Opioid-induced Constipation Screening and Diagnosis With Bill McCarberg, MD

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Opioid-induced Constipation Screening and Diagnosis With Bill McCarberg, MD

OIC Screening and Diagnosis
Bill H. McCarberg, MD

Release Date: December 22, 2014

Expiration Date: December 21, 2015 (THIS ACTIVITY IS NO LONGER AVAILABLE FOR CREDIT)

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PROGRAM OVERVIEW

Can you ID OIC? Find solutions to detect, diagnose, and manage opioid-induced constipation (OIC) sooner in your patients with chronic, non-cancer pain.This CME case-based activity features:

Tools to screen patients and talk to them about OIC
Criteria and symptoms that can be used to better assess and diagnose OIC

LEARNING OBJECTIVES

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

Incorporate into practice, communication strategies to improve the screening of patients for OIC
Evaluate patients’ symptoms and clinical history to guide OIC diagnosis

FACULTY
Bill H. McCarberg, MD
Founder, Chronic Pain Management Program
Kaiser Permanente San Diego (retired)
Adjunct Assistant Clinical Professor
University of California, San Diego
San Diego, CA

DISCLOSURES STATEMENTS

In accordance with the Accreditation Council for Continuing Medical Education (ACCME), Dannemiller requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest.

Bill H. McCarberg, MD
Speakers Bureau: Millennium Pharmaceuticals, Inc
Consultant/Advisory Board: Collegium Pharmaceutical; Iroko Pharmaceuticals, LLC;
Millennium Pharmaceuticals, Inc; Pfizer Inc; Zogenix, Inc
Stockholder: BioSpecifics Technologies Corp; Johnson & Johnson; Nektar
Therapeutics; PDL BioPharma, Inc (formerly Protein Design Labs, Inc)

In order to resolve conflict of interest, presentations of this activity were peer reviewed by an independent reviewer. The reviewer has no relationship with a commercial interest. The resulting certified activity was found to provide educational content that is current, evidence based, and commercially balanced.

Independent Reviewer
Bernard M. Abrams, MD
Medical Director
Dannemiller
San Antonio, TX
Clinical Professor of Neurology
University of Missouri School of Medicine at Kansas City
Kansas City, MO
Nothing to disclose with regard to commercial support

Educational Planning Committee
Dannemiller
Gordon Ringler
Nothing to disclose with regard to commercial support

Spire Learning
Jeanne Prater Shareholder (Spouse/Partner): Johnson & Johnson
Employee (Spouse/Partner): Novo Nordisk
Jaime Symowicz, PhD
Nothing to disclose with regard to commercial support

DISCLAIMER

The content and views presented in this educational activity are those of the presenter and do not necessarily reflect those of Dannemiller, Takeda Pharmaceuticals International, Inc., U.S. Region, Sucampo, or Spire Learning. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

OFF-LABEL STATEMENT

The faculty author does not intend to discuss non–FDA-approved or investigational use of any commercial products in this presentation. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

LEVELS OF EVIDENCE

Levels of evidence are provided for any patient care recommendations made during this presentation.

Level A (randomized controlled trial/meta-analysis): High-quality, randomized controlled trial (RCT) that considers all important outcomes. High-quality meta-analysis (quantitative systematic review) using comprehensive search strategies

Level B (other evidence): A well-designed, nonrandomized clinical trial. A nonquantitative systematic review with appropriate search strategies and well-substantiated conclusions. Includes lower-quality RCTs, clinical cohort studies, and case-controlled studies with nonbiased selection of study participants and consistent findings. Other evidence, such as high-quality, historical, uncontrolled studies, or well-designed epidemiologic studies with compelling findings, is also included

Level C (consensus/expert opinion): Consensus viewpoint or expert opinion.Each rating is applied to a single reference in the presentation, not the entire body of evidence on the topic

FACULTY BIOGRAPHY

Bill H. McCarberg, MD

Bill H. McCarberg, MD, is Founder of the Chronic Pain Management Program for Kaiser Permanente (retired) in San Diego, California. He is also an Adjunct Assistant Clinical Professor at the University of California, San Diego School of Medicine. Dr McCarberg is currently working with Neighborhood Healthcare in Escondido, California. He received his medical degree from Northwestern University Feinberg School of Medicine in Chicago, Illinois, and he completed his medical internship and residency in family medicine at Highland Hospital in Rochester, New York.

Dr McCarberg has given more than 500 presentations on pain management topics and is the author or coauthor of 115 articles, book chapters, and books. He is board certified by the American Board of Pain Medicine and the American Board of Family Practice with additional certification in geriatric medicine. He is also treasurer of the American Board of Pain Medicine and president of the Western Pain Society. In addition, Dr McCarberg is a member of the American Academy of Family Physicians, the American Academy of Pain Medicine, the American Pain Society, and the International Association for the Study of Pain. He is the recipient of several awards, including the Shilling Compassionate Care Award from Kaiser Permanente and the Elizabeth Narcessian award for leaders in the field of pain education from the American Pain Society. In 2008, he was named Ambassador of the Year by the National Pain Foundation. Dr McCarberg was consistently rated in the top 10% by Member Appraisal of Physician/Provider Services at Kaiser Permanente from 1998 to 2011.

TARGET AUDIENCE

• Primary care physicians
• Pain specialists

ACCREDITATION

Physicians
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Dannemiller and Spire Learning. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians.

Dannemiller designates this activity for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

METHOD OF PARTICIPATION

This activity has no fee and should take approximately 30 minutes to complete. Participants should first read the objectives and other introductory CME information, then complete the pre-assessment and participate in the online case activity. To receive credit for this activity, participants must complete the post-assessment with a passing score of 80% and then complete the evaluation. This credit is valid through April 15, 2015. No credit will be given after this date. In the event you have questions about this activity or are unable to print the certificate, please e-mail Christine Kocienda at ckocienda@spirelearning.com, and a certificate will be e-mailed within 2 weeks.

This educational activity is jointly sponsored by Dannemiller and Spire Learning.

This educational activity is supported by an educational grant from Takeda Pharmaceuticals International, Inc., U.S. Region and Sucampo.

Hardware/Software Requirements

A computer with an internet connection

References for Opioid-induced Constipation Screening and Diagnosis With Bill McCarberg, MD

Bell TJ, Panchal SJ, Miaskowski C, et al. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European Patient Survey (PROBE 1). Pain Med. 2009;10:35-42.
Moore RA, McQuay HJ. Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis Res Ther. 2005;7:R1046-R1051.
Kalso E, Edwards JE, Moore RA, McQuay HJ. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain. 2004;112:372-380.
Allan L, Hays H, Jensen NH, et al. Randomised crossover trial of transdermal fentanyl and sustained release oral morphine for treating chronic non-cancer pain. BMJ. 2001;322:1154-1158.
Swegle JM, Logemann C. Management of common opioid-induced adverse effects. Am Fam Physician. 2006;74:1347-1354.
Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(2 suppl):S105-S120.
Bell T, Annunziata K, Leslie JB. Opioid-induced constipation negatively impacts pain management, productivity, and health-related quality of life: findings from the National Health and Wellness Survey. J Opioid Manag. 2009;5:137-144.
McCarberg BH. Overview and treatment of opioid-induced constipation. Postgrad Med. 2013;125:7-17.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130:1480-1491.
Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32:920-924.
McMillan SC. Assessing and managing opiate-induced constipation in adults with cancer. Cancer Control. 2004;11(3 suppl ):3-9.
Leppert W. The role of opioid receptor antagonists in the treatment of opioid-induced constipation: a review. Adv Ther. 2010;27:714-730.
Rao SSC. Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastroenterol Clin North Am. 2007;36:687-711.
Librach SL, Bouvette M, De Angelis C, et al; Canadian Consensus Development Group for Constipation in Patients with Advanced Progressive Illness. Consensus recommendations for the management of constipation in patients with advanced, progressive illness. J Pain Symptom Manage. 2010;40:761-773.
Peppin JF. Opioid-induced constipation: causes and treatments. Pract Pain Manag. 2012;April:59-65.
Thomas JR, Cooney GA, Slatkin NE. Palliative care and pain: new strategies for managing opioid bowel dysfunction. J Palliat Med. 2008;11(suppl 1):S1-S19.