When

Friday, May 2, 2014 
6:00 AM - 7:30 AM PDT          Breakfast will be provided

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Faculty*

Michelle Rhiner, MSN, NP
Instructor, Family Medicine
Loma Linda University School of Medicine
Loma Linda, California

Neal E. Slatkin, MD
Vice-President Medical Services
Chief Medical Officer
Hospice of the Valley
San Jose, California

April Hazard Vallerand, PhD, RN, FAAN
Professor, College of Nursing
Wayne State University
Detroit, Michigan

Where

Anaheim Marriott 
700 West Convention Way                                    Anaheim, CA 92802                                                Meeting Room: Marquis Ballroom Center

 
Driving Directions 

Disclaimer

Meeting space has been assigned to provide a Satellite Symposium supported by Teva CNS via an educational grant during the Oncology Nursing Society’s (ONS) 39th Annual Congress, May 1-4, 2014 in Anaheim, CA.  The Oncology Nursing Society’s assignment of meeting space does not imply product endorsement nor does the Oncology Nursing Society assume any responsibility for the educational content of the symposium.

 

Persistent and Breakthrough Pain
Individualizing Opioid Therapy for Fluctuating Cancer Pain

Educational Objectives

At the conclusion of this educational activity, participants should be better prepared to:

  1. Describe the diagnostic criteria for BTP and clinical characteristics of various episode subtypes
  2. Assess patients with cancer for transient increases in pain that compromise function or reduce quality of life
  3. Tailor multimodal opioid-based regimens for cancer-related persistent pain and BTP to achieve adequate analgesia, reach functional goals, and minimize treatment-related risks
  4. Comply with medical standards of care and Risk Evaluation and Mitigation Strategies when treating and monitoring patients who require prescription opioids for cancer pain
  5. Educate patients with cancer pain about the safe use of prescription opioids, including transmucosal immediate-release fentanyl products

Statement of Need and Learner’s Gap

Cancer pain is prevalent and often inadequately treated.1,2 Affecting approximately one quarter of patients with newly diagnosed malignancy and more than three quarters with advanced cancer, pain is consistently reported as one of the most troubling cancer symptoms for patients and their families.1-4 Because pain is biopsychosocial in nature, it manifests clinically as a dynamic condition, with pain levels fluctuating over days, hours, and even minutes.5 Indeed, even when the persistent baseline component of cancer pain is generally controlled with an analgesic regimen, most patients will continue to experience short periods during the day when their pain spikes. Referred to as breakthrough pain (BTP), these transient episodes have been linked to increased physical disability, poor psychological status, and higher health care costs.3,6-8 In the oncology setting, the treatment of persistent and BTP frequently relies on opioid agonists.9,10 Implementing and tailoring opioid-based therapy require consideration of potential pain etiologies and patient-specific treatment goals and risks—a challenging task in the context of the myriad issues faced by the oncology health care team.10-12 Oncology nurses, in particular, often interact with patients throughout the continuum of cancer care, allowing them to identify untreated pain and advocate for affected individuals. This Evidence-Based Best Practices program will discuss comprehensive assessment and treatment approaches for cancer-related BTP, including Risk Evaluation and Mitigation Strategies associated with prescription opioids and patient-monitoring strategies to promote safe opioid use.

References

  1. Cohen MZ, Easley MK, Ellis C, et al. Cancer pain management and the JCAHO’s pain standards: an institutional challenge. J Pain Symptom Manage. 2003;25(6):519-527.
  2. Goudas LC, Bloch R, Gialeli-Goudas M, Lau J, Carr DB. The epidemiology of cancer pain. Cancer Invest. 2005;23(2):182-190.
  3. Svendsen KB, Andersen S, Arnason S, et al. Breakthrough pain in malignant and non-malignant diseases: a review of prevalence, characteristics and mechanisms. Eur J Pain. 2005;9(2):195-206.
  4. Bruera E, Kim HN. Cancer pain. JAMA. 2003;290(18):2476-2479.
  5. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581-624.
  6. Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain. Pain. 1999;81(1-2):129-134.
  7. Fortner BV, Okon TA, Portenoy RK. A survey of pain-related hospitalizations, emergency department visits, and physician office visits reported by cancer patients with and without history of breakthrough pain. J Pain. 2002;3(1):38-44.
  8. Hwang SS, Chang VT, Kasimis B. Dynamic cancer pain management outcomes: the relationship between pain severity, pain relief, functional interference, satisfaction and global quality of life over time. J Pain Symptom Manage. 2002;23(3):190-200.
  9. Nalamachu S, Hassman D, Wallace MS, Dumble S, Derrick R, Howell J. Long-term effectiveness and tolerability of sublingual fentanyl orally disintegrating tablet for the treatment of breakthrough cancer pain. Curr Med Res Opin. 2010;27(3):519-530.
  10. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Adult Cancer Pain. Fort Washington, Pennsylvania; 2010.
  11. Fine PG, Portenoy RK. A Clinical Guide to Opioid Analgesia. 2nd ed. New York: Vendome Group, LLC; 2007.
  12. Starr TD, Rogak LJ, Passik SD. Substance abuse in cancer pain. Curr Pain Headache Rep. 2010;14(4):268-275.

Agenda

  • 6:00 AM – 6:05 AM Faculty Introductions
  • 6:05 AM – 6:25 AM Meeting the Challenge of Cancer Pain Management
  • 6:25 AM – 6:50 AM Breakthrough Cancer Pain: Assessment and Differential Diagnosis
  • 6:50 AM – 7:15 AM Tailoring Breakthrough Pain Management: Safe and Effective Opioid Therapy
  • 7:15 AM – 7:30 AM Concluding Comments and Q&A Session

Nursing Continuing Education

Global Education Group is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s COA.

This educational activity for 1.5 contact hours is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

Americans with Disabilities Act

Event staff will be glad to assist you with any special needs (ie, physical, dietary, etc). Please contact Barbara Jean Wynne prior to the live event at 201-535-4941.

For information about the accreditation of this program, please contact Global at 303-395-1782 or inquire@globaleducationgroup.com.


This activity is co-provided by Global Education Group and Integritas Communications.

This activity is supported by an educational grant from Teva CNS.