Unrelieved chronic or persistent pain is a significant public health problem in the US, with prevalence estimates ranging from 15% to 30%.1 A World Health Organization (WHO) survey of primary care patients found 21.5% suffered severe pain for most of a 6-month period during the previous year.2 Persistent pain significantly impacts quality-of-life and is often accompanied by anxiety, depression and sleep disorders, all of which complicate management.
Educational Objectives
- Utilize a basic approach to the evaluation and assessment of the patient with persistent nonmalignant pain.
- Apply the basic nonpharmacological and pharmacological approaches to the management of persistent pain.
To begin the program, read the information below and check the acknowledgement statement; then click "Start Module."
© 2010 American Medical Association. All rights reserved. The contents of this CME program may not be reproduced in any form without written permission from the AMA. This CME program does not define a standard of care, nor is it intended to dictate an exclusive course of management. Standards of medical care are determined on the basis of all the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns evolve.
The products appearing in this continuing medical education program are given for information purposes only. Their inclusion does not imply AMA endorsement, nor does omission of any product indicate AMA disapproval.
Original Release date: September, 2007
Updated: February, 2010
Expiration Date: March, 2012
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Medical Association designates this education activity for a maximum of 1 AMA PRA Category 1 Credit™. Physician should only claim credit commensurate with the extent of their participation in the activity.
This continuing medical education program is intended for primary care physicians and those physicians who care for patients experiencing pain.
Financial Support
The development of this CME web program was supported through an independent educational grant from Purdue Pharma L.P., and produced in accordance with the AMA Standards for Industry-Supported Multimedia Continuing Medical Education and Other Communications.
CME Principal Faculty
American Medical AssociationPerry G. Fine, MD, Content Consultant
Associate Medical Director
Pain Management Center
Professor of Anesthesiology
University of Utah
Salt Lake City, UT
Pauline Lesage, MD, LLM, Contributing Author
Medical Director, Jacob Perlow Hospice
Beth Israel Medical Center
Associate Professor, Family Medicine
Albert Einstein School of Medicine
New York, NY
Philipp M. Lippe, MD, Content Reviewer
Executive Medical Director
American Academy of Pain Medicine
Clinical Professor of Neurosurgery
Stanford University
Stanford, CA
Arthur G. Lipman, PharmD, Content Consultant
Professor, College of Pharmacy & Director of Clinical Pharmacology
Pain Management Center, Pain Medicine and Palliative Care Advisory Group
Huntsman Cancer Institute
University of Utah Health Sciences Center
Salt Lake City, UT
Russell K. Portenoy, MD, Contributing Author, Planning Committee
Chairman, Department of Pain Medicine
and Palliative Care
Beth Israel Medical Center
New York, NY
Professor of Neurology and Anesthesiology
Albert Einstein College of Medicine
Bronx, NY
American Academy of Neurology
Charles E. Argoff, MD, Content Consultant
Co-Director, Cohn Pain Management Center
Assistant Professor of Neurology
North Shore University Hospital
Manhasset, NY
American College of Obstetricians and Gynecologists
Jonathan S. Berek, MD, Content Reviewer
Professor and Chair, College of Applied Anatomy
Executive Vice Chair, Department of OB/GYN
Chief, Gynecology Service
Chief, Division of Gynecologic Oncology
David Geffen School of Medicine at UCLA
Los Angeles, CA
American Society of Anesthesiologists
May L. Chin, MD, Content Reviewer
Professor of Anesthesiology
Director, Pain Management Center
George Washington University Hospital
Washington, DC
American Pain Society
Scott M. Fishman, MD, Content Reviewer
Professor and Chief, Division of Pain Medicine
Department of Anesthesiology and Pain Medicine
University of California , Davis
Sacramento, CA
American Academy of Pain Medicine
Kenneth A. Follett, MD, PhD, Content Reviewer
Professor, Neurosurgery
University of Iowa Hospital & Clinics
Iowa City, IA
American Academy of Pediatrics
Constance S. Houck, MD, Contributing Author
Senior Associate in Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine
Children's Hospital
Assistant Professor, Anesthesia
Harvard Medical School
Boston, MA
American Academy of Orthopaedic Surgeons
L. Andrew Koman, MD, Content Consultant
Vice Chair and Professor, Department of Orthopedic Surgery
Wake Forest University School of Medicine
Winston-Salem, NC
American Academy of Physician Assistants
Sharon Kulesz, MS, PA-C, Content Reviewer
Director, Alilance Development & Education, AAPA
Alexandria, VA
American Academy of Family Physicians
Cheryl L. Lambing, MD, Content Reviewer
Assistant Clinical Professor
University of California , Los Angeles
Ventura, CA
American Society of Addiction Medicine
Seddon R. Savage, MD, MS, Content Consultant
Pain Consultant, Manchester VAMC
Associate Professor of Anesthesiology
Adjunct Faculty, Dartmouth Medical School
Bradford, NH
American College of Emergency Physicians
Knox H. Todd, MD, MPH , FACEP, Content Consultant
Director, Pain and Emergency Medicine Initiative
Adjunct Associate Professor, Rollins School of Public Health
Emory University School of Medicine
Atlanta, GA
Planning Committee
Barry Dickinson, PhD, CME Program Committee
American Medical Association
R. Mark Evans, PhD, Contributing Editor
American Medical Association
Patti Fitzgerald, Contributing Editor
American Medical Association
Russell K. Portenoy, MD
Chairman, Department of Pain Medicine
and Palliative Care
Beth Israel Medical Center
New York, NY
Professor of Neurology and Anesthesiology
Albert Einstein College of Medicine
Bronx, NY
Disclosures
Disclosure Policy
It is the policy of the AMA to ensure balance, independence, objectivity, and scientific rigor in all of its activities. This AMA CME program has been independently planned by the AMA and complies with the AMA Division of Healthcare Education Products and Standards’ Policies and Procedures for Resolving Conflicts of Interest (COI) for their CME activities, to identify and resolve COI, review faculty and staff disclosure statements, and determine the level of participation of the planning committee members and principal faculty. Faculty and planning committee members have attested that their financial relationships do not affect their ability to present well-balanced evidence-based content for this activity.
In order to assure the highest quality of certified CME programming, and to comply with the ACCME Standards for Commercial Support, the AMA requires that all faculty, planning committee and AMA CME Program Committee members disclose relevant financial relationships with any commercial or proprietary entity producing health care goods or services relevant to the content being planned or presented. The following disclosures are provided:
CME Advisory Board
| Dr. Argoff: | Consultant: Pfizer Grant Support: Endo; Speaker’s Bureau: Endo, Pricara, Pfizer, Lilly, Forest, King Pharmaceuticals |
| Dr. Berek: | Nothing relevant to disclose |
| Dr. Chin: | Nothing relevant to disclose |
| Dr. Ferrell: | Nothing revelant to disclose |
| Dr. Fine: | Advisory Board: Endo, Cephalon, Lilly, Alpharma, Wyeth & GlaxoSmithKline |
| Dr. Fishman: | Nothing relevant to disclose |
| Dr. Follett: | Nothing revelant to disclose |
| Dr. Houck: | Nothing revelant to disclose |
| Dr. Koman: | Consultant: Wright Medical; Medical Director/Board member: DT Scimed, Kerannetics |
| Dr. Kulesz: | Nothing revelant to disclose |
| Dr. Lambing | Nothing revelant to disclose |
| Dr. Lesage: | Nothing revelant to disclose |
| Mr. Lipman: | Consultant: Pfizer, Progenics, Johnson & Johnson, Biovail, NiCox; Speaker’s Bureau: Johnson & Johnson, Forest/Cypress |
| Dr. Lippe: | Nothing revelant to disclose |
| Dr. Portenoy: | Consultant: Alpharma, Ameritox, Cephalon, GW Pharma, Grupo Ferrer, Insys Therapeutics, King Pharmaceuticals, Neuromed, Purdue Pharma, Shire Pharmaceuticals, Titan, Transcept Pharmaceuticals, WEX Pharmaceuticals, Wyeth, Xenon
Grants: Archimedes Pharmaceuticals, Cephalon, Endo Pharmaceuticals, Fralex, GW Pharmaceuticals, King Pharmaceuticals, Pfizer, Inc., Purdue Pharma, United BioSource Corp., Wyeth |
| Dr. Savage: | Advisory Board: Ameritox, Registrat, Meda |
| Dr. Todd: | Consultant: Purdue Pharma; Research Grant: Baxter |
AMA Planning Committee and Editors |
|
| Dr. Evans: | Nothing revelant to disclose |
| Dr. Dickinson: | Nothing revelant to disclose |
| Ms. Fitzgerald: | Nothing revelant to disclose |
| Dr. Portenoy: | Consultant: Alpharma, Ameritox, Cephalon, GW Pharma, Grupo Ferrer, Insys Therapeutics, King Pharmaceuticals, Neuromed, Purdue Pharma, Shire Pharmaceuticals, Titan, Transcept Pharmaceuticals, WEX Pharmaceuticals, Wyeth, Xenon
Grants: Archimedes Pharmaceuticals, Cephalon, Endo Pharmaceuticals, Fralex, GW Pharmaceuticals, King Pharmaceuticals, Pfizer, Inc., Purdue Pharma, United BioSource Corp., Wyeth |
Disclosure of Off-Label Uses
The content of this CME publication may contain discussion of off-label uses of some of the agents mentioned. Please consult the product prescribing information for full disclosure of labeled uses.
Art and Illustration
Copyright © 2007-2010 Scott Bodell, Bodell Communications, Inc.
