Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Pain Pathophysiology Unraveled
UAN 0530-0000-18-047-L01-P
AANP Rx Hours 0.0
Course Description
In order to successfully clinically manage pain, it is essential to begin with an understanding of the underlying mechanisms responsible for its generation. A skillful approach based upon better knowledge concerning the anatomical structures, pathways, and events that result in pain is more likely to lead to effective clinical management of pain. The discussion will include an overview of medication classes typically considered for pain and the pathways they affect.
David M. Glick, DC, DAAPM, CPE, FASPE
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - 3's Company: COX-2 Inhibitors, Medicinal Marijuana, and Opioid Prescribing
UAN 0530-0000-18-031-L01-P
AANP Rx Hours 0.0
Course Description
There is much controversy around many aspects of pain treatment, and compelling arguments have focused on both sides of the fence regarding appropriate opioid use and prescribing, legalization of marijuana, and the safety of cox-2 inhibitors. In all 3 cases, there are issues associated with strong positions, although the evidence, when put into practice, is less black and white. For each topic, we will evaluate current literature and debate the clinical, legal, and ethical controversies surrounding recent developments in pain management. Attendees will get a better understanding as presenters debate evidence based application of the cdc guidelines in various clinical settings, evaluate clinical and ethical concerns regarding marijuana for medicinal or recreational use, and take a critical look at the literature and its application when using cox-2 inhibitors for treating pain.
Alexandra McPherson, PharmD, MPH
10:40a - 11:40a - Role of All Practice Providers Involved in Pain Management in the Acute-Care Setting
UAN 0530-0000-18-063-L01-P
AANP Rx Hours 0.1
Course Description
Millions of patients each year suffer from acute pain as a result of trauma, illness, or surgery. Pain is the most common reason for admission to the emergency department (ED), comprising more than 40% of the over 100 million ED visits annually. The prevalence of intense acute pain is similarly high among patients undergoing surgery: in the United States, over 73 million surgical procedures are performed annually, and most patients report experiencing a high degree of pain postoperatively. Studies indicate that treatment of acute pain remains suboptimal due to attitudes and educational barriers on the part of clinicians and patients, as well as the intrinsic limitations of available therapies. Inadequate management of acute pain negatively impacts numerous aspects of patient health and may increase the risk of developing chronic pain. This presentation will review the differences between acute and chronic or persistent pain, while providing attendees with a multimodal treatment approach for the acute care setting. Emphasis will be placed on the role of the advanced practice provider.
Theresa Mallick-Searle, MS, NP-BC, ANP-BC
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:10p - Product, Disease Awareness, Medical Information Program*
Lunch will be served.
Sponsored by Salix Pharmaceuticals, Gerald Sacks, MD
1:10p - 2:00p - Pain Diagnostics: Clinical Pearls to Improve Common Tests for Pain
UAN 0530-0000-18-046-L01-P
AANP Rx Hours 0.0
Course Description
Diagnostic testing is an integral component for the differential diagnosis. In routine clinical practice there has been a tendency for clinical examinations to become more cursory, largely influenced by increasing demands of time and patient expectations of technological advances. The end result may arguably lead to an overreliance on technology for basic clinical diagnosis. The purpose of this session is 2-fold. It is meant to provide a review and, for some, an introduction to basic structural and functional studies used for the diagnosis of pain related problems. Attention will also be given to the limitations of such studies and the importance of establishing clinical relevance to their findings. Factors that adversely affect clinical management potentially resulting in failed treatment will be discussed as well as best practices when utilizing such studies to help enhance clinical outcomes for treatment.
David M. Glick, DC, DAAPM, CPE, FASPE
2:00p - 2:10p - Break & Exhibits
2:10p - 3:00p - The 411 on Nonprescription Analgesics: When to Hold 'Em, When to Fold 'Em
UAN 0530-0000-18-052-L01-P
AANP Rx Hours 0.7
Course Description
Pain is the number one reason why patients seek advice from their pharmacist or primary care provider. Patients very often seek to use a nonprescription analgesic to self-treat a painful complaint, yet often do not understand the exclusions to selftreatment or how to select the best analgesic. Participants in this presentation will learn what nonprescription analgesics are available, indications for use, appropriate dosing and duration of therapy, appropriateness of candidates, and how to monitor and educate patients about their nonprescription analgesic. At this presentation, participants will learn the mechanism of action, indications, adverse effects, and precautions of oral and topical nonprescription analgesics, along with patient counseling points when recommending a nonprescription analgesic.
Alexandra McPherson, PharmD, MPH
3:00p - 3:50p - Medical Efficacy of Cannabis Therapeutics: Focus on Pain Management
UAN 0530-0000-18-061-L01-P
AANP Rx Hours 0.0
Course Description
The endocannabinoid system (ecs) is now recognized as an important modulator of many physiological processes. Even more recently, an increasing body of evidence has been accumulated to suggest the antioxidant, anti-inflammatory, neuroprotective, and antinociceptive roles of the ecs. In 1997, the Office of National Drug Control Policy commissioned the Institute of Medicine (iom) to conduct a comprehensive study of the medical efficacy of cannabis therapeutics. The iom concluded that cannabis is a safe and effective medicine, patients should have access, and the government should expand avenues for research and drug development. This course will discuss cannabis as it relates to effective pain management.
Theresa Mallick-Searle, MS, NP-BC, ANP-BC
*Not certified for credit.
Schedule (subject to change
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Minimizing Pills and Maximizing Skills: Achieving Successful Opioid Cessation in Chronic Pain
UAN 0530-0000-18-060-L01-P
AANP Rx Hours 0.6
Course Description
Per the department of Health and Human Services, opioid related overdose deaths have increased almost 400% over the last 18 years. This shift has yielded heightened scrutiny of prescribing practices, and opioids have subsequently fallen out of favor as a first-line treatment for chronic pain. In this changing landscape of pain care, it is more important than ever for clinicians to identify treatment pathways that will maximize patient outcomes while minimizing medication load. This presentation will review current literature related to use of opioids and medical challenges associated with weaning individuals off this class of drug. The role of evidence based behavioral treatment modalities known to result in improvement in physical and emotional functioning will be discussed in detail, including their use in the context of opioid weaning. The terms dependence, abuse, tolerance, and addiction are often used interchangeably when discussing opioid medication; however, use of nomenclature in this fashion is erroneous. The differences between these words will be explained and the implications for treatment discussed. Clinical pathways that often lead to medication escalation will be identified. The role of behavioral interventions for pain treatment and the literature supporting their use will be reviewed, including data from an interdisciplinary clinical program which provides patients such education while concurrently reducing opioid medication.
Ravi Prasad, PhD
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by PERNIX Therapeutics, Gerald Sacks, MD
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - Falling Down the Rabbit Hole: A Primer for Chronic Pain Management and Substance Abuse Disorders
UAN 0530-0000-18-038-L01-P
AANP Rx Hours 0.0
Course Description
The field of pain management has undergone a circuitous adventure, much like a rabbit hole. As the economic, mental health, and medical consequences of prescribing opioid medications have mounted, the prevailing logic regarding the usefulness of prescribing opioids for chronic pain has shifted. The widespread dissemination of opiates and the lax safety measures placed on their storage has also led to an increase in nonmedical use. Given the high level of comorbidity between opioid use disorders and chronic pain, providers' decisions about how to address treatment with patients who may have or who have been diagnosed with substance use disorders are often complex. The new CDC guidelines will require providers to assess for risk of overdose or development of a substance use disorder, and to be keenly aware of their patients' pain levels and pain management strategies when working as part of a system where opioid medications may be prescribed. Participants will learn how patient and provider education programs and communication interventions may improve outcomes in pain management. Participants will also learn how to select candidates for opioid trials, assess for risk, and initiate opioid therapy, but only after exploring nonopioid and nonpharmacological strategies.
David Cosio, PhD, ABPP
10:40a - 11:40a - Crisis=Opportunity: Reducing Medication Burden While Managing Chronic Pain
UAN 0530-0000-18-062-L01-P
AANP Rx Hours 0.1
Course Description
Although long regarded as an appropriate standard of care for treating acute and cancer pain, the use of prescription opioids to treat chronic benign pain conditions has been highly controversial. The lack of empirical support in conjunction with the increased prevalence of prescription opioid abuse has subsequently led professional and regulatory boards, as well as the general public, to become more critical of physician prescribing practices. As a result, patients who were once prescribed high doses of opioid medication are now being told that they need to reduce or eliminate their reliance on this form of treatment. How can individuals successfully eliminate use of a substance that they have relied on for an extended period of time? A pain physician will review current literature related to the use of opioids and will discuss the medical challenges associated with weaning individuals off of this class of drug. A psychologist will then speak about the role of interdisciplinary treatment programs in facilitating opioid cessation while concurrently improving patients' functional outcomes. Emphasis will be placed on the critical role that psychological and behavioral interventions play in this process, and the evidence which supports their inclusion.
Jennifer M. Hah, MD, MS
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:10p - Product, Disease Awareness, Medical Information Program*
Lunch will be served.
1:10p - 4:20p - Extended-Release and Long-Acting Opioid Analgesics: Risk Evaluation and Mitigation Strategy (REMS)
UAN 0530-9999-18-064-L01-P
AANP Rx Hours 0.5
Program Overview: Pain is a significant public health problem, affecting more than 100 million adults in the US and causing significant reductions in patients' quality of life. The use of narcotic medications for pain management has increased dramatically in the US over the past two decades. However, pain patients are often undertreated due to a variety of physician- and patient-related concerns and barriers.
In addition, despite the pain-relieving properties of opioid medications, the potential for abuse remains a concern. In response to this apprehension about opioid misuse, overdose, abuse, and addiction, the Food and Drug Administration (FDA) developed the Risk Evaluation and Mitigation Strategy (REMS) to ensure that the benefits outweigh the risks for long-acting and extended-release opioid analgesics.
The activity, Extended-Release and Long-Acting Opioid Analgesics: Risk Evaluation and Mitigation Strategy (REMS), incorporates the REMS blueprint into education that is designed to induce changes in physician knowledge, competence, and performance that will translate into improved quality of patient care and reduced pain for patients.
Target Audience: This education is intended for primary care providers and other clinicians involved in pain management, and is designed to help them recognize and balance optimal pain reduction to improve function and productivity with minimization of adverse events (e.g. abuse, addiction, and risk of workplace accidents). Additional challenges to optimal pain management include keeping up to date with the increasing volume of information on pain management, implementing changes recommended by evolving guidelines, and recognizing changes to practice needed to combat the growing rate of opioid abuse.
Jointly provided by Global Education Group and Rockpointe
This educational activity is supported by an independent educational grant from the Extended-Release/Long-Acting Opioid Analgesic REMS Program Companies. Please see http://ce.er-laopioidrems.com/IwgCEUI/rems/pdf/List_of_RPC_Companies.pdf for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Extended-Release/Long-Acting Opioid Analgesics REMS education requirements issued by the US Food & Drug Administration.
Lynn Webster, MD
Bill McCarberg, MD
*Not certified for credit.
