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OIC Part 1: Recommendations on Initiating Prescription Therapies for Opioid-Induced Constipation

Release date: April 20, 2016; CME valid through: April 20, 2019
Re-reviewed: April 18, 2019; CME valid through: April 18, 2020


NOTE: As previously mentioned in this series, Naldemedine is now approved and on the market.

Target Audience & Educational Design:

Recommendations on Initiating Prescription Therapies for Opioid-Induced Constipation enduring virtual seminars (webinars) are designed for clinicians and all healthcare practitioners involved in the treatment of patients in pain. This educational initiative was planned and facilitated by leaders and experts from the American Academy of Pain Medicine (AAPM). AAPM is the leading medical association representing physicians committed to advancing the emerging science and practice of pain medicine. This program is designed to improve access to quality, evidence-based multidisciplinary pain care across the healthcare continuum.

Purpose Statement:
The purpose of these enduring virtual seminars (webinars) is to discuss an optimal symptom-based method for assessing opioid-induced constipation in clinical practice and a threshold of symptom severity to prompt consideration of prescription therapy.

Educational Need:
OIC has evolved as an outcome of modern pain management techniques, with limited consensus on its treatment and its appropriate and concise definitions. Further, there is little evidence-based data to support best practice for treating OIC, and therefore a real need to define the problem and propose recommendations for treatment based upon the available evidence.

Educational Objectives for the Recommendations on Initiating Prescription Therapies for Opioid-Induced Constipation program are as follows:
- Define opioid-induced constipation.
- Identify selected factors to consider before evaluating patients’ potential need for OIC treatment using a validated assessment tool.
- Identify optimal treatment strategies for patients with OIC.
- Categorize various medication options to treat OIC.
- Match the mechanism to each drug class and medication discussed.

Fee Information& Refund/Cancellation Policy: 
There is no fee for this educational activity.

Accreditation:
The American Academy of Pain Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physician Credit Designation:
The American Academy of Pain Medicine designates this enduring material activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The American Academy of Pain Medicine does not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of AAPM. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.  

Disclaimer:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Faculty/Planner Disclosure Policy Statement:
It is the policy of AAPM to plan and implement educational activities in accordance with ACCME’s Essential Areas and Elements to ensure balance, independence, objectivity, and scientific rigor. As an ACCME accredited provider, AAPM is eligible to receive commercial support from commercial interests but cannot receive guidance, either nuanced or direct, on the content of the activity or on who should deliver the content. All program faculty and planners are required to disclose all financial relationships they may have or have had within the last 12 months with commercial interests whose products or services are related to the subject matter of the presentation. Any real or apparent conflicts of interest will be resolved prior to the presentation. All confirmed faculty disclosure information will be made available to participants prior to the activity. Faculty will also be expected to disclose this information to the audience both verbally and in print (slide presentation) at the beginning of each presentation. Faculty members are also required to inform program participants if any unlabeled uses of products regulated by the U.S. Food and Drug Administration will be discussed.

Disclosures - Faculty Presenters:
Charles Argoff, MD, CPE
Professor of Neurology
Albany Medical College
Director
Comprehensive Pain Center
Albany Medical Center Department of Neurology
Albany, NY
Allergan (Honorarium, Speaker); AstraZeneca (Honorarium, Speaker/Consultant); Collegium (Honorarium, Consultant); Daiichi Sankyo (Honorarium, Consultant); Depomed (Honorarium, Speaker); Dong Therapeutics (Research Grant, Principal Investigator); Endo (Research Grant, Principal Investigator); Forest (Research Grant, Principal Investigator); Janssen (Honorarium, Speaker); Lilly (Research Grant, Principal Investigator); Pfizer (Honorarium, Consultant); Purdue (Honorarium, Consultant); Teva (Honorarium, Consultant); Xenoport (Honorarium, Speaker)

Michael Camilleri, MD, MPhil, MRCP, FACP, AGAF
Professor of Medicine, Pharmacology, and Physiology, Mayo Clinic College of Medicine
Consultant, Division of Gastroenterology and Hepatology, Mayo Clinic
Rochester, Minnesota
AstraZeneca (Research grant, Research study); Shionogi (Consulting fee, Advisory board); Takeda (No compensation, Advisory board.)

Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHP
Adjunct Associate Professor
Western New England College of Pharmacy
Western New England University
Springfield, MA
Director
PGY2 Pharmacy Pain Residency
Samuel Stratton VA Medical Center, Pharmacy
Albany, NY
AstraZeneca (Honorarium, Speakers bureau/Advisory Board); Depomed (Honorarium, Advisory Board); Endo (Honorarium, Consultant); Kaleo (Honorarium, Speakers bureau/Advisory Board); Kem Pharm (Honorarium, Consultant); Millennium Health (Honorarium, Speakers Bureau/Advisory Board); Scilex Pharmaceuticals (Honorarium, Consultant.)

Brett Snodgrass, APRN, FNP-C
Family Nurse Practitioner
Director of Clinical Operations
LifeLinc Anesthesia, Memphis, TN
President, BBS Consultants, Olive Branch, MS
AstraZeneca (Honorarium, Speaker); Depomed Pharmaceuticals (Honorarium, Speaker); Iroko Pharmaceuticals (Honorarium, Speaker); McNeil (Honorarium, Speaker); Purdue Pharmaceuticals (Honorarium, Speaker.)
Financial support for this project was provided by educational grants from AstraZeneca Pharmaceuticals LP; Salix Pharmaceuticals, Inc.; Takeda Pharmaceuticals U.S.A., Inc., and Sucampo; and Shionogi Inc.
_______________________________________
Disclosures - Program Planners:
Charles Argoff, MD, CPE
Professor of Neurology
Albany Medical College
Director
Comprehensive Pain Center
Albany Medical Center Department of Neurology
Albany, NY
Allergan (Honorarium, Speaker); AstraZeneca (Honorarium, Speaker/Consultant); Collegium (Honorarium, Consultant); Daiichi Sankyo (Honorarium, Consultant); Depomed (Honorarium, Speaker); Dong Therapeutics (Research Grant, Principal Investigator); Endo (Research Grant, Principal Investigator); Forest (Research Grant, Principal Investigator); Janssen (Honorarium, Speaker); Lilly (Research Grant, Principal Investigator); Pfizer (Honorarium, Consultant); Purdue (Honorarium, Consultant); Teva (Honorarium, Consultant); Xenoport (Honorarium, Speaker)

Michael Camilleri, MD, MPhil, MRCP, FACP, AGAF
Professor of Medicine, Pharmacology, and Physiology, Mayo Clinic College of Medicine
Consultant, Division of Gastroenterology and Hepatology, Mayo Clinic
Rochester, Minnesota
AstraZeneca (Research grant, Research study); Shionogi (Consulting fee, Advisory Board); Takeda (No compensation, Advisory Board.)

Larry C. Driver, MD
Professor, Department of Pain Medicine,
Professor, Department of Critical Care
Division of Anesthesiology and Critical Care
The University of Texas MD Anderson Cancer Center
Houston, TX
Nothing to Disclose

Tracey O. Fremd, NP
Principal, Tracey Fremd Consulting, Inc.
Cameron Park, CA
Tracey Fremd Consulting (Salary, Principal/Consultant); Millennium Health (Honorarium, Speaker); Depomed (Honorarium; Speaker.)

Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHP
Adjunct Associate Professor
Western New England College of Pharmacy
Western New England University
Springfield, MA
Director
PGY2 Pharmacy Pain Residency
Samuel Stratton VA Medical Center, Pharmacy
Albany, NY
AstraZeneca (Honorarium, Speakers bureau/Advisory Board); Depomed (Honorarium, Advisory Board); Endo (Honorarium, Consultant); Kaleo (Honorarium, Speakers bureau/Advisory Board); Kem Pharm (Honorarium, Consultant); Millennium Health (Honorarium, Speakers Bureau/Advisory Board); Scilex Pharmaceuticals (Honorarium, Consultant.)

Vitaly Gordin, MD
Associate Professor of Anesthesiology
Penn State University
Medical Director, Spine Center
Director, Pain Medicine Division
Penn State Hershey Medical Center
Hershey, PA
Nothing to Disclose

Rosemary Polomano, PhD, RN, FAAN
Professor of Pain Practice, Anesthesiology, and Critical Care
University of Pennsylvania School of Nursing
Philadelphia, PA
AcelEx (Honorarium-Consultant/Speaker); Mallinckrodt Pharmaceuticals (Honorarium-Speaker); Salix Pharmaceuticals (Honorarium-Speaker)

Brett Snodgrass, MSN, APRN, FNP-C
Family Nurse Practitioner
Director of Clinical Operations
LifeLinc Anesthesia, Memphis, TN
President, BBS Consultants, Olive Branch, MS
AstraZeneca (Honorarium, Speaker); Depomed Pharmaceuticals (Honorarium, Speaker); Iroko Pharmaceuticals (Honorarium, Speaker); McNeil (Honorarium, Speaker); Purdue Pharmaceuticals (Honorarium, Speaker.)

Lynn R. Webster, MD, FACPM, FASAM
Vice President, Scientific Affairs, PRA Health Sciences
Past President, American Academy of Pain Medicine
Salt Lake City, UT
AstraZeneca Pharmaceuticals (Consultant); Depomed (Advisory Board.)

Jennifer Westlund, MSW
Director of Education
American Academy of Pain Medicine
Chicago, IL
Nothing to disclose

Ashley Marostica, RN, MSN
Nothing to Disclose

Amanda Glazar, PhD
Nothing to Disclose

Laura Gilsdorf
Nothing to Disclose  
Financial Support:
Financial support for the Recommendations on Initiating Prescription Therapies for Opioid-Induced Constipation project was provided by educational grants via the AAPM Foundation from AstraZeneca Pharmaceuticals LP; Salix Pharmaceuticals, Inc.; Takeda Pharmaceuticals International, Inc., U.S. Region and Sucampo; Shionogi Inc.


Endorsed by the AGA Institute
AAPM's Opioid-Induced Constipation on-demand education courses are endorsed by the American Gastroenterological Association (AGA) Institute

Instructions for Course Participants:

This enduring material activity will consist of a didactic presentation accompanied by PowerPoint slides. 
  • While listening to/viewing content, you may pause the presentation at any time to record notes, etc., and re-start where you left off.
  • You are required to view the entire presentation.
  • An evaluation must be completed prior to claiming your certificate.
  • After completing the evaluation, a statement of credit can be generated and printed on your own at your convenience.
For additional assistance, please contact the American Academy of Pain Medicine, 8735 W. Higgins Road, Suite 300, Chicago, IL 60631, 847-375-4731.

Technical Support: 
For further assistance with software requirements contact support@blueskyelearn.com.

Privacy Policy: 
AAPM's privacy policy can be located at: https://painmed.org/privacy-policy