Applying Patient-Centered Pain Care to Practice: A Case of Unexplained Pain Onset

This activity is part of a series

Faculty

Melissa Weimer, DO, MCR, FASAM
Associate Professor of Medicine and Public Health, Yale School of Medicine and Yale School of Public Health
Medical Director, Addiction Medicine Consult Service, Yale New Haven Hospital, New Haven, CT
Melissa Weimer, DO, MCR, FASAM

Dr. Melissa B. Weimer, DO, MCR, FASAM, is an Associate Professor of Medicine and Public Health at Yale School of Medicine and Yale School of Public Health. She is a clinician-educator who is board certified in both Internal Medicine and Addiction Medicine. She is the Director of the Yale Addiction Medicine Consult Service at Yale New Haven Hospital and Associate Program Director for the Yale Addiction Medicine Fellowship program. Dr. Weimer has a clinical and research focus on improving the care of patients with addiction and its associated comorbidities, particularly in the hospital setting, and has specialty expertise in the treatment of complex pain. She is also passionate about expanding the workforce of healthcare professionals who can treat individuals with substance use disorders.

Kiran V. Patel, MD
Interventional Pain, The Spine & Pain Institute of New York
Director of Neurosurgical Pain, Lenox Hill Hospital
Assistant Clinical Professor, Department of Anesthesiology & Pain Medicine, Hofstra School of Medicine
Program Director, Pain Medicine Fellowship Hofstra Northwell School of Medicine, New York, NY
Kiran V. Patel, MD

Kiran V. Patel, MD is board certified in pain management and anesthesiology. She completed both her Interventional Pain Medicine fellowship and Anesthesiology residency at the prestigious Columbia University Medical Center-New York Presbyterian Hospital.

Dr. Patel is the Director of Neurosurgical Pain at Lenox Hill Hospital and the Pain Medicine Fellowship Program Director at the Hofstra Northwell School of Medicine. She is currently in private practice at the Spine & Pain Institute of New York. Dr. Patel specializes in the treatment of back and neck pain caused by arthritis, degenerative disc disease, spinal stenosis and pain following spine surgery. She also has expertise in treating neuropathic pain, cancer related pain, reflex sympathetic dystrophy (RSD), atypical facial pain, pelvic pain, headache, and peripheral neuralgias.

Statement of Need

Effective management of chronic pain requires an understanding of the underlying pathophysiologic mechanisms that contribute to the sensation of pain. Identifying the different types of pain a patient is experiencing is essential to choosing the appropriate management approach for an individual patient. Practical implementation of diagnostic and assessment tools for differentiation between nociceptive, neuropathic and nociceptive pain can be challenging for clinicians due to time constraints and lack of training. Additionally, distinguishing acute and chronic pain pathways, as well as differentiating acute, subacute (a new term introduced in the 2022 updates to the CDC Guideline for Prescribing Opioids for Chronic Pain), and chronic pain are vital pieces to the puzzle of optimal pain management.

This first installment of a REMS BriefCase series will provide learners with an in-depth review of the underpinnings of pain, implementing a workflow for pain evaluation and risk assessment tools, and how to incorporate multimodal treatment plans in practice to improve the overall health-related quality of life (HRQL) in patients with chronic pain.

Learning Objectives

At the end of this CME/CE activity, participants should be able to apply knowledge of acute and chronic pain pathways and underlying mechanisms to clinical assessment and appropriate management of pain.

Financial Support

This activity is supported by an independent educational grant from the Opioid Analgesic REMS Program Companies.

Please click here for a listing of REMS Program Companies. This activity is intended to be fully compliant with the Opioid Analgesic REMS education requirements issued by the US Food and Drug Administration (FDA).

Target Audience

Physicians, surgeons, dentists, PAs, nurse practitioners, nurses, and pharmacists.

Credit Information

Jointly Accredited Provider

In support of improving patient care, CME Outfitters, LLC, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians (ACCME) 1.0

CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. CME Outfitters, LLC, designates this enduring material 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.

Nurses (ANCC) 1.0

This activity is designated for 1.0 contact hour.

Note to Nurse Practitioners

Nurse Practitioners can apply for AMA PRA Category 1 Credit through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

Family Physicians (AAFP) 1.0

The AAFP has reviewed the activity and deemed it acceptable for up to 1.00 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval expires with the expiration date of the credit availability. Physicians should claim only the credit commensurate with the extent of their participation in the activity. AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 Credit™ toward the AMA Physician's Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

Note for California Nurses

This continuing nursing education activity was approved by the California Board of Registered Nursing. CME Outfitters LLC’s provider number is CEP15510.

Pharmacists/Pharmacy Tech (ACPE) 1.0

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit.
Activity UAN: JA0007185-0000-22-117-H01-P

Dentists (ADA CERP) - 0.75

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PAs (AAPA) 1.0

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ABIM MOC

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Royal College MOC

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

MIPS Improvement Activity

This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.


Dr. Weimer reports the following financial relationships: Consultant: CVS Health and Path CCM, Inc.


Dr. Patel reports the following financial relationships: Advisory Board: Abbott; Averitas Pharma, Inc.; BIOTRONIK, Inc.; Boston Scientific Corporation; Mainstay Medical; and Relievant Medsystems, Inc. Research Support: Abbott; Speakers Bureau: Abbott; Mainstay Medical; and Relievant Medsystems, Inc.

The following peer reviewer and CME Outfitters staff have no financial relationships:

  • Shirley Michelle Franks, MSN, APRN, FNP-BC (peer reviewer)
  • Thomas W. Heinrich, MD (planning committee AAFP)
  • Evan Luberger (planning committee)
  • Kellie Busby, PharmD (planning committee)
  • Kasey Brandt, PharmDr (planning committee)
  • Susan H. Yarbrough, CHCP (planning committee)
  • Sandra Caballero, PharmD (planning committee)
  • Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credit

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NOTE: Pharmacist CE Universal Activity Number, Enduring: JA0007185-0000-22-117-H01-P.

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Applying Patient-Centered Pain Care to Practice: A Case of Unexplained Pain Onset
Event Date: 12/23/2022