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Foundations of Assessing and Treating Pain

2 hr(s)CME/CE
Goal: The program seeks to provide a foundation for health care professionals who prescribe opioids, to fully assess patients before prescribing opioids, and to prescribe them carefully and safely. The proposed training is designed to fill the practice gaps in opioid prescribing that are described below.
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Activity Steps

Activity Content
Post-Assessments
Certificate

This activity is designed to change: Competence, Performance, Patient Outcomes. 2 hr(s)

Overview

Professional Practice Gaps

Educational Objectives:

After completing this activity participants will be able to:

  • Assess patient pain comprehensively using a systematic approach
  • Categorize the type of pain involved (i.e., acute vs. chronic, nociceptive vs. neurogenic) so as to create a working diagnosis for each patient
  • Safely and effectively initiate a patient’s pain treatment using pharmacological and/or non-pharmacological methods, using first-line therapies if possible
  • Use a patient-centered approach in evaluating patients with pain and in explaining treatment options
  • Collaborate with other healthcare providers in a multidisciplinary approach to evaluating and treating patients with chronic pain

Modules in this Training Activity

Activity Content

Pages Status
1

Assessing Pain

2

Treatment of Pain

Training Activity References

Audience and Accreditation

Audience: Providers

Type Est. Time Released Expires
AMA PRA Category 1 Credit(s)™ 2 hr(s) 03/25/19 03/25/22

Accreditation Statement: Clinical Tools, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA PRA Category 1 Credit™ Designation Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 2 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

A letter of completion for 2 hour(s) is available for non-physicians.

A score of 70% on the post-test is required to complete the activity.

Participation Requirements

Funding
Initial development of this activity was supported by a grant from the National Institute on Drug Abuse (#1R44DA027245-01).

Authors

As an ACCME accredited provider of continuing medical education, Clinical Tools, Inc.requires everyone who is in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest to the provider. The ACCME defines ‘relevant’ financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Any conflicts of interest are resolved prior to the delivery of the educational activity to the learner. CTI does not permit individuals with financial conflicts of interest to participate in any stage of activity development.

T Bradley Tanner, MD (President, Clinical Tools, Inc.)
Disclosure: Has disclosed no relevant financial relationships. Dr. Tanner is the owner of Clinical Tools.
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T. Bradley Tanner, MD is president of Clinical Tools and responsible for the vision of the company. He has received funding via grants and contracts from NIDA, NIAAA, NIMH, NCI, AHRQ, CDC, the Dept of Defense, and NASA to develop medical and health education projects. Dr. Tanner served as principal investigator on 2 NIDA grants to develop the DATA-2000 qualifying buprenorphine training program and clinical practice tools on Bup.ClinicalEncounters.com. He also has a strong background in technology and oversees the development and delivery of all Clinical Tools websites. Dr. Tanner is also a board-certified psychiatrist with experience in inpatient, outpatient, and emergency health settings. He currently treats patients and educates medical students and residents via his role as a Clinical Associate Professor of Psychiatry at the University of North Carolina at Chapel Hill.
Karen Rossie, DDS, PhD (Research Scientist, Clinical Tools, Inc. )
Disclosure: Has disclosed no relevant financial relationships.
Read Bio
Karen Rossie, DDS, PhD, directs projects at Clinical Tools. She majored in biology at Cleveland State University and studied dentistry at Case Western Reserve University followed by completing a Masters in pathology at Ohio State University, and later, a PhD in Psychology from the Institute of Transpersonal Psychology. She taught and practiced oral pathology and oral medicine for 15 years at the Ohio State University and the University of Pittsburgh, doing research in autoimmune disease, bone marrow transplantation, oral cancer, salivary gland disease, candidiasis, and diabetes. She has used this diverse background to lead or contribute to CTI projects related to tobacco cessation, opioid abuse treatment, anxiety, dementia care, alcohol use disorder, screening and brief interventions for substance abuse, obesity, and pain and addiction.

Reviewers

Steve Applegate, MEd, MEd (President, Applegate Consulting, )
Disclosure: Has disclosed no relevant financial relationships.
Read Bio
Mr. Applegate has experience in substance use counseling, state initiatives impacting substance use, and professional training. His prior positions include director of higher education and instructional design at the North Carolina Governor’s Institute on Alcohol and Substance Abuse, project director of the North Carolina Initiative of the Mid-Atlantic Addiction Technology Transfer Center, and program director of the Addiction Sciences Center (an outpatient substance abuse treatment center at the University of Virginia Health Sciences Center). Mr. Applegate works as an on-site consultant and travels to the Clinical Tools (CTI) office on a monthly basis from his office in Richmond, VA. Mr. Applegate helped design the CTI Instructional Manual and works to continue to revise it as we expand our Instructional Design methodology. Mr. Applegate has extensive experience with online education and training, especially in the area of substance abuse. He often pushes the envelope of technology and brainstorms with Clinical Tools how we can utilize new technology in our products. He helped guide the development of the curriculum plan and assessments in Phase I of the current project.

Most Recent Reviews

CTI Content Review: Thursday, 01/05/2017
CTI Editorial Review: Monday, 01/09/2017

Funding Information Development of this website was funded by grant #1R44DA035042 from the National Institute of Drug Abuse. The website contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDA. The site is maintained by Clinical Tools, Inc. No commercial support is received.
Clinical Tools is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Participation Requirements

Activity Credit: Obtaining credit for participation in this activity requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the activity, you will be instructed on how to print out a certificate for your records.

Time Requirement: Keep track of the amount of time it takes you to complete this activity. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity.

Technical Requirement: Our site requires the latest versions of Google Chrome, Safari, Firefox, or Microsoft Edge. The site is not optimized for Internet Explorer and certain functionality will not work with that browser. Please utilize a supported browser when accessing the site.

Professional Practice Gaps

It is well knowns that acute pain is very common. Chronic pain is also very common problem encountered in clinical practice, with moderate to severe pain, affecting 10-14% of the population (Mills et al., 2019). Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain (Chou et al., 2009), and CDC guidelines for prescribing opioids(Dowell et al., 2016) are available.

Based on an extensive review of evidence and expert consensus, the FDA determined that all health care providers involved in pain management need training in safe opioid prescribing (FDA, 2017). Patients having opioid addiction or misuse are frequently encountered in primary care due to the alarming extent of the opioid epidemic: 9.9 million people aged 12 or older had misused pain relievers in the past year when surveyed in 2018 (SAMHSA, 2019). Research confirmed that high risk prescribing practices contributed to the opiod epidemic (Dowell et al., 2016). The AMA and American Association of Medical Colleges, having reviewed the evidence, each concluded that training in clinical skills related to opioids will help address the opioid epidemic (Parks, 2016; AAMC, 2017).

Practice Gap References

AAMC. Training Future Physicians to Address Opioid Crisis. AAMC News, September 19, 2017. https://news.aamc.org/patient-care/article/training-future-physicians-address-opioid-crisis/ Accessed 02/13/2019.

Chou R, Fanciullo GJ, Fine PG, et al. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. J Pain Off J Am Pain Soc. February 2009;10(2):113-130. doi:10.1016/j.jpain.2008.10.008. PMCID: PMC4043401. PMID: 19187889.

Dowell D, Arias E, Kochanek K, et al. Contribution of Opioid-Involved Poisoning to the Change in Life Expectancy in the United States, 2000-2015. JAMA. September 19, 2017;318(11):1065-1067.

FDA. FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain (May 2017). Available at: https://www.fda.gov/drugs/news-events-human-drugs/fda-education-blueprint-health-care-providers-involved-management-or-support-patients-pain Accessed 02/13/2019.

Mills SEE, Nicolson KP, Smith BH. Chronic Pain: A Review of Its Epidemiology and Associated Factors in Population-Based Studies. BJA Br J Anaesth. August 2019;123(2):e273-e283. doi:10.1016/j.bja.2019.03.023. PMCID: PMC6676152. PMID: 31079836.

Parks, Troy. Opioid Crisis Needs Training Emphasis in GME. American Medical Association, November 17, 2016. https://www.ama-assn.org/delivering-care/opioids/opioid-crisis-needs-training-emphasis-gme Accessed 02/13/2019.

SAMHSA. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health | SAMHSA Publications and Digital Products Results from the 2018 National Survey on Drug Use and Health. May 2019. Accessed 4/1/2020.

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