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Are You Asking the Question? Strategies for Engaging the Patient in the Diagnosis and Management of Opioid-Induced Constipation

Gastroenterology
Curriculum:
Opioid-Induced Constipation
Credits:
1 ANCC Contact Hours 1 AMA PRA Category 1 Credit(s) ™
Launch Date:
March 28, 2017
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

The target audience for this program is primary care clinicians, including physicians, nurse practitioners, physician assistants, and nurses who are treating patients that are taking prescription opioids for chronic pain. Palliative care providers are also welcome to participate in this activity.

Relevant Terms:

Opioid-induced Constipation; Chronic Pain

H. Christian Weber, MD

H. Christian Weber, MD
Co-Course Director
Associate Chief and Clinical Director
Gastroenterology and Hepatology
VA Boston Healthcare System
Assistant Professor of Medicine
Assistant Professor of Pathology and Laboratory Medicine
Boston University School of Medicine
Boston, MA

Dr. Weber joined the faculty of Boston University School of Medicine as Assistant Professor of Medicine in the Section of Gastroenterology in 1997. Dr. Weber is a native of Germany and graduated from  Hamburg University Medical School. He completed his training in internal medicine at the University of Mainz, Germany, and at the MetroWest Medical Center in Framingham, MA, and his fellowship in  gastroenterology at Georgetown University Medical Center and the National Institutes of Health. He is board-certified in gastroenterology.
 
 Dr. Weber's research focuses on the biology and clinical aspects of gastrointestinal hormones. His clinical interests include obesity, gastric acid-related disorders, such as peptic ulcer disease and  gastroesophageal reflux disease (GERD), functional bowel disorders, such as irritable bowel syndrome (IBS), and genetic disorders of the gut. He  is a nationally recognized authority in the field of  gastrointestinal neuroendocrine tumors (NET), including Zollinger-Ellison syndrome, and has authored or co-authored numerous peer-reviewed original publications, book chapters, reviews and abstracts.  Dr. Weber is a member of several professional societies including the American Gastroenterological Association (AGA) and American College of Gastroenterology (ACG) and is also member of editorial  boards of several professional journals.
 
 

Jason M. Worcester, MD

Jason M. Worcester, MD
Co-Course Director
Medical Director
Adult Primary Care
Assistant Professor of Medicine
Boston University School of Medicine
Boston, MA

Dr. Worcester is the Medical Director of the Adult Primary Care Practice at the Shapiro Ambulatory Care Center in Boston, Massachusetts. His interests include medical education, preventative medicine, preoperative medicine, addiction medicine and clinical practice administration.
 
 
 
 
 
 
 
 
 
 

Patricia M. Bruckenthal, PhD, APRN-BC, ANP, FAAN

Patricia M. Bruckenthal, PhD, APRN-BC, ANP, FAAN
Associate Dean for Nursing Research and Innovation
Associate Professor
Stony Brook University School of Nursing            
Stony Brook, NY

Dr. Bruckenthal is the Associate Dean for Research and Innovation and an Associate Professor in the Stony Brook University School of Nursing in Stony Brook, New York. She has worked as a nurse practitioner in pain management for over 20 years. She received her undergraduate and graduate nursing degrees at Stony Brook University and her PhD at the University of Massachusetts, Amherst, Massachusetts. Her postdoctorate traineeship was completed at the Applied Behavioral Medicine Research Institute at Stony Brook University.

Dr. Bruckenthal has presented at numerous national and international conferences on pain management issues and is a member of several clinical and research nursing societies. She is a past president of the American Society for Pain Management Nursing, and is an Advanced Diplomat of the American Academy of Pain Management. She is on the editorial board of Pain Management Nursing and has authored numerous peer-reviewed publications. Dr. Bruckenthal’s research focuses on self-management of chronic pain and pain assessment and management of older adults. She was a co-investigator on a multi-site clinical trial, funded by the National Institutes of Health, of Pain Coping Skills Training (PCST) for patients with chronic osteoarthritis pain which demonstrated the effectiveness of PCST treatment delivery by nurse practitioners–a major advance for improving access to this option for pain management.  She continues to train health professionals in pain self-management and health behavior change techniques.
 
1. Integrate individualized preventative measures into current practice for patients initiating opioids, using adaptable office protocols and tools to ensure these recommendations are made.
2. Employ skills demonstrated through case-based scenarios and use validated assessment tools to overcome communication barriers in initiating patient-provider conversations about bowel habits, diagnosing opioid induced constipation (OIC), and resolving OIC without compromising pain control.

Statement of Need
All patients taking a pain medication containing an opioid are at risk for developing adverse effects, specifically opioid-induced constipation (OIC). Therefore all patients being considered for or currently on chronic opioid therapy should be assessed for OIC risk. Because OIC may present with a variety of nonspecific symptoms such as abdominal pain, bloating and decreased bowel movement frequency, clinicians need to be proactive in identifying and managing OIC in all their patients on chronic opioid therapy.
 
This two-part CME/CNE-certified online publication provides real-world case examples that focus on increasing healthcare clinicians competence and performance in screening, diagnosing, treating, and managing, in partnership with the patient, OIC. Participants will learn about: tools to screen patients and talk to them about OIC; criteria and symptoms to better diagnose OIC; and OIC therapeutic options and individualizing patients’ management plans.
 
Faculty Disclosures
Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve any apparent conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and devices is being discussed. 

H. Christian Weber, MD
Co-Course Director
Associate Chief and Clinical Director
Gastroenterology and Hepatology
VA Boston Healthcare System
Assistant Professor of Medicine
Assistant Professor of Pathology and Laboratory Medicine
Boston University School of Medicine
Boston, MA
Dr. Weber has disclosed that he serves as a consultant for Allergan and Karos Pharmaceuticals. His spouse serves as a consultant for Neovil Pharmaceuticals AG. He does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Jason M. Worcester, MD
Co-Course Director
Medical Director
Adult Primary Care
Assistant Professor of Medicine
Boston University School of Medicine
Boston, MA
Dr. Worcester has no relevant financial relationships with any commercial interest and does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Patricia M. Bruckenthal, PhD, APRN-BC, ANP, FAAN
Associate Dean for Nursing Research and Innovation
Associate Professor
Stony Brook University School of Nursing            
Stony Brook, NY
Dr. Bruckenthal has disclosed that she serves as a consultant for Endo Pharmaceuticals, and as a speaker for AstraZeneca and Pernix Therapeutics. She does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Accredited Provider Disclosures
Kristen Stakelin, MD: CME Course Reviewer for Boston University School of Medicine’s Office of Continuing Medical Education, has indicated no real or apparent conflicts.
Siobhan Nevin, RN, BSN, CWOCN: CNE Course Advisor for Boston University School of Medicine’s Office of Continuing Medical Education, has indicated no real or apparent conflicts.
Patti-Ann Collins, DNP, MSN/MBA, RN: Lead Nurse Planner for Boston University School of Medicine’s Office of Continuing Medical Education, has no relevant financial relationships with any commercial interest.
Christopher Drury, MA, MA: Medical Writer for Boston University School of Medicine’s Office of Continuing Medical Education, has indicated no real or apparent conflicts.
Dana Frazier, CHCP: Program and Grant Manager for Boston University School of Medicine’s Office of Continuing Medical Education, has indicated no real or apparent conflicts.
 
Accreditation Statements
Boston University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Boston University School of Medicine designates this enduring educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education Provider Unit, Boston University School of Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
CNE Contact Hours: 1.0 all of which are eligible for pharmacology credit.

Nurses will receive contact hours after completion of an evaluation and claim for credit form.
 
Estimated time to complete: 1.0 hour
 
How To Receive Credit
By reviewing the course content and successfully completing the post-test and evaluation, physicians are entitled to receive 1.0 AMA PRA category 1 credits™, nurses are entitled to receive 1.0 CNE contact hours, all of which are pharmacology credit worthy. Statement of credit will be available to print from your user history page.
  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Successfully complete the post-test, activity evaluation, and claim credit. A post-test score of 75% or higher is required, and you may retake the post-test 2 times to achieve a passing score.
  • Your certificate will be available to print from your user history page.
NOTE: EARN ADDITIONAL CREDITS
This activity is part of a curriculum with multiple activities. You will be alerted of the next activity(ies) in the curriculum when they become available. Additional credit is available for each additional activity. 
 
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Commercial Support
This activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals LP and Takeda Pharmaceuticals International, Inc., U.S. Region.
 
Disclaimer
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKES NO WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL TRUSTEES OF BOSTON UNIVERSITY BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.
 
 

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