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A Balanced Approach to the Management of Chronic Pain in Primary Care

A Balanced Approach to the Management of Chronic Pain in Primary Care


Expert Perspective

Time to Complete

1.50 hours


February 15, 2013


February 15, 2014

Maximum Credits

1.50 / AMA PRA Category 1 Credit(s)TM

Accredited Provider

Jointly sponsored by
Commercial Supporter
Support for this activity has been provided through an educational grant from Purdue Pharma L.P.

Program Description

Chronic pain is a significant public health problem in the United States that is both common and costly. Overall, there are 116 million adults in the U.S. with a chronic pain condition; the associated total economic cost is estimated at over $600 billion. Opioid analgesics can effectively reduce pain and improve quality of life in many chronic pain conditions, but they also have significant adverse events—the most worrisome of which is the risk of addiction. Clinicians therefore need to carefully assess patients before considering a trial of opioid therapy and understand how best to utilize opioid therapy as part of a multimodal approach to care. To provide guidance to clinicians, this Web-based activity features a series of faculty discussions on the optimal use of opioid therapy for the management of noncancer chronic pain in clinical practice. A series of patient/clinician vignettes demonstrating specific learning points relating to the clinical use of opioid analgesics is featured to facilitate the discussions.

Intended Audience

This activity is intended for primary care clinicians, including physicians, physician assistants, nurse practitioners, nurses, and other health care professionals who manage patients with chronic pain.

Educational Objectives

Upon completion of this activity, participants should be better able to:

  • Select the safest and most appropriate analgesic agents for each patient based on pain condition, comorbidities, psychosocial history, medical history, history of substance abuse, and other relevant information that affects their pain and its treatment
  • Develop communication and educational strategies to enhance patient adherence to their pain care
  • Formulate treatment plans to select, adjust and titrate, monitor, and exit or transition from opioid therapy


Bruce D. Nicholson, MD
Clinical Associate Professor, Department of Anesthesia
Penn State School of Medicine, Milton S. Hershey Medical Center
Hershey, Pennsylvania
President, Pain Specialists of Greater Lehigh Valley
Medical Director, Division of Pain Medicine
Lehigh Valley Hospital Health Network
Allentown, Pennsylvania

Bruce D. Nicholson, MD, has disclosed the following relevant financial relationships:
Advisory Board: Dapmed Insys, Pfizer, Johnson & Johnson, Nektar, QRx
Consultant: Endo Pharmaceuticals, Johnson & Johnson, QRx
Grant recipient/research: Endo Pharmaceuticals (PI), Medtronic, Pfizer (PI), funds paid to Lehigh Valley Health Network
Speakers Bureau: Johnson & Johnson, Pfizer, Purdue Pharma

Jennifer L. Stephens, DO, FACP
Associate Clinical Professor, University of South Florida
Tampa, Florida
Vice Chair, Quality – Department of Medicine
Medical Director, Lehigh Valley Physicians Practice
Lehigh Valley Health Network
Allentown, Pennsylvania

Jennifer L. Stephens, DO, FACP, has disclosed the following relevant financial relationship:
Presenter: Greater New York Hospital Association (on patient centered medical homes)


American Academy of CME
John JD Juchniewicz, MCIS, CCMEP,
President, has disclosed no relevant financial relationships.
Zinovy Meyler, DO, Independent Clinical Reviewer, has disclosed no relevant financial relationships.

Drexel University College of Medicine
Michael Onori,
Patient Actor, has disclosed no relevant financial relationships.
Kathleen F. Ryan, MD, Associate Professor of Medicine, Director, Medical Simulation Center, has disclosed no relevant financial relationships.

Curatio CME Institute
Thomas Finnegan, PhD,
Associate Medical Director, has disclosed no relevant financial relationships.
Jonathan S. Simmons, ELS, Senior Managing Editor, has disclosed no relevant financial relationships.




AMA PRA Category 1 Credit(s)TM

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 the American Academy of CME and Curatio CME Institute. The American Academy of CME is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The American Academy of CME designates this enduring material for a maximum of 1.50 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Unapproved Product Use

This educational activity will include discussion of drugs or devices or uses of agents that have not been approved by the FDA or have been approved by the FDA for specific uses only. It is the responsibility of the clinician to determine the FDA clearance status of each drug or device he or she wishes to use in clinical practice. The American Academy of CME, Curatio CME Institute, and Purdue Pharma do not recommend the use of any agent outside the labeled indications.

The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of the American Academy of CME, Curatio CME Institute, or Purdue Pharma. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


The information presented in this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a clinician regarding diagnosis and treatment of a specific patient’s medical condition.


Method of Participation
There are no fees for participating in this CME activity. To receive credit, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, including videos and text, and (3) complete the post-test and activity evaluation form, including the certificate information section.

To obtain a certificate, participants must receive a score of 70% or better on the post-test. The post-test can be accessed at the end of the activity.

For CME-related questions, email jjuchniewicz@academycme.org.

If you have any other questions relating to this activity, please contact myCME.Support@haymarketmedical.com.

© 2012. This CME-certified activity is held as copyrighted © by the American Academy of CME and Curatio CME Institute. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).

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Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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