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Pain Treatment CME (Continuing Medical Education) Courses

Courses are listed in chronological order of their end (expiration) dates; newer courses are toward the top and those soon expiring are toward the bottom. To find courses pertaining to specific disciplines, press Control(Ctrl)+F and enter "Physicians," "Pharmacists," "Nurses," etc. in the search box.

IMPORTANT: Courses are provided by the sponsoring organizations listed in the course descriptions; not by Pain-Topics.org. Questions regarding a particular course or credits should be directed to the sponsoring organization indicated in the course materials. Pain Treatment Topics has no financial interest in any of these offerings; see also, Disclaimer below.

To the extent possible, and in accord with the Pain Treatment Topics Open Access Policy, only courses are listed that allow free viewing of the contents, although there may be a cost from the sponsor organization (not Pain-Topics.org) to receive CME/CEU credits. Registration at the site to view documents may be required.

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Pain Management: Focus on Function

Access: http://www.cecity.com/apha/ce_monographs/2011_projects/pain_management/print.pdf
Audience: Pharmacists
Start/End: August 15, 2011 / March 26, 2014
Credits: Up to 2.0 ACPE CE credits (0.2 CEUs)
Price: Free access to article; testing is free to APA members, $15 for nonmembers
Program Format: Monograph
Sponsor: American Pharmacists Association; supported by educational grants from Endo Pharmaceuticals Inc. and Purdue Pharma, L.P.
Author(s): Kathyrn Hahn, PharmD, CPE, DAAPM; Daniel Kennedy, BSPharm, FAPhA
Description: The management of chronic pain is addressed on several levels; topics include the selection of appropriate patients for opioid therapy, managing risk, and the importance of helping each patient identify their individual functional and analgesic treatment goals. Practitioners are reminded to use the 4 A’s — Analgesia, Activities, Adverse effects, Aberrant Behavior — to monitor patient response to therapy. Access checked August 23, 2011.

A Case-Based Approach to Chronic Pain and Long-Term Opioid Therapy

Access: http://cme.dannemiller.com/sections/professional/cme_slide_presentations/orlando

(free registration required)

Audience: Physicians, Physician Assistants, Nurse Practitioners, Nurses
Start/End: November 2011 / October 31, 2013
Credits: Up to 2.0 AMA PRA Cat. 1 credits for physicians and physician assistants; 2.0 AANP contact hours (no hours in pharmacology) for nurse practitioners; 2.4 contact hours from the California Board of Registered Nursing
Price: Free
Program Format: Web-based Multimedia
Sponsor: Dannemiller Education Center; supported by an educational grant from Purdue Pharma, L.P.
Author(s): Paul J. Christo, MD; Steven D. Passik, PhD
Description: This educational activity addresses the challenges of providing appropriate opioid therapy while reducing the risk of abuse and misuse. The program includes a review of patient evaluation practices, then reinforces the need for regular patient reassessment to identify changes in physiology or psychosocial issues that may affect the patient's need for analgesia. The presenters review various agents and how they affect pain pathways. Case studies are used to examine a multimodal approach to manage pain. Definitions of terms — dependence, tolerance, addiction, misuse, and abuse — differentiate one from another in terms of a patient's biological, psychiatric, or social risk for inappropriate opioid use. A discussion of risk reduction includes a review of the specific characteristics of several opioid agents that could alter prescribing decisions. Access checked February 16, 2012.

Is Untreated Pain a Disease? (CSA Pain Management Module 2)

Access: http://www.csahq.org/cme2/course.module.php?course=3&module=16&terms=show
Audience: Physicians
Start/End: Reviewed/Reapproved June 2010 / July 27, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit
Price: Free for CSA members, $25 per credit hour for non-members
Program Format: Brief article
Sponsor: California Society of Anesthesiologists (CSA)
Author(s): Joshua P. Prager, MD, MS
Description: This module examines experimental study results that show evidence of structural changes in the spinal cord with long-term symptoms of neuropathic pain or nerve injury. Additional studies of chronic pain show noticeable receptive field changes in the brain that have a more far-reaching effect on a person’s overall health. The author proposes that these changes signify disease and, therefore, clinicians should attempt to treat acute pain to prevent a chronic condition. Access checked August 14, 2010.

Pain Report #13 - End-of-Life Care: The Management of Pain in Palliative Medicine

Access: http://cme.dannemiller.com/sections/professional/cme_article/accreditation.cfm?id=329

(free registration required)

Audience: Physicians, Physician Assistants, Pharmacists, Nurse Practitioners, Nurses
Start/End: June 2011 / June 30, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit for physicians and physician assistants; 1.0 ACPE CE credit (0.1 CEUs) for pharmacists; 1.0 AANP contact hours (0.5 hour in pharmacology) for nurse practitioners; 1.2 contact hours from the California Board of Registered Nursing
Price: Free
Program Format: Monograph
Sponsor: Dannemiller Education Center; supported by an educational grant from Purdue Pharma, L.P.
Author(s): Alexander Peralta, Jr., MD
Description: This activity addresses the challenges involved in providing compassionate palliative care while relieving symptoms, including the management of pain in patients with advanced disease. The guidelines developed by the National Consensus Project for Quality Palliative Care are reviewed and the undertreatment of pain is discussed. An examination of the challenges and barriers to effective pain management includes a discussion of various therapeutic options for the primary types of end-of-life pain commonly experienced by patients. The concepts of central sensitization, neuroplasticity and neurogenesis are reviewed. The author emphasizes the need for clinicians to understand the pharmacology of opioids, including the management of poly-opioid therapy and the use of opioids in episodic pain. Access checked December 16, 2011.

Assessment and Management of Chronic Pain in the Older Adult

Access: http://japha.metapress.com/link.asp?id=010038un0713m80v

(link to the full-text PDF is on the right-hand side of the web page)

Audience: Pharmacists
Start/End: May 1, 2010 / May 1, 2013
Credits: 2.0 ACPE contact hours (0.2 CEUs)
Price: Free access to article; testing is free to APA members, $15 for nonmembers
Program Format: Review article
Sponsor: American Pharmacists Association
Author(s): James W. Cooper, BPharm, PhD; Allison H. Burfield, RN, PhD
Description: This educational activity begins with a discussion of the causes of chronic pain in the older adult, including common comorbidities, and continues with a review of assessment techniques in the cognitively intact and impaired elder. The latest American Geriatrics Society guidelines are used as an outline for the selection of appropriate pharmacologic treatments — including agent and dosing schedule — for chronic pain older adults. The authors evaluate issues of risk and adverse drug reactions as well as inappropriate drugs and drug combinations of concern for older patients. Access checked July 9, 2010.

Pain Management in the Rheumatology Setting: Individualized Multimodal Therapies for Improved Patient Function

Access: http://www.medscape.org/viewprogram/32328
Audience: Physicians
Start/End: March 7, 2012 / March 7, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Web-based multimedia
Sponsor: Medscape Education, Women’s Health
Author(s): Charles Argoff, MD; Philip Mease, MD; Chaim Putterman, MD; Ronald Rapoport, MD, FACR
Description: This program begins with a review of the pathophysiologic mechanisms of pain and utilizes graphics to enhance the understanding of more complex concepts. The discussion of pain phenotypes includes recently acquired knowledge on the significance of genetic background, environmental factors, neurohormonal influences, and neuroplasticity. The presenters stress the fact that pain is frequently under-recognized and undertreated in patients with rheumatoid arthritis and provide a detailed discussion on the wide-ranging effects of chronic progressive pain. A case study and a review of recent trial outcomes enhance this learning activity. Access checked March 27, 2012.

Management of Noncardiac Chest Pain in Women

Access: http://www.medscape.org/viewarticle/759089
Audience: Physicians
Start/End: March 1, 2012 / March 1, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Monograph (full document can be printed by clicking the “Print” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health
Author(s): Raghubinder Gill, Jo Collins, Nicolas Talley, MD, PhD
Description: Noncardiac chest pain (NCCP) in women is common, but diagnosis can be challenging because the origins of the pain may have a musculoskeletal, pulmonary, gastroenterological, neurological, or psychosomatic basis. The authors review the differential diagnosis of NCCP as well as statistics on the incidence of cardiac artery disease and several other causes of chest pain in women. After a discussion regarding the need for a full evaluation for coronary artery disease, an algorithm provides an approach to further evaluation of the patient with unexplained chest pain. In light of the fact that gastroesophageal reflux disease (GERD) is a common cause of NCCP, a review of pharmacologic and nonpharmacologic treatments is provided. Appropriate management and studies reporting efficacy of therapeutic options for nonreflux-associated NCCP are also presented. Access checked March 22, 2012.

Opioid-Based Treatment Strategies for Persistent and Breakthrough Cancer Pain

Access: http://painclinician.com/education/activity/tailoring_opioid_based_therapy...cancer_pain_physicians/
Audience: Physicians, Pharmacists, Nurses
Start/End: February 29, 2012 / February 28, 2013
Credits: Up to 2.0 AMA PRA Cat. 1 credits; 2.0 ACPE credits (0.2 CEU) for pharmacists; 2.0 contact hours approved by the Oncology Nursing Society for nurses
Price: Free
Program Format: Monograph (PDF option in lower left corner of HTML monograph)
Sponsor: PAINClinician.com
Author(s): Sanjiv S. Agarwala, MD; Keith D. Eaton, MD, PhD; Paul Glare, MD; Jeffrey A. Gudin, MD; et al.
Description: This 4-part educational activity addresses the complexities of evaluating and treating patients with persistent and breakthrough cancer pain. The presenters discuss assessment, differential diagnosis, and patient-specific treatment of breakthrough pain. Tailor-made opioid treatment strategies are based on pathophysiology and patient response—including pain episodes, predictability, the patient's baseline opioid regimen, and an individualized risk-benefit evaluation. The monograph and video commentary sections review all aspects of opioid therapy, including pharmacology, routes of administration, formulations, and opioid rotation strategies. The PDF version includes tear-out pages containing pain assessment tools, an opioid risk tool, and a list of opioid analgesic agents. Access checked May 16, 2012.

Pain Report #12 - Optimizing Chronic Pain Management in Elderly Persons: Integrating Pharmacokinetics & Pharmacodynamics

Access: http://cme.dannemiller.com/sections/professional/cme_article/accreditation.cfm?id=309

(free registration required)

Audience: Physicians, Pharmacists, Nurse Practitioners, Nurses
Start/End: March 2010 / February 28, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit; 1.0 ACPE CE credit (0.1 CEUs) for pharmacists; 1.0 AANP contact hours (0.6 hour in pharmacology) for nurse practitioners; 1.2 contact hours from the California Board of Registered Nursing
Price: Free
Program Format: Monograph
Sponsor: Pain.com; supported by an educational grant from Purdue Pharma, L.P.
Author(s): Bernard M. Abrams, MD; John Kriak, PharmD
Description: This activity focuses on analgesic therapy in the rapidly growing population of senior adults. In addition to the challenges of pain assessment in some elderly patients, effective treatment due to altered pharmacokinetics can be a test of prescriber skills. The article reviews physiological changes in the older adult and includes a helpful summary table of common, relevant age-related changes. Practitioners are cautioned to perform a full health assessment and not treat patients primarily according to chronological age because overall health status varies greatly in this population. Two additional tables aid the selection of the most appropriate pharmacological agent according to etiology, physiology, and patient-specific areas of vulnerability. The authors compare and contrast different types of pain relief drugs and include information on the mechanisms of action, adverse effects, dosing recommendations, and special considerations. Access checked March 4, 2010.

Prevalence, Clinical Features, and Potential Therapies for Fibromyalgia in Primary Headaches: Possible Causes of Comorbidity Between Fibromyalgia & Primary Headaches

Access: http://www.medscape.org/viewarticle/758915
Audience: Physicians
Start/End: February 24, 2012 / February 24, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Monograph (Full document can be printed by clicking the “Print” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health
Author(s): Marina de Tommaso, MD
Description: Comorbid fibromyalgia and chronic headache—primarily migraine and tension-type headaches—are not uncommon and the author begins with a discussion of the potential causes. While the etiology of fibromyalgia remains unknown, this monograph offers a review of the relationship of central sensitization in fibromyalgia and in migraine, as well as other potential pathophysiological relationships and commonalities. Discussions include variations in the clinical characteristics commonly presented by headache patients with fibromyalgia. Pharmacological and nonpharmacological treatment approaches reported in available primary study results for headache and fibromyalgia are reviewed. The authors state that most studies have not reported significant benefits for one treatment in both pain conditions and, therefore, encourage further studies. Access checked March 12, 2012.

Chronic Pain in Primary Care: Focus on Low Back Pain

Access: http://painclinician.com/education/activity/chronic_pain_in_primary_care_focus_on_low_back_pain/
Audience: Physicians
Start/End: February 21, 2012 / February 20, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit
Price: Free
Program Format: Monograph (PDF option in lower left corner of HTML monograph)
Sponsor: PAINClinician.com
Author(s): David Simpson, MD, FRCP, FAAN; Cynthia Koh-Knox, PharmD, RPh
Description: Chronic low back pain can be clinically complex and is a prevalent disorder causing patient suffering and lost productivity. This educational activity reviews the pathophysiologic processes of chronic pain and the need to assess the potential "red flags" of serious spinal pathology. The discussion on evaluation includes the value of testing and physical maneuvers to help identify the origin of patient symptoms. Emphasis is on patient awareness regarding the development of realistic goals for treatment, including consideration of biopsychosocial elements. The discussion on individualized multimodal therapy includes prior medical history, comorbidities, level of function, and the potential for drug adverse effects. Graphic elements and tables enhance the program. Access checked April 26, 2012.

A Review of the Evaluation of Pain Using a Variety of Pain Scales

Access: http://cme.dannemiller.com/sections/professional/cme_article/accreditation.cfm?id=318

(free registration required)

Audience: Physicians, Nurses
Start/End: January 2011 / January 31, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit for physicians; 1.2 contact hours from the California Board of Registered Nursing
Price: Free access to article; the testing fee is between $4 and $5.
Program Format: Monograph
Sponsor: Dannemiller Education Center
Author(s): Michael L. Whitworth, MD
Description: This monograph provides a wide range of assessment tools and techniques for evaluating and treating patients with multifactorial and challenging pain. The author reviews cultural, environmental, and physical conditions that can affect pain or its perception. Additionally, other factors can alter a patient's ability to communicate verbally — such as sedation or ventilation, cognitive levels, or emotional state —leading to an underestimation of pain. Defining pain can be difficult for patients, so clinicians need to be able to help them effectively describe intensity, location, and pain character. Several less commonly used assessment scales are provided, including the Hochman scale which uses function or behavior as a way to assess pain, and the Comparative Pain Scale of the International Pudendal Neuropathy Association. Access checked December 16, 2011.

Persistent and Breakthrough Cancer Pain: An Expert Video Roundtable

Access: http://painclinician.com/education/activity/persistent_and_breakthrough_cancer_pain/
Audience: Physicians, Physician Assistants, Nurses
Start/End: January 25, 2012 / January 25, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit; other healthcare professionals should inquire about credit
Price: Free
Program Format: Web-based multimedia
Sponsor: PAINClinician.com
Author(s): Neal Slatkin, MD; Barbara Murphy, MD; Sharon Weinstein, MD; David Kaufman, MD
Description: Pain affects the quality of life for a high percentage of patients with advanced cancer and those receiving cancer treatment. Controlling persistent pain requires a structured course of opioid therapy plus periodic assessment — on psychosocial, disability, and functional levels — so that clinicians can select appropriate agents for breakthrough pain. This program includes a discussion of pain assessment and the differences in defining “functionality” from one patient to another. A review of the variations in cancer breakthrough pain versus other types of pain includes a definition of the subtypes of cancer breakthrough pain (eg, incident, spontaneous unpredictable, and end of dose failure) as well as an algorithm for ‘Multidimensional Pain Assessment for Improved Outcomes.’ Access checked February 29, 2012.

New Approaches in the Treatment of Rheumatoid Arthritis: Treating to Target

Access: http://www.medscape.org/viewarticle/756397
Audience: Physicians
Start/End: January 10, 2012 / January 10, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Monograph (Full document can be printed by clicking the “Print” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health
Author(s): Roy M. Fleischmann, MD
Description: Approaches to the treatment of rheumatoid arthritis (RA) have become more complex in recent years. The author discusses important considerations in therapeutic decision-making and evaluates the appropriate choice of oral disease-modifying anti-rheumatic drugs (DMARDs) and biologic agents for a patient with progressive RA. Discussions include: 1) the use of disease activity tools to evaluate a patient’s response to treatment, 2) the goal of minimizing complications, and 3) an examination of the definitions of disease remission and treatment failure. Published evidence on strategies for switching drugs when patients do not respond to anti-TNF agents is reviewed. Access checked January 31, 2012.

Clinical Year in Review 2011: Emerging Strategies to Achieve RA Treatment Success

Access: http://www.medscape.org/viewarticle/756083
Audience: Physicians
Start/End: January 09, 2012 / January 09, 2013
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Web-based multimedia
Sponsor: Medscape Education, Women’s Health
Author(s): Roy M. Fleischmann, MD; Arthur F. Kavanaugh, MD
Description: This program presents a discussion between two leading rheumatologists on the most recent evidence for effective rheumatoid arthritis (RA) treatment strategies from the year 2011. The discussion stresses the importance of continual assessment and the use of treat-to-target strategies. The presenters review the design and results of the OPTIMA study and an older longer-term trial, the PREMIER study, with an emphasis on variations in the timing of initial therapy and outcomes of the two studies regarding patient response in physical functionality and remission. Additional information includes comparisons of new drugs in development with older agents, plus considerations of drug safety and patient out-of-pocket costs for RA treatment. Access checked January 31, 2012.

Chronic Pain: Evidence for Multimodal Management (2-Part Program)

Access Programs:
Part 1 of 2 – Chronic Pain: Best Practices in Interdisciplinary Multimodal Management
http://painclinician.com/education/activity/...interdisciplinary_multimodal_management

Part 2 of 2 – Implementing Effective Collaborative Care in Patients with Complex Chronic Pain Conditions
http://painclinician.com/education/activity/...patients_with_complex_chronic_pain_conditions/
 

Audience: Physicians
Start/End: December 6, 2011 / December 6, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit for Part 1; up to 0.75 AMA PRA Cat. 1 credit for Part 2
Price: Free
Program Format: Web-based multimedia
Sponsor: PAINClinician.com
Author(s): Charles E. Argoff, MD; Michael J. Brennan, MD; Paul P. Doghramji, MD; Mark S. Wallace, MD; Douglas C. Schottenstein, MD; Deanna M. Janora, MD
Description: This educational activity was designed for physicians practicing in all areas of pain management and is comprised of 2 parts that can be completed independently of each other for credit. In part 1, the authors review the mechanisms of pain, then present techniques for the multi-dimensional patient assessment of chronic pain and, finally, examine the options for multimodal treatment. Part 2 uses case studies to focus on the use of drug treatments based on patient-specific pathophysiologic pain mechanisms as well as the patient’s functional and psychosocial needs. The authors incorporate a discussion of the need to integrate the use of nonpharmacologic therapies that address the biopsychosocial issues that contribute to the severity, chronicity, intensity, and functional issues for each patient. Access checked January 11, 2012.

Chronic Pain: Translating Evidence into Treatment Strategies (2-Part Program)

Access Programs:
Part 1 of 2 – Translating Population-Based Clinical Studies into Patient-Specific Treatment Strategies http://painclinician.com/education/activity/interaction/part_1_of_2...clinical_studies/

Part 2 of 2 – Translating Evidence to the Clinic: Assessing and Treating Chronic Neuropathic Pain
http://painclinician.com/education/activity/part_2_of_2_chronic_pain_translating_evidence_to_the_clinic/
 
Audience: Physicians
Start/End: November 8, 2011 / November 8, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit for Part 1; up to 0.5 AMA PRA Cat. 1 credit for Part 2
Price: Free
Program Format: Web-based multimedia
Sponsor: PAINClinician.com
Author(s): Jeffrey Gudin, MD; Steven Stanos, DO; Penny Tenzer, MD, FAAFP; David M. Kaufman, MD
Description: This educational activity, designed for primary care physicians, is comprised of 2 parts that can be completed independently of each other for credit. In Part 1, the authors review the mechanisms of pain, including inflammatory, neuropathic, and dysfunctional pain. Additional instruction focuses on the pathophysiology of spinal pain and a video component demonstrates physical testing techniques on a patient with low back pain as part of a comprehensive chronic pain assessment. Part 2 presents a patient case study to explore evidence for the appropriate treatment of chronic neuropathic pain. Discussions on pharmacotherapeutic options include the safe use of over-the-counter analgesics and the consideration of specific patient needs, including comorbidities, functional needs, and overall personal treatment goals. Access checked January 11, 2012.

Osteoarthritis: From Biomarkers to Strategies for Pain Management

Access: http://www.medscape.org/viewarticle/750179
Audience: Physicians
Start/End: October 17, 2011 / October 17, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Monograph (Full document can be printed by clicking the “Print This” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health; supported by an educational grant from Endo Pharmaceuticals
Author(s): F. Michael Gloth III, MD; Virginia Byers Kraus, MD; Marc C. Hochberg, MD
Description: This monograph, developed for a March 2011 symposium of the same name, presents the most recent advances in our scientific understanding of the complex etiology of osteoarthritis (OA). Greater knowledge of the structural and inflammatory changes within the joint has provided more specific insight into the changes that cause the pain and functional limitation experienced by the patient. Discussions include the application of OA biomarkers as well as the risks and benefits of using opioids to manage arthritis pain. The authors provide a list of evaluation questions to assess the appropriate use of opioids as it relates to the patient and the medical practice. Access checked November 2, 2011.

Safety of Biologic Therapy in Rheumatoid Arthritis

Access: http://www.medscape.org/viewarticle/750810
Audience: Physicians
Start/End: October 11, 2011 / October 11, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit hour
Price: Free
Program Format: Monograph (Full document can be printed by clicking the “Print This” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health; Nature Reviews Rheumatology
Author(s): Robert S. Woodrick, MD; Eric M. Ruderman, MD
Description: This monograph presents a summary of information collected from post-marketing studies reporting toxicity and safety concerns with the use of biologic agents in patients treated for rheumatic diseases. The authors review one of the most important risks associated with biologic therapies — an increased incidence of atypical, sometimes serious, viral and bacterial infections. Recent data on earlier concerns over the increased risk of malignancies is also reviewed. Data on the incidence of unique adverse conditions that relate to specific biologic agents are discussed; including cardiovascular disease, hyperlipidemia, cytopenias, gastrointestinal perforations, demyelinating conditions, and changes in liver function. This information can assist the clinician in patient risk evaluation and long-term follow-up for patients on biologic therapies. Access checked November 21, 2011.

Clinical Case Challenge in Pain: Mechanisms, Models, & Multimodal Management

Access: http://www.medscape.org/viewarticle/749867
Audience: Physicians
Start/End: September 28, 2011 / September 28, 2012
Credits: Up to 1.5 AMA PRA Cat. 1 credit hours
Price: Free
Program Format: Web-based multimedia
Sponsor: Medscape Education, Women’s Health
Author(s): Perry G. Fine, MD (Chair); Sean Mackey, MD, PhD
Description: This program consists of symposia lectures by pain experts who presented at the Annual Scientific Meeting of the American Pain Society in May 2011. The molecular and cellular mechanisms of pain as well as the differentiation of nociceptive, neuropathic, and mixed pain states are reviewed. A discussion on the neurobiology of pain focuses on ways in which CNS dysregulation, central mechanisms, and alterations in pain perception may contribute to the impairment of inhibitory pain mechanisms in fibromyalgia syndrome and complex regional pain syndrome. Patient case presentations enhance the discussion of techniques for the integration of multimodal therapies into the management of chronic pain. Access checked November 2, 2011.

Fibromyalgia: The Patient Who Hurts Too Much

Access: http://www.fcmcme.org/fm_pres_081809/fm_pages_081809/fm_page_webinst.htm
Audience: Physicians, Pharmacists, Nurses
Start/End: September 1, 2009 / August 29, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit; 1.0 ACPE CE (0.10 CEUs) for pharmacists; 1.0 ANCC CE contact hours for nurses (nursing credit expires 6/30/2012)
Price: Free
Program Format: Web-based multimedia
Sponsor: Foundation for Care Management
Author(s): Kathleen Davis, MD
Description: A discussion of the most recent understanding of the underlying mechanisms of fibromyalgia are incorporated into the diagnostic assessment of a new patient with suspected fibromyalgia. The origins of pain are reviewed and evidence-based pain management is explored for patients with chronic diffuse pain who are resistant to standard therapies. Best practice strategies for the treatment and long-term care of patients with symptoms of depression, fatigue, and sleep problems are also reviewed. Treatment approaches for patients with overlap syndromes and common comorbidities are examined. Access checked November 9, 2009.

Fibromyalgia: Overcoming Barriers to Diagnosis & Treatment

Access: http://fibromyalgiahcp.org/cme2
Audience: Physicians
Start/End: August 17, 2011 / August 17, 2012
Credits: Up to 2.0 AMA PRA Cat. 1 credit hours
Price: Free
Program Format: Web-based multimedia
Sponsor: National Fibromyalgia Association, Albert Einstein College of Medicine, University of Florida College of Pharmacy, M2 Communications
Author(s): I. Jon Russell, MD, PhD; Victor Rosenfeld, MD; Ginevra Liptan, MD
Description: This 4-part educational program has been designed to aid practitioners in the development of an individualized treatment approach for patients with fibromyalgia syndrome. Challenges associated with the accurate diagnosis and the differentiation of comorbidities associated with fibromyalgia are discussed. Beyond conventional pain therapy, significant attention is paid to decreasing central sensitization and the treatment of fatigue. The program includes a good review of common sleep problems — including a visual comparison of the sleep patterns in people with and without fibromyalgia syndrome — and recommendations for therapeutic options for improving sleep. The importance of patient education is emphasized and the latest pharmacologic and nonpharmacologic evidence-based treatment approaches are reviewed. Access checked October 5, 2011.

Rheumatoid Arthritis: A Practical Guide for the Primary Care Provider

Access: http://www.medscape.org/viewarticle/745566
Audience: Physicians
Start/End: July 29, 2011 / July 29, 2012
Credits: Up to 1.25 AMA PRA Cat. 1 credit
Price: Free
Program Format: Monograph (Full document can be printed by clicking the “Print This” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health
Author(s): Aryeh Fischer, MD; Rachel E. Swigris, DO; Cindy Lampner, MLS
Description: Primary care physicians — oftentimes the first clinician to diagnose a patient’s rheumatoid arthritis (RA) condition — need to stay current on the best evaluation techniques, consider all differential diagnoses, and collaborate with rheumatologists to manage potential complications and comorbidities of RA. This activity reviews the American College of Rheumatology definitions of the stages and severity of disease. Scientific information on current understandings of the pathophysiology of RA is provided as the basis of available pharmacotherapeutic options, including early treatment. A discussion of biologic therapies includes a graphic presentation of the target sites on the RA inflammatory pathway. Access checked August 15, 2011.

Untangling the Knots of Neuropathic Pain: Identifying and Treating the Not So Obvious

Access: http://www.medscape.org/viewarticle/746369
Audience: Physicians, Physician Assistants, Nurses
Start/End: July 26, 2011 / July 26, 2012
Credits: Up to 1.5 AMA PRA Cat. 1 credit; AAPA (for physician assistants) and ANCC (for registered nurses) accept AMA PRA Category 1 credits
Price: Free
Program Format: Monograph (Full document can be printed by clicking the “Print This” link near the top of the program; print-out includes all graphic components)
Sponsor: Medscape Education, Women’s Health
Author(s): Timothy J. Furnish, MD; Erin F. Lawson, MD.
Description: This activity uses a test-and-teach learning style to address the complex physiological and psychosocial issues related to the treatment of 2 types of neuropathic pain. Using a case-based approach, the authors review current levels of knowledge for the pathophysiology of fibromyalgia and painful diabetic neuropathy. Each case history explores the best diagnostic techniques as well as the most appropriate evidence-based drug treatment approach, from first-line therapy to novel therapeutic options. Multi-disciplinary treatment plans are aimed at improving quality of life and reducing pain; the relationship of patient depression to each disorder is discussed briefly and includes evidence for treatment. Access checked August 15, 2011.

Beyond the Evidence Base in Opioid Therapy

Access: http://painclinician.com/education/activity/beyond_the_evidence_base_in_opioid_therapy

(free registration required)

Audience: Physicians, Pharmacists, Nurse Practitioners
Start/End: July 7, 2011 / July 7, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit
Price: Free
Program Format: Webcast
Sponsor: PAINClinician.com
Author(s): Russell Portenoy, MD
Description: This program reviews 8-year data showing significant increases in the use of opioids and the corresponding increase in the misuse, abuse, and diversion of these agents. The presenter explores the evolution of the interface between pain management and chemical dependency concerns. The best-practice evidence available for prescribing opioids in chronic pain is reviewed and a 4-question method for evaluating patient appropriateness for long-term treatment is suggested. Emphasizing that opioid therapy should be selective, the discussion includes a reminder that pain management includes a broad array of potential strategies. Access checked August 23, 2011.

Prescription Drugs with Abuse Potential: Perspectives from the Pain Medicine Community

Access: http://painclinician.com/education/.../prescription_drugs_..._community/

(free registration required)

Audience: Physicians, Physician Assistants, Nurses
Start/End: July 1, 2011 / July 1, 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit
Price: Free
Program Format: Webcast
Sponsor: PAINClinician.com
Author(s): Perry Fine, MD
Description: This educational activity reviews the most current guidelines on the use of opioid therapy in patients with chronic noncancer pain. Discussions include evidence for effective patient selection and risk assessment methods, the importance of a treatment plan that includes the patient’s therapeutic goals, and techniques for focused patient follow-up. The author reviews the importance of counseling and educating patients on the use of opioids and recommends that clinicians become familiar with local and federal policies and laws regarding opioid prescribing. Access checked August 23, 2011.

Optimizing Disease Control to Manage RA-Associated Pain in Adults

Access: http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/106742/
Audience: Pharmacists, Pharmacy Technicians
Start/End: May 1, 2010 / May 31, 2012
Credits: Up to 2.0 ACPE CE credit (0.20 CEUs)
Price: Free to view; $6.50 fee for testing
Program Format: Monograph
Sponsor: U.S. Pharmacist
Author(s): Lori C. Dupree, PharmD, BCPS
Description: This educational activity begins with a review of the pathophysiology of rheumatoid arthritis (RA), including a discussion of patient evaluation and disease presentation. Biologic and non-biologic disease-modifying antirheumatic drugs (DMARDs) are explored in terms of risk-benefit considerations and the evidence for biologic-non-biologic drug combinations. The monograph includes an easy-to-read table of DMARDs that includes indications for use, dosing, and special considerations, as well as initial and continued monitoring recommendations. This drug therapy list and a discussion of nonpharmacologic interventions could also make the article useful for patient education. The authors stress the need for collaborative, multi-disciplinary RA management that includes combination therapies designed to induce disease remission or halt disease progression and provide optimal pain control. Access checked June 4, 2010.

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Expired Courses, Still Accessible

Online education courses of interest often are accessible beyond their expiration dates; however, credits may not be available. Courses are listed in chronological order of their end (expiration) dates; recently expired courses are listed toward the top and those with the oldest expiration date are toward the bottom.

Pain Management: The American Medical Association Online Series

Access: http://www.ama-cmeonline.com/pain_mgmt/  [LINK TEMPORARILY DISABLED by AMA]
Audience: Physicians
Start/End: September 2007 / March 2012  RECERTIFICATION EXPECTED IN JULY 2012
Credits: Up to 1.0 AMA PRA Cat. 1 credit per module
Price: Free
Program Format: 12 individual monographs
Sponsor: American Medical Association (supported by a grant from Purdue Pharma L.P.)
Description: This comprehensive 12-module program on pain management offers an opportunity to choose individual modules of interest. Topics covered include pathophysiology, overall pain management options, barriers to treatment, substance abuse concerns, treating elderly and pediatric patients, treating persistent nonmalignant pain, neuropathic pain, and 3 modules on the assessment and treatment of cancer pain. Access checked May 22, 2010.

Mechanisms & Neuroplasticity of Pain: Clinical Implications

Access: http://cme.medscape.com/viewprogram/31339 (free Medscape registration required)
Audience: Physicians
Start/End: August 10, 2010 / EXPIRED
Credits: Up to 1.25 AMA PRA Cat. 1 credit
Price: Free
Program Format: 6-part Web-based Multimedia (all parts required for course credit)
Sponsor: MedscapeCME
Author(s): Lynn Webster, MD; Charles Argoff, MD; Sean Mackey, MD; Bruce Nicholson, MD
Description: Note: this program includes neurobiological discussions that are advanced and still somewhat theoretical. The program consists of symposia lectures by pain experts who presented at the annual meetings of the American Academy of Pain Medicine and the American Pain Society in February 2010 and May 2010, respectively. Chronic pain and opioid therapy guidelines are reviewed and interdisciplinary treatment approaches are discussed. The experts present recent research that supports developing theories showing correlations between unresolved acute pain attacks and chronic pain, along with influences of neuroplasticity [the ability of all areas of the nervous system to reorganize by forming new neural connections as a result of experiences or new situations]. Gold standard treatments and emerging agents are examined in the context of changing levels of knowledge on the neurobiological mechanisms of chronic pain. Access checked August 31, 2010.

What Do I Need to Know About Gout?

Access: http://www.jfponline.com/supplements.asp?id=8724
Audience: Physicians
Start/End: June 1, 2010 / EXPIRED
Credits: Up to 1.0 AMA PRA Cat. 1 credit
Price: Free
Program Format: Journal article
Sponsor: Journal of Family Practice
Author(s): Michael A. Becker, MD; Gary E. Ruoff, MD
Description: This educational activity focuses on the diagnosis and treatment of gout in patients visiting primary care practitioners. Course content includes a discussion of comorbidities that contribute to the exacerbation of acute gout flares. Treatment approaches for pain relief in acute gout attacks and chronic gout are reviewed in detail. Data are presented regarding the type of patients who have been shown to benefit from urate-lowering medications like allopurinol, probenecid, and febuxostat. Case study examples and a patient care plan enhance this learning experience. Access checked May 28, 2011.

Pharmacist’s Role in the Appropriate Selection of a Nonprescription Product for Pain Relief

Access: http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/105845/

Audience: Pharmacists; Pharmacist Technicians
Start/End: September 1, 2008 / EXPIRED
Credits: 2.0 ACPE credit hours (0.20 CEUs)
Price: Free; registration is required for CE testing and credit
Program Format: Monograph
Sponsor: U.S. Pharmacist (Professional journal)
Author(s): W. Steven Pray, PhD, DPh
Description: Counseling opportunities are common in pharmacy practice and, as a member of a multi-disciplinary pain management team, it is important to be aware of nonprescription analgesic products that are currently available. Over-the-counter drugs and devices, including external analgesics, cryotherapy, and thermotherapy products, are discussed in terms of patient selection and guidelines for use. Techniques are recommended for assisting patients in weighing the pros and cons of products before purchase. Access checked June 23, 2009.

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