Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Pain Pathophysiology Unraveled
UAN 0530-0000-18-047-L01-P
AANP Rx Hours 0.0
Course Description
In order to successfully clinically manage pain, it is essential to begin with an understanding of the underlying mechanisms responsible for its generation. A skillful approach based upon better knowledge concerning the anatomical structures, pathways, and events that result in pain is more likely to lead to effective clinical management of pain. The discussion will include an overview of medication classes typically considered for pain and the pathways they affect.
David M. Glick, DC, DAAPM, CPE, FASPE
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by Arbor Pharmaceuticals, Steven Norris, MD
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - Rational Polypharmacy: An Update for Specific Conditions
UAN 0530-0000-18-048-L01-P
AANP Rx Hours 0.0
Course Description
Multidrug therapy, also known as rational polypharmacy, has been a part of treatment approaches for chronic pain for many years. This course will review the concept of rational polypharmacy as it applies to the treatment of migraine, neuropathic pain, and musculoskeletal pain conditions.
Charles E. Argoff, MD, CPE
10:40a - 11:40a - Botulinum Toxins as Neuromodulators in Chronic Pain Management
UAN 0530-0000-18-086-L01-P
AANP Rx Hours 0.1
Course Description
The emerging role of botulinum toxins as chemical neuromodulators, specifically in the management of chronic intractable painful syndromes, will be presented. There is compelling evidence showing that toxins modulate chronic neurogenic inflammation, commonly expressed as peripheral sensitization leading to central sensitization with allodynia and hyperalgesia. Existing medical literature will be discussed. Several cases successfully managed with type A botulinum toxins will be discussed, including chronic intractable headaches of several etiologies (migraine, posttraumatic, postintracranial bleed, etc), occipital neuralgia, intractable facial pain, temporomandibular joint pain syndromes, postradiation fibrosis, and other focal painful syndromes (ie, distal limb ischemic pain seen in Raynaud's phenomenon, temporal arteritis, and others).
Ramon L. Cuevas-Trisan, MD
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:10p - Product, Disease Awareness, Medical Information Program*
Lunch will be served.
Sponsored by Salix Pharmaceuticals, Naum Shaparin, MD
1:10p - 2:00p - Pain Diagnostics: Clinical Pearls to Improve Common Tests for Pain
UAN 0530-0000-18-046-L01-P
AANP Rx Hours 0.0
Course Description
Diagnostic testing is an integral component for the differential diagnosis. In routine clinical practice there has been a tendency for clinical examinations to become more cursory, largely influenced by increasing demands of time and patient expectations of technological advances. The end result may arguably lead to an overreliance on technology for basic clinical diagnosis. The purpose of this session is 2-fold. It is meant to provide a review and, for some, an introduction to basic structural and functional studies used for the diagnosis of pain related problems. Attention will also be given to the limitations of such studies and the importance of establishing clinical relevance to their findings. Factors that adversely affect clinical management potentially resulting in failed treatment will be discussed as well as best practices when utilizing such studies to help enhance clinical outcomes for treatment.
David M. Glick, DC, DAAPM, CPE, FASPE
2:00p - 2:10p - Break & Exhibits
2:10p - 3:00p - Lost in Translation: Making Sense of Clinical Treatment Guidelines
UAN 0530-0000-18-040-L01-P
AANP Rx Hours 0.0
Course Description
Multiple clinical treatment guidelines have been published regarding headache and pain management. However, many have questioned the benefit of such clinical guidelines for the treatment of individual patients. This course will review key published treatment guidelines for migraine, interventional pain management, chronic opioid use, neuropathic pain, and chronic low back pain. The faculty will review the relevant guidelines and discuss their strengths and critical weaknesses when using such guidelines to actually treat people.
Charles E. Argoff, MD, CPE
3:00p - 3:50p - Osteoarthritis Pain: Past, Present, and Future
UAN 0530-0000-18-044-L01-P
AANP Rx Hours 0.3
Course Description
Pain related to osteoarthritis is extremely common, affecting a very large segment of the adult population. For years, many therapeutic approaches have been used with variable degrees of success. Over time, however, we have learned that some commonly used therapies may be ineffective or, worse yet, can lead to significant harm. In this course, available management methods, including oral agents, topical and physical agents, orthotics, and various injectable agents will be discussed, emphasizing existing and emerging medical evidence with proliferant/reparative agents and support of their use. Basic concepts regarding surgical options and their evidence will also be discussed in order for primary and specialty care providers in the audience to better use these treatment options, and know when to refer and how to educate their patients more effectively.
Ramon L. Cuevas-Trisan, MD
*Not certified for credit.
Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Year of the Locusts: The Impact of the CDC Guidelines on Practitioners and Patients
UAN 0530-0000-18-072-L01-P
AANP Rx Hours 0.0
Course Description
The CDC guidelines have caused controversy and spurred heated discussion. Produced with a paucity of evidence based medicine, they were never evaluated and iterated in the manner of more appropriate guidelines. In this course, we will examine the guidelines and their effect on practitioners--primary care physicians, pain specialists, etc--and chronic pain noncancer patients as well as some chronic cancer patients. Many functioning patients have had their opioid dosages diminished, either in concert with their physician or forcibly, without any say in the matter. This, along with a marked reduction in the amount of legal opioid medications that can be produced, has led to significant unintended consequences: practitioners are leaving the field; some refuse to even prescribe any opioids, mostly due to fear of overregulation; once functional patients are being abandoned by the medical field; patients are searching for something to return them to functionality, which can lead to overdose and death, particularly from heroin and illicit fentanyl. Indeed, the opioid crisis has now become the heroin and fentanyl crisis. During this presentation, solutions, and the changes necessary to bring them about, will be discussed.
Gary W. Jay,
MD, FAAPM, FACFEI
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by Collegium Pharmaceuticals, Miguel de la Garza, MD
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - What's All the "GABA" About? Pregabalin and Gabapentin Abuse
UAN 0530-0000-18-058-L01-P
AANP Rx Hours 0.0
Course Description
The gabapentinoids are a popular class of medications among prescribers for use in chronic pain and various other neurological conditions. In fact, prescription rates for both gabapentin and pregabalin have increased in the United States and other countries in recent years. However, these medications have a street value to a newer niche of users, including patients taking them at megadoses to enhance the effects of other psychotropic drugs, and other patients taking them to manage or mitigate opioid withdrawal symptoms and possibly even opioid cravings. While pregabalin is already classified as a controlled substance, gabapentin does not yet carry this classification. In response to rising abuse, various states and regulatory bodies are considering changes to enhance patient safety and protect the provider's license. Learn what changes you should make to your practice, if any, in light of the growing abuse of gabapentinoids and how to identify patients potentially abusing them.
Abigail T. Brooks, PharmD
10:40a - 11:40a - Diabetic Peripheral Neuropathic Pain: Evaluating Treatment Options
UAN 0530-0000-18-058-L01-P
AANP Rx Hours 0.5
Course Description
According to estimates from the Centers for Disease Control and Prevention, 29.1 million people (close to 10% of the US population) have diabetes and 30% to 50% of them eventually develop diabetic peripheral neuropathy, often with pain. Neuropathic pain due to diabetes is a commonly encountered chronic problem that has increased in frequency as the obese and diabetic population continues to increase. Many pharmacologic approaches including various algorithms are used to treat painful diabetic neuropathy; however, the effectiveness of many such medications is questionable. New evidence, including recent recommendations from the American Academy of Neurology, will be compared and contrasted with a prior systematic review and guideline, published in 2011. Agents and approaches with more recent evidence will be discussed in order to update knowledge of participants and assist them to better manage this disabling ailment.
Ramon L. Cuevas-Trisan, MD
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break, Exhibits, & Lunch
Light lunch will be served
12:10p - 3:20p - Extended-Release and Long-Acting Opioid Analgesics: Risk Evaluation and Mitigation Strategy (REMS)
3.0 AMA PRA Category 1TM Credits [Compliant with the FDA ER/LA Opioid REMS education requirements]
UAN 0530-9999-18-064-L01-P
AANP Rx Hours 0.5
Program Overview: Pain is a significant public health problem, affecting more than 100 million adults in the US and causing significant reductions in patients' quality of life. The use of narcotic medications for pain management has increased dramatically in the US over the past two decades. However, pain patients are often undertreated due to a variety of physician- and patient-related concerns and barriers.
In addition, despite the pain-relieving properties of opioid medications, the potential for abuse remains a concern. In response to this apprehension about opioid misuse, overdose, abuse, and addiction, the Food and Drug Administration (FDA) developed the Risk Evaluation and Mitigation Strategy (REMS) to ensure that the benefits outweigh the risks for long-acting and extended-release opioid analgesics.
The activity, Extended-Release and Long-Acting Opioid Analgesics: Risk Evaluation and Mitigation Strategy (REMS), incorporates the REMS blueprint into education that is designed to induce changes in physician knowledge, competence, and performance that will translate into improved quality of patient care and reduced pain for patients.
Target Audience: This education is intended for primary care providers and other clinicians involved in pain management, and is designed to help them recognize and balance optimal pain reduction to improve function and productivity with minimization of adverse events (e.g. abuse, addiction, and risk of workplace accidents). Additional challenges to optimal pain management include keeping up to date with the increasing volume of information on pain management, implementing changes recommended by evolving guidelines, and recognizing changes to practice needed to combat the growing rate of opioid abuse.
Jointly provided by Global Education Group and Rockpointe
This educational activity is supported by an independent educational grant from the Extended-Release/Long-Acting Opioid Analgesic REMS Program Companies. Please see http://ce.er-laopioidrems.com/IwgCEUI/rems/pdf/List_of_RPC_Companies.pdf for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Extended-Release/Long-Acting Opioid Analgesics REMS education requirements issued by the US Food & Drug Administration.
Lynn Webster, MD
Bill McCarberg, MD
*Not certified for credit.
