Navigating the Challenges in an Era of Opioid Deprescribing: Behavioral Strategies for Patient Engagement and Success

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Description

FREE LIVE ACTIVITY

Date: July 12, 2019
Time: 12:00 PM PDT / 1:00 PM MDT / 2:00 PM CDT / 3:00 PM EDT
Duration: 1 Hour
Format: Didactic, PowerPoint, Question-&-Answer Session

Calls by federal agencies and national organizations to reduce opioid use in order to mitigate opioid-related harms have put pressure on clinicians to prescribe fewer opioids. However, clinicians lack a roadmap for selecting pain patients for whom opioid deprescribing is appropriate and for how to implement a conservative, patient-centered taper that optimizes outcomes.

The faculty will provide strategies to identify which patients could benefit from potential opioid deprescribing, and stratify them into 3 groups: patients who are engaged and open to tapering, patients who are resistant to tapering, and patients with opioid use disorder who may also require medication assisted therapy. In reality, patients in the first 2 groups fall on a range from resistant to emotional readiness, with few patients ready for opioid deprescribing on day 1. The faculty will then equip clinicians with tools and behavioral strategies to facilitate a process that unfolds over several visits to move patients toward psychological and emotional readiness to engage in a taper trial. Key aspects of a collaborative patient-centered taper include patient education, setting expectations, individualizing a slow and flexible schedule, and providing patient support.

Presenters:

Beth D. Darnall, PhD
Associate Professor,
Department of Anesthesiology, Perioperative,
and Pain Medicine
Stanford University School of Medicine,
Palo Alto, California

Aram Mardian, MD
Clinical Associate Professor,
Family, Community, and Preventive Medicine,
University of Arizona College of
Medicine—Phoenix
Founding Chief,
Chronic Pain Wellness Center,
Phoenix VA Health Care System,
Phoenix, Arizona

Learning Objectives:
After participating in this activity, participants will be better able to:

Apply strategies to determine which patients on opioid analgesic therapy might benefit from deprescribing.
Assess patient readiness to taper opioid analgesics (when opioid deprescribing is the goal).
Describe key behavioral strategies to help move patients along the pathway from resistance to readiness to engage with a tapering trial.
Distinguish between clinician behaviors and language that foster patient engagement versus those that foster separation or alienation.
Identify and address patient fears and negative expectations to enhance engagement during patient-centered opioid tapering and minimize nocebo effects.

Target Audience:
This activity was developed to meet the needs of Clinicians treating patients in pain.

Note: This webinar will be recorded and archived to https://pcssnow.org/ within 2 weeks of the live training.

Continuing Education: The American Academy of Pain Medicine (AAPM) provides a live webinar titled “Navigating the Challenges in an Era of Opioid Deprescribing: Behavioral Strategies for Patient Engagement and Success” and offers continuing medical education (CME) for physicians. Successful completion requires that participants register for the webinar, attend and participate, and complete an online post-test and evaluation. Participants receive their CME certificates after they submit their evaluations online.

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

Credit Designation: The American Academy of Pain Medicine designates this live 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.

Funding: Funding for this initiative was made possible (in part) by Providers’ Clinical Support System for Opioid Therapies (grant no. 5H79TI025595) from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reﬂect the ofﬁcial policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

For more information visit: https://pcssnow.org/
For questions email: pcss@aaap.org

Disclaimer: The material presented in this activity represents the opinion of the authors/faculty and not necessarily the view of the American Academy of Pain Medicine.

Instructions for Course Participants:

This activity will consist of a didactic presentation accompanied by PowerPoint slides, live polling questions, and a question-and-answer session.
There is no fee to participate.
You are required to view the entire presentation.
Learners must answer all post-test questions and receive a passing score (minimum 75%) to proceed to the activity evaluation. Learners will be allowed a maximum of three opportunities to successfully receive a passing score.
An evaluation must be completed prior to receipt of your certificate.
After completing the post-test and activity evaluations, a statement of credit will 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.
If you need further assistance with software requirements please contact support@blueskybroadcast.com.

Privacy: To view the AAPM Privacy Policy, visit: https://painmed.org/privacy-policy

Faculty/Planner Disclosures & Policy: It is the policy of AAPM to plan and implement educational activities in accordance with the ACCME to ensure balance, independence, objectivity, and scientific rigor. As an ACCME-accredited provider, AAPM may receive commercial support from industry but does not 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 must be resolved prior to the presentation. Faculty are expected to disclose this information to the audience both verbally and in print (slideshows) at the beginning of each presentation. Faculty 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. Disclosure information appears below.

Disclosure information appears below.

Faculty:
Beth Darnall, PhD
Stanford University School of Medicine
Palo Alto, California
Disclosures:
appliedVR: Chief Science Officer
National Funding:
NIH / NCCIH R01AT008561: Co-Principal Investigator
PCORI (Patient-Centered Outcomes Research Institute®) #1610-3700: Principal Investigator
NIH/ NICHD: Site Principal Investigator

Aram Mardian, MD
University of Arizona College of Medicine—Phoenix
Phoenix VA Health Care System
Phoenix, Arizona
Disclosures:
Site Director for PCORI funded study: No Compensation Received, Investigator
EMPOWER Clinical Trial (https://empower.stanford.edu/): Research Grant to my Institution, Investigator
The views expressed in this presentation are those of the authors and do not reflect the official policy of the Department of Veterans Affairs or US Government.

AAPM Education and CME Oversight Committee:
Larry C. Driver, MD (PCSS Clinical Expert)
University of Texas Distinguished Teaching Professor,
Professor, Department of Pain Medicine,
Professor, Section of Integrated Ethics,
The University of Texas M.D. Anderson Cancer Center,
Houston, Texas
No relevant financial relationships

Vitaly Gordin, MD
Halyard: Honorarium for cadaver training

Michael Harned, MD
Medtronic; Abbott Medical: Honoraria for promotional speaking and/or teaching

Armando Villarreal, MD, MBA
Fruit Street: Ownership interest for Board Membership

The following have no relevant financial relationships:
Magdalena Anitescu, MD, PhD
Bernard Canlas, MD
May Chin, MD
Juan Firnhaber, MD
Susan Moeschler, MD
Thomas Pittelkow, DO, MPH
Marc Sloan, MD

Planners:
Jennifer Westlund, MSW (AAPM Staff Planner)
Director of Education, American Academy of Pain Medicine
No relevant financial relationships

Angela Casey
VP, Director of Scientific Services, PharmaCom Group
No relevant financial relationships

Stephanie Lee
Senior Account Manager, PharmaCom Group
No relevant financial relationships

Disclosure Disclaimer: Please note the disclosure information stated above were relevant financial relationships based upon the 12-month reporting period prior to the live education activity date of July 12, 2019.

Expert Educational Design: This educational activity was planned and facilitated by leaders 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 activity is designed to improve access to quality, evidenced- based multidisciplinary pain care across the healthcare continuum.

Provider: Presented by the American Academy of Pain Medicine and hosted by Blue Sky Broadcast.

Contributors

Beth D. Darnall, PhD

Dr. Darnall is Associate Professor at Stanford University School of Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine. She is affiliated faculty of the Stanford Wu Tsai Neurosciences Institute and is faculty (by courtesy) in Psychiatry and Behavioral Sciences. She is Chief Science Officer at AppliedVR, a digital health therapeutics company. Dr. Darnall is a pain scientist and principal investigator for NIH and PCORI-funded clinical trials that broadly investigate the benefit of behavioral medicine and self-management strategies to manage acute and chronic pain and reduce need for prescription opioids.
Aram Mardian, MD

Dr. Mardian is clinical associate professor of Family, Community, and Preventive Medicine at the University of Arizona College of Medicine – Phoenix, is a board-certified family physician, and holds additional certifications in addiction medicine, pain medicine, and medical acupuncture. He is the founding Chief of the Chronic Pain Wellness Center at the Phoenix VA Health Care System, which has developed into a model for interprofessional whole person care for patients with pain and opioid use disorder. Dr. Mardian was a contributor for the Arizona Opioid Prescribing Guidelines published in 2014 and 2018 and a workgroup member for the VA/DoD Clinical Practice Guideline “Management of Opioid Therapy for Chronic Pain” published in February 2017. He serves as Co-Chair for the Health Care Advisory Team for the Arizona Prescription Drug Misuse & Abuse Initiative and Co-Chair for the Arizona Pain and Addiction Curriculum Workgroup.