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Case Challenges in Opioid-induced Constipation

Gastroenterology
Curriculum:
Opioid-induced Constipation
Credits:
1 ANCC Contact Hours 1 AMA PRA Category 1 Credit(s) ™
Launch Date:
November 30, 2015
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Primary care clinicians and palliative care providers; including physicians; nurse practitioners; physician assistants; and nurses who are treating patients that are taking prescription opioids for chronic pain.

Relevant Terms:

Opioid-induced constipation; chronic pain

H. Christian Weber, MD

H. Christian Weber, MD
Associate Chief and Clinical Director
Gastroenterology and Hepatology
VA Boston Healthcare System
Assistant Professor of Medicine
Assistant Professor of Pathology and Laboratory Medicine
Boston University School of Medicine
Boston, MA

Dr. Weber joined the faculty of Boston University School of Medicine as Assistant Professor of Medicine in the Section of Gastroenterology in 1997. Dr. Weber is a native of Germany and graduated from Hamburg University Medical School. He completed his training in internal medicine at the University of Mainz, Germany, and at the MetroWest Medical Center in Framingham, MA, and his fellowship in gastroenterology at Georgetown University Medical Center and the National Institutes of Health. He is board-certified in gastroenterology.
 
Dr. Weber's research focuses on the biology and clinical aspects of gastrointestinal hormones. His clinical interests include obesity, gastric acid-related disorders, such as peptic ulcer disease and gastro-esophageal reflux disease (GERD), functional bowel disorders, such as irritable bowel syndrome (IBS), and genetic disorders of the gut. He is a nationally recognized authority in the field of gastrointestinal neuroendocrine tumors (NET), including Zollinger-Ellison syndrome, and has authored or co-authored numerous peer-reviewed original publications, book chapters, reviews and abstracts. Dr. Weber is a member of several professional societies including the American Gastroenterological Association (AGA) and American College of Gastroenterology (ACG) and is also member of editorial boards of several professional journals.
 

Jason Worcester, MD

Jason Worcester, MD
Associate Medical Director
Adult Primary Care Assistant Professor of Medicine
Boston University School of Medicine
Boston, MA

Dr. Worcester is the Associate Medical Director of the Adult Primary Care Practice at the Shapiro Ambulatory Care Center in Boston, Massachusetts. His interests include medical education, preventative medicine, preoperative medicine, addiction medicine and clinical practice administration.
 
 
 
 
 
 
 
 
 

Donna Beers, BSN, RN-BC, CARN

Donna Beers, BSN, RN-BC, CARN
Manager, Primary Care Clinical Transformation
Boston Medical Center
Boston, MA

Donna Beers BSN, RN-BC, CARN has over 25 years of nursing experience. In addition to having her certification in addictions nursing, she is also board certified in pain management nursing. Ms. Beers works at Boston Medical Center as the Manager of Primary Care Clinical Transformation. After working on NIDA-funded randomized control trial looking at improving the safety of opioid prescribing in Primary Care, she expanded the program into an interdisciplinary practice-wide approach designed to improve the health care experience for both the patient and provider, and improve the safety of the patients and community. She has extensive experience providing overdose prevention education and naloxone distribution, and well as working with out-of-treatment medically hospitalized substance users.
1. Regularly screen patients on opioids for opioid-induced constipation.
2. Correctly diagnose opioid-induced constipation.
3. Competently manage patients with opioid-induced constipation employing a range of non-pharmacological and pharmacological approaches.
4. Employ strategies for treating refractory opioid-induced constipation.

Statement of Need
All patients taking a pain medication containing an opioid are at risk for developing adverse effects, specifically opioid-induced constipation (OIC). Therefore all patients being considered for or currently on chronic opioid therapy should be assessed for OIC risk. Because OIC may present with a variety of nonspecific symptoms such as abdominal pain, bloating and decreased bowel movement frequency, clinicians need to be proactive in identifying and managing OIC in all their patients on chronic opioid therapy.
 
This two-part CME/CNE-certified online publication provides real-world case examples that focus on increasing healthcare clinicians competence and performance in screening, diagnosing, treating, and managing, in partnership with the patient, opioid induced constipation. Participants will learn about: tools to screen patients and talk to them about OIC; criteria and symptoms to better diagnose OIC; and OIC therapeutic options and individualizing patients’ management plans.
 
Faculty Disclosures
Boston University School of Medicine asks all individuals involved in the development of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve any apparent conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and devices is being discussed.
 
H. Christian Weber, MD
CME Course Director
Associate Chief and Clinical Director
Gastroenterology
VA Boston Healthcare System
Assistant Professor of Medicine
Assistant Professor of Pathology and Laboratory Medicine
Boston University School of Medicine
Faculty has disclosed that he is a consultant for Actavis, AstraZeneca, GLG Pharma, and Guidepoint Global. He does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Jason M. Worcester, MD
Associate Medical Director,
Adult Primary Care Assistant Professor of Medicine
Boston University School of Medicine
Faculty has no relevant financial relationships with any commercial interest and does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Donna Beers BSN, RN-BC, CARN
Manager, Primary Care Clinical Transformation
Boston Medical Center
Faculty has no relevant financial relationships with any commercial interest and does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Kristen Stakelin, MD
Peer Reviewer
Assistant Professor of Medicine
University of Kentucky College of Medicine
Faculty has no relevant financial relationships with any commercial interest and does not plan on discussing unlabeled/investigational uses of commercial support.
 
Siobhan Nevin, RN, BSN, CWOCN
CNE Course Advisor
Inflammatory Bowel Disease Center
Boston Medical Center
Faculty has no relevant financial relationships with any commercial interest and does not plan on discussing unlabeled/investigational uses of a commercial product.
 
Accreditation Planning
Patti-Ann Collins, DNP, MSN/MBA, RN, Lead Nurse Planner, has no relevant financial relationships with any commercial interest.
Dana Frazier, CHCP, planner, has no relevant financial relationships with any commercial interest.
Julie White, MS, planner, has no relevant financial relationships with any commercial interest.
 
Accreditation Statements
Boston University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Boston University School of Medicine designates this enduring educational 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.

Continuing Nursing Education Provider Unit, Boston University School of Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
CNE Contact Hours: 1.0 all of which are eligible for pharmacology credit.

Nurses will receive contact hours after completion of an evaluation and claim for credit form.
 
Estimated time to complete: 1.0 hour
 
How To Receive Credit
By reviewing the course content and successfully completing the post-test and evaluation, physicians are entitled to receive 1.0 AMA PRA category 1 credits™, nurses are entitled to receive 1.0 CNE contact hours, all of which are pharmacology credit worthy. Statement of credit will be available to print from your user history page.
  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Successfully complete the post-test, activity evaluation, and claim credit. A post-test score of 70% or higher is required, and you may retake the post-test 3 times to achieve a passing score.
  • Your certificate will be available to print from your user history page.
NOTE: EARN ADDITIONAL CREDITS
This activity is part of a curriculum with multiple activities. You will be alerted of the next activity(ies) in the curriculum when they become available. Additional credit is available for each additional activity. 
 
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Commercial Support
This activity is supported by an independent educational grant from AstraZeneca Pharmaceuticals LP and Takeda Pharmaceuticals International, Inc., U.S. Region.
 
DISCLAIMER
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKES NO WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL TRUSTEES OF BOSTON UNIVERSITY BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.
 
 
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