8th Annual Legacy Lecture, "My Journey Through the Maze of Pain"

Learning Objectives

As a result of participating in this activity, learners will be better able to:

Empathize with the impact that pain has on the person with pain and their lifestyle
Discuss how the impact of treatment plays a role in the treatment outcomes
Empower persons with chronic pain to become active agents in their care and treatment

Critical Questions

What are the expectations of the individual person with pain?
What happens between appointments with their health care plan and lifestyle changes?
How do you really know if they are following through with necessary activities?
What do we need to change in order to improve care?
Are the goals of treatment realistic for the person with pain?

Accreditation & Designation

Release date: This activity was released 12/16/2022.

Termination date: The content of this activity remains eligible for CME Credit until 12/15/2025, unless reviewed or amended prior to this date.

Claiming Credit: Watch the entire presentation and complete the Improvement Plan/Evaluation

Neurovations Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Neurovations Education designates this other activity (blended learning) for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Desirable Physician Attributes

Patient Care [ACGME/ABMS] Provide care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health
Provide Patient-centered Care [IOM] Identify, respect, and care about patients’ differences, values, preferences and expressed needs; listen to, clearly inform, communicate with, and educate patients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion of healthy lifestyles, including a focus on population health
Interpersonal and Communication Skills [ACGME/ABMS] Effective information exchange and teaming with patients, their families, and other health professionals
Professionalism [ACGME/ABMS] As manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

Pain management domains and core competencies

1. Multidimensional nature of pain: What is pain?
- Describe the impact of pain on society
- Explain how cultural, institutional, societal, and regulatory influences affect assessment and management of pain

2. Pain assessment and measurement: How is pain recognized?
- Assess patient preferences and values to determine pain-related goals and priorities
- Uses and models language that destigmatizes pain, reflects a whole-person perspective, builds a therapeutic alliance, and promotes behavior change
- Demonstrates empathic, compassionate, and professional communication during pain assessment

3. Treatment: How is pain safely and effectively treated?
- Empowers patients to recognize and apply health promotion and self-management strategies

Disclosure of Financial Relationships & Measures to Resolve of Conflicts of Interest

[Host, uninvolved in CME planning and development] Eric Grigsby discloses the following financial relationships within the past 24 months: Research: Seikagaku Corporation, Eli Lilly, Xalud, Medtronic, Neuronetics, NatureCell; Consulting: Bioness, Bioventus, Medtronic

No other person with control of, or responsibility for, the planning, delivery, or evaluation of accredited continuing education has, or has had within the past 24 months, financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships have been mitigated. Materials were reviewed in advance of the activity by person(s) that do not have conflicts of interest related to the content. In some cases, content may have been modified as part of the review and mitigation process. All clinical recommendations are evidence-based and free of commercial bias (e.g., peer-reviewed literature, adhering to evidence-based practice guidelines).

Additional Reading

Payne, R., Anderson, E., Arnold, R., Duensing, L., Gilson, A., Green, C., ... & Shuler, N. (2010). A rose by any other name: pain contracts/agreements. The American Journal of Bioethics, 10(11), 5-12.
Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., ... & Carr, D. B. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113(1), 9-19.
Dworkin, R. H., Turk, D. C., Revicki, D. A., Harding, G., Coyne, K. S., Peirce-Sandner, S., ... & Farrar, J. T. (2009). Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). Pain, 144(1-2), 35-42.
Mackey, S. (2014). National pain strategy task force: the strategic plan for the IOM pain report. Pain Medicine, 15(7), 1070-1071
IOM (Institute of Medicine). 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press.
Todd, K. H., Cowan, P., Kelly, N., & Homel, P. (2010). Chronic or recurrent pain in the emergency department: national telephone survey of patient experience. Western Journal of Emergency Medicine, 11(5), 408.
Henry, S. G., Paterniti, D. A., Feng, B., Iosif, A. M., Kravitz, R. L., Weinberg, G., ... & Verba, S. (2019). Patients’ experience with opioid tapering: A conceptual model with recommendations for clinicians. The Journal of Pain, 20(2), 181-191.
Elder, C. R., DeBar, L. L., Ritenbaugh, C., Rumptz, M. H., Patterson, C., Bonifay, A., ... & Deyo, R. A. (2017). Health care systems support to enhance patient-centered care: lessons from a primary care-based chronic pain management initiative. The Permanente Journal, 21.
Cowan, P. (2013). Support groups for chronic pain. In Handbook of Pain and Palliative Care (pp. 639-648). Springer, New York, NY.
IOM (Institute of Medicine). 2011. Patients charting the course: Citizen engagement and the learning health system: Workshop summary. Washington, DC: The National Academies Press