CME Needs Assessment
Pain is one of the most common reasons for patients to seek medical attention and one of the most prevalent medical complaints in the US.1-3 According to the 2011 Institute of Medicine Report-Relieving Pain In America, more than 116 million Americans are burdened with chronic pain alone.4 Three in five of those 65 years or older said that they experienced pain that lasted a year or more; more than 60% of U.S. nursing home residents report pain, most commonly attributable to arthritis, and 17% have substantial daily pain.2,4 More than one-quarter of adults said they had experienced low back pain, and 15% of adults experienced migraine or severe headache in the past three months. For the millions of Americans who experience persistent pain, the impact on function and quality of life can be profound.2-5 Pain is associated with high utilization of health care and the societal costs related to treatment are compounded by the loss in productivity associated with persistent pain.6 Lost productive time from common pain conditions among workers costs an estimated $61.2 billion per year and most of this is related to reduced performance while at work.7 The annual economic cost associated with chronic pain most likely exceeds $560 billion.4
Opioid medications are prescribed commonly for acute pain and pain associated with advanced illness, and although the use of these drugs to help manage chronic non-cancer pain continues to be limited, their use for the latter indication has increased substantially during the past two decades. In parallel with this increase in medical use has been a deeply concerning rise in prescription drug abuse and unintentional overdose. Drug overdose deaths in the United States exceed 38,000 annually with prescription drugs involved in more than 55% of such deaths. Prescription opioid drugs were involved in nearly 75% of the 22,000 plus prescription drug overdose deaths reported in 2010.8 Consequently, federal actions such as FDA-mandated risk mitigation strategies for long-acting opioids, federal support for requiring mandatory education for DEA registration, and state-based initiatives designed to more tightly regulate opioid use have emerged. Physicians and other clinicians need current, state-of-the-art education to assist them in developing the necessary skills to evaluate and manage patients with persistent pain. This CME program reviews the assessment and management of pain and persistent pain syndromes that are commonly seen in primary care.