTENDED AUDIENCES
This activity is intended for primary care providers, pain specialists, and other clinicians interested in chronic pain management.
LEARNING OBJECTIVES
At the conclusion of this program, participants will be better prepared to:
- Explain salient pathophysiologic events underlying chronic pain and their practical considerations for treatment
- Conduct initial and ongoing multidimensional assessment of patients with chronic pain
- Evaluate evidence-based approaches supporting diagnostic and treatment modalities for chronic pain syndromes
- Individualize pharmacologic strategies based on differential diagnosis, inferred pathophysiology, and patients’ prior medical history, comorbidities, level of function, and treatment goals
- Formulate multimodal treatment strategies tailored to the patients’ complex pain symptomatology, psychosocial determinants, and affected functional domain
STATEMENT OF NEED
Chronic pain is highly prevalent, yet also underdiagnosed and undertreated (Argoff et al, 2009; Walid et al, 2008). Among the most disabling complaints patients report to physicians (Edwards et al, 2006), chronic pain affects an estimated 1 of every 5 (22%) adult patients in the primary care setting (Gureje et al, 1998). Understood as a clinical construct, chronic pain is described as pain that persists for more than 3 months or beyond the time normally associated with healing for a specific illness or injury (Benzon et al, 2008). Chronic pain affects more people than any other type of pain and is encountered by every physician across all medical specialties (Bope et al, 2004; Jones et al, 2005). The incidence and prevalence of chronic pain syndromes are projected to increase as the population ages, particularly in connection with such age-related syndromes as low back pain and osteoarthritis (Gatchel et al, 2007; Robinson, 2007).
The paradigm of multimodal treatment has emerged as the most promising approach to the management of chronic pain, despite a still nascent evidence base. Clinicians can benefit from expert insights into this evidence and its practical application in the primary care setting (Gatchel et al, 2007).
LEARNER’S GAP
Epidemiologic studies demonstrate significant functional impairment in patients with chronic pain. Assessment methods vary significantly among clinicians, however, and this variability may result in inadequate care for some patients' (Davies et al, 2008; Gatchel et al, 2007; Hagen et al, 2008). Assessing each patient’s pain experience from a biopsychosocial perspective requires considerable clinical time and resources (Gore et al, 2006; Watkins et al, 2004). Community-based primary care providers can thus benefit from evidence-based insights into efficient, real-world pain management strategies, particularly those that emphasize thorough assessment of pain-generating mechanisms, patient comorbidities, functional status, and treatment goals (Argoff et al, 2009; Baron and Tolle, 2008; Darer et al, 2004; de Leon-Casasola, 2008; Woolf, 2004, 2007).
Recent advances in our understanding of the pathologic mechanisms underlying chronic pain and their practical implications for patient care support the need for continuing education. Clinicians can derive significant benefit, for example, from expert commentary on multidrug and behavioral strategies. While rational multimodal therapy is largely based on empirical observations, it remains a cornerstone of chronic pain management and warrants up-to-date education.
CREDIT DESIGNATION
Purdue University College of Pharmacy designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Purdue University College of Pharmacy and Asante Communications, LLC. Purdue University College of Pharmacy, an equal access/equal opportunity institution, is accredited by the ACCME to provide continuing medical education for physicians.
CONFLICT OF INTEREST STATEMENT
All faculty and staff involved in the planning or presentation of continuing education activities sponsored/provided by Purdue University College of Pharmacy are required to disclose to the participants any real or apparent commercial financial affiliations related to the content of the presentation or enduring material. Full disclosure of all commercial relationships must be made in writing to the participants prior to the activity.
FACULTY
Paul P. Doghramji, MD, FAAFP
Attending Physician
Pottstown Memorial Medical Center
Pottstown, Pennsylvania
Senior Staff Member
Collegeville Family
Practice Medical Director of Health Services
Ursinus College
Collegeville, Pennsylvania
Preceptor in the Physician Assistant Program
Arcadia University
Glenside, Pennsylvania
CME Reviewer
Robert W. Bennett, MS, RPh
Professor
Department of Pharmacy Practice
Director, Continuing Medical Education
Purdue University College of Pharmacy
West Lafayette, Indiana
FACULTY/PLANNING COMMITTEE DISCLOSURES
Paul P. Doghramji, MD, FAAFP AstraZeneca US (consultant, speaker’s bureau); Cephalon, Inc (consultant, speaker’s bureau); MAP Pharmaceuticals, Inc (advisory board); Pfizer Inc (advisory board, consultant, speaker’s bureau); Sanofi Aventis U.S. LLC (advisory board); URL Pharma, Inc (advisory board).
Robert W. Bennett, MS, RPh Has no relevant financial relationships to disclose.
All additional planning committee members, Asante Communications, LLC, staff, and Purdue University College of Pharmacy staff have no financial relationships to disclose.
METHOD OF PARTICIPATION
To receive credit for this activity, you must read the CME information (including learning objectives and disclosures) and the article. Upon finishing the article, please log on to PAINClinician.com/ChronicPain to complete the posttest and activity evaluation. To receive your CME certificate, you will need to pass the posttest with 70% accuracy or better. If you receive less than 70%, review the article and take the test again. After successful completion of the posttest, you will be asked to fill out the activity evaluation form and prompted to print your CME certificate.
DISCLAIMER
The opinions, ideas, recommendations, and perspectives expressed in this program and accompanying materials are those of the program author(s) and presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations, or perspectives of their affiliated institutions, Purdue University College of Pharmacy, Asante Communications, LLC, or the activity’s commercial supporters.
COPYRIGHT INFORMATION
Copyright © 2011 Purdue University College of Pharmacy and Asante Communications, LLC. All rights reserved. No part of this syllabus may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.
Faculty
