Unrelieved chronic or persistent pain is a significant public health problem in the U.S., with prevalence estimates ranging from 15% to 30%. 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. Persistent pain significantly impacts quality-of-life and is often accompanied by anxiety, depression and sleep disorders, all of which complicate management.
- Utilize a basic approach to the evaluation and assessment of the patient with persistent nonmalignant pain.
- Describe the evidence related to chronic opioid therapy for persistent non-cancer 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."
Copyright © 2013 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.
The American Medical Association designates this education activity for a maximum of 2 AMA PRA Category 1 Credit™. Physician should only claim credit commensurate with the extent of their participation in the activity.
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
This continuing medical education program is intended for primary care physicians and those physicians who care for patients experiencing pain.
The original development of this CME module was supported in 2003 through an 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. The June 2013 revision of this activity is supported by a grant from the American Academy of Addiction Psychiatry’s Prescribers’ Clinical Support System for Opioid Therapies, a three-year grant funded by the Substance Abuse and Mental Health Services Administration and the Center for Substance Abuse Treatment.
CME Principal Faculty
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
Arthur G. Lipman, PharmD, FASHP, Clinical Content Reviewer
University Professor, Department of Pharmacotherapy, College of Pharmacy
Adjunct Professor, Department of Anesthesiology, School of Medicine
Director of Clinical Pharmacology, Pain Management Center, University Health Care
University of Utah Health Sciences Center
Editor, Journal of Pain & Palliative Care Pharmacotherapy
Charles E. Argoff, MD, Reviewer
Professor of Neurology
Albany Medical College
Director, Comprehensive Pain Center
Albany Medical Center
Jonathan S Berek, MD, MMS, Clinical Content Reviewer
Professor and Chair
Department of Obstetrics & Gynecology
Stanford University School of Medicine
Director, Stanford Women's Cancer Center
Stanford Cancer Institute
Reed Thompson, MD , FACS, Clinical Content Reviewer
Associate Professor, Donald W. Reynolds Department of Geriatrics
University of Arkansas for Medical Sciences
Little Rock , AR
Karen Knox, PhD, RN, ARNP, MSN, MPH, ACNS-BC
Advanced Practice Registered Nurse, Clinical Content Reviewer
Associate Professor, College of Nursing
Vitaly Gordin, MD, Reviewer
Director for Pain Division, Department of Anesthesiology
Penn State Hershey Medical Center
Martin Grabois, MD, Reviewer
President, American Academy of Pain Medicine,
Baylor College of Medicine
Department of Physical Medicine and Rehabilitation
Bill McCarberg, MD, Reviewer
Adjunct Assistant Clinical Professor, University of California
San Diego, CA
Founder, Chronic Pain Management Program, Southern California Permanente Medical Group
Cheryl L. Lambing, MD, Reviewer
Assistant Clinical Professor
University of California , Los Angeles
Medical Director for Professional and Community
Education and Outreach
Ventura County Health Care Agency
Bruce Ferrell, MD, Director, Reviewer
UCLA Adult Palliative Care Services
University of California, Los Angeles
Los Angeles, CA
Seddon R. Savage, MD, MS, Reviewer
Pain Consultant, Manchester VAMC
Adjunct Associate Professor of Anesthesiology, Department of Anesthesiology, Geisel School of Medicine at Dartmouth College
Rita LePard, CME Program Committee
American Medical Association
Barry D. Dickinson, PhD
Secretary, Council on Science & Public Health
American Medical Association
Senior Policy Analyst
American Medical Association
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
Consultant, Speaker’s Bureau, Grant support: Endo, Forest, Lilly, Neurogenex, Pfizer, Consultant: Insys Pharmaceuticals, Gruenthal Pharmaceuticals, King, Sanofi-Aventis, Nuvo Research, Jazz, Shinogi, Iroko, Zogeniz,
|Dr. Berek:||Nothing relevant to disclose|
|Dr. Ferrell:||Nothing relevant to disclose|
|Dr. Gordin:||Nothing revelant to disclose|
|Dr. Grabois:||Consultant: Pfizer|
|Dr. Knox:||Nothing relevant to disclose|
Consultant: Endo, Insys Pharmaceuticals, Neurogenex, Pfizer, Purdue Pharma, QRx Pharma, Salix, Sucampo, Teva
|Dr. Lambing:||Nothing revelant to disclose|
|Dr. Lipman:||Nothing revelant to disclose|
Grant support: Boston Scientific, Covidien Mallinckrodt, Endo, Medtronic, ProStrakan, Purdue Pharma, Salix, St. Jude
|Dr. Savage:||Nothing revelant to disclose|
|Dr. Thompson:||Nothing revelant to disclose|
|Dr. Dickinson:||Nothing revelant to disclose|
|Ms. LePard:||Nothing revelant to disclose|
|Ms. Williams:||Nothing revelant to disclose|
AMA CME Program Committee members have no relevant relationships to disclose.
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
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