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ACTHIV 2017 - Chronic Pain in HIV Primary Care: A Practical, Evidence-Based Approach

ACTHIV 2017 - Chronic Pain in HIV Primary Care: A Practical, Evidence-Based Approach
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ACTHIV
Original Presentation: 4/21/2017
Web Posting: 9/15/2017
CE Expiration: 09/15/2018

The enduring material is jointly provided by William Beaumont Hospital, American Academy of CME, Inc., and the American Conference for the Treatment of HIV (ACTHIV).

The 11th Annual American Conference for the Treatment of HIV (ACTHIV) was held April 20-22, 2017 in Dallas, TX. The Conference was supported by funding from the Clinical Education Initiative, New York State Department of Health, AIDS Institute; and from the HIV Medicine Association (HIVMA). The conference and this web archive were supported by educational grants from Bristol-Myers Squibb; Gilead Sciences; Janssen Therapeutics, Division of Janssen Products, LP; Merck & Co.; and ViiV Healthcare.

ONLINE CE CREDIT:

To obtain online CE credit, please follow this link to the course post-test quiz and follow the instructions.

FACULTY:
Jessica Merlin, MD, MPH, Assistant Professor of Medicine at University of Alabama at Birmingham.

Estimated time to complete: 33 minutes

TARGET AUDIENCE
Physicians (both specialists and primary care/family medicine), nurse practitioners, and nurses who are frontline providers of care to persons at risk of or with HIV infection. Physician assistants, pharmacists, case managers and other healthcare professionals may also participate.

Learning Objectives
As a result of participating in this activity, participants should be better able to:

  • Develop an evidence-based approach to the overall evaluation and management of chronic pain in people living with HIV
  • Assess the risks and benefits of long-term opioid therapy in HIV-infected individuals with chronic pain (including risks in those who are not yet on opioids and those in whom opioid continuation is being assessed)

ACCREDITATION

Physicians:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of William Beaumont Hospital, American Academy of CME, Inc., and the American Conference for the Treatment of HIV (ACTHIV). William Beaumont Hospital is accredited by the ACCME to provide continuing medical education for physicians.

William Beaumont Hospital designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses and Nurse Practitioners:

American Academy of CME, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

American Academy of CME, Inc. designates this educational activity for 0.5 contact hours (0.4 pharmacotherapeutic contact hours).

Physician Assistants:

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 0.5 hours of Category I credit for completing this program.

There is no fee to participate in this activity.

HOW TO RECEIVE CREDIT

In order to obtain your certificate of credit, you must:

  • read the CME/CE information and review the full content of the activity
  • achieve a passing grade on the post-test (70% or greater), and
  • complete the evaluation.

Your certificate for the activity will be made available immediately to print online.

DISCLOSURES

According to the disclosure policy of Academy and Beaumont, all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relevant relationships with any commercial interests related to this activity. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity and levels of evidence. Disclosures will be made known to the participants prior to the activity.

The opinions expressed in this educational activity are those of the faculty, and do not represent those of the Academy, Beaumont, ACTHIV or the American Nurses Credentialing Council’s Commission on Accreditation. This educational activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.

Off-Label Usage Disclosure

This activity contains off-label discussion.

Faculty Disclosure

Jessica Merlin, MD, MPH, has no relevant financial relationships with commercial interests.

Planner Disclosures

The following planners have indicated they have no relevant financial relationships to disclose: Bruce Agins, MD; John T. Brooks, MD; Gina Brown, MD; Maggie Chartier, PhD, MPH; Vanessa Elharrar, MD, MPH; Monica Gandhi, MD, MPH; John JD Juchniewicz, MCIS, CHCP; Bill G. Kapogiannis, MD; Natalie Kirkwood, RN, BSN, JD; Harry Lampiris, MD; Sharon Lee, MD; Edward Moylan, RP; Tonia Poteat, PhD, MPH, PA-C; Asa E. Radix, MD, MPH; Dianne Rausch, PhD; Polly E. Ross, MD; Cheryl Smith, MD; Brooke J. Taylor, MPH, CHCP; Carole Treston, RN, MPH, ACRN, FAAN; Ronald Dean Wilcox, MD; Barbara A. Young, MSW, LCSE, LCADC, SAC

The following planners have indicated they have relevant financial relationships to disclose:

Laura Armas-Kolostroubis, MD: Advisory Board: Bristol-Myers Squibb, Janssen Therapeutics, Theratech; Promotional Speakers Bureau: Gilead Sciences
Roger Bedimo, MD: Advisory Board: Bristol-Myers Squibb, Merck & Co., Theratechnologies; GrantRecipient/Research Support: Merck & Co, Bristol-Myers Squibb.
Carlos del Rio, MD: Board Member: HIVMA, IAS-USA
Donna Futterman, MD: Grant/Research Support: Gilead Sciences
Joel Gallant, MD, MPH: Advisory Boards: Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Merck & Co., ViiV Healthcare/ GlaxoSmithKline; Grant/ Research Support: AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics, Merck & Co., Sangamo BioSciences, ViiV Healthcare/GlaxoSmithKline
Rajesh Gandhi, MD: Educational - Grant/Research Support: EBSCO, Gilead Sciences, Merck & Co., ViiV Healthcare
Sharon Hillier, PhD: Advisory Board: Merck & Co., Perrigo; Consultant Cepheid, Symbiomix; Grant/Health Support: Symbiomix
Margaret Hoffman-Terry, MD, FACP, AAHIVS: Advisory Board: Merck & Co.; Consultant: Gilead Sciences, Merck & Co., ViiV Healthcare; Grant/Research Support: Gilead Sciences, ViiV Healthcare; Promotional Speaker’s Bureaus: Gilead Sciences, Merck & Co., ViiV Healthcare
Vincent Lo Re, MD, MSCE: Board Member: International Society for Pharmacoepidemiology; Grant/Research Support: AstraZeneca
Michael J. Mugavero, MD, MHSc: Advisory Board: Bristol-Myers Squibb, Gilead Sciences; Consultant: Abt Assoc., Bristol-Myers Squibb, Gilead Sciences, Merck & Co.; Grant/Research Support: Bristol-Myers Squibb
Renslow Sherer, MD: Advisory Board: Gilead Sciences; GrantRecipient/Research Support: Gilead Sciences, Janssen Therapeutics
William R. Short, MD, MPH: Advisory Board: Gilead Sciences, Janssen Therapeutics; Consultant: Gilead Sciences, Janssen Therapeutics; Promotional Speakers Bureaus: Gilead Sciences, Janssen Therapeutics
Kathleen E. Squires, MD: Advisory Board: Bristol-Myers Squibb, Gilead Sciences, Merck & Co., Janssen Therapeutics, ViiV Healthcare; Consultant: Merck & Co.; GrantRecipient/Research Support: Gilead Sciences
Melanie Thompson, MD: GrantRecipient/Research Support: Bristol-Myers Squibb, GlaxoSmithKline, Gilead Sciences, Merck & Co., Sharp Dohme, Roche Molecular Systems, TaiMed Biologics, ViiV Healthcare
Andrea Weddle, MSW: Advisory Board (ACA): Janssen Therapeutics
Susan Ellen Weiss, FNP: Advisory Board: Gilead Sciences; Consultant: Gilead Sciences, Merck & Co.; Board Member: AAHIVM; Promotional Speaker’s Bureau: Bristol-Myers Squibb, Gilead Sciences, Janssen Therapeutics

Privacy Policy
For more information about Beaumont's privacy policy, please access https://www.beaumont.org/patients-families/patients-rights-privacy/privacy
For more information about Academy privacy policy, please access http://www.academycme.org/privacy.htm

For CME information or credit details, contact: cme@beaumont.edu

For CNE information or credit details, contact: CEServices@academycme.org

Hardware/Software Requirements To access this activity hardware and software requirements are noted below.

Windows Requirements: • Operating system: Windows XP Service Pack 2 or later • Browser: Internet Explorer 7 or later, Mozilla Firefox 2.5 or later • Internet connection: DSL, cable modem, or other high-speed connection • Flash: Adobe Flash Player 9 or later
Macintosh Requirements: • Operating system: Mac OS X v10.3 or later • Browser: Mozilla Firefox 2.5 or later • Internet connection: DSL, cable modem, or other high-speed connection • Flash: Adobe Flash Player 9 or later

Copyright 2017. American Academy of CME, Inc., William Beaumont Hospital, and American Conference for the Treatment of HIV.

Bibliographic Sources:

  • Krebs EE, et al. Development and Initial Validation of the PEG, a Three-item Scale Assessing Pain Intensity and Interference. J Gen Intern Med. 2009 Jun; 24(6): 733–738.
  • Managing Pain Before It Manages You Fourth Edition by Margaret A. Caudill ISBN 9781462522774
  • Motivational Interviewing: A Guide for Medical Trainees 1st Edition by Antoine Douaihy (Editor), Thomas M Kelly (Editor), Melanie A Gold (Editor) ISBN 978-0199958184
  • CDC Guideline for Prescribing Opioids for Chronic Pain. Available at: https://www.cdc.gov/drugoverdose/prescribing/guideline.html

Presenter
  • Jessica Merlin, MD, MPH
    Assistant Professor
    University of Alabama at Birmingham
Presenter Bio
Jessica Merlin, MD, MPH
Jessica Merlin, MD, MPH, received her MD from the University of Pennsylvania. She stayed at Penn for her residency in internal medicine and fellowship in infectious diseases, and then completed a palliative care fellowship at Mt. Sinai. In 2011, Dr. Merlin joined the faculty at the University of Alabama at Birmingham (UAB). Dr. Merlin is the medical director of the Pain and Palliative Care Clinic at UAB’s HIV patient-centered medical home. Her research focuses on chronic pain in individuals with HIV, and more generally, individuals with comorbid mental illness and addiction. She currently holds a K23 career development award from the National Institutes of Health to develop a behavioral intervention for chronic pain tailored to individuals with HIV. Her program of research also includes the pathophysiology of chronic pain in individuals with HIV, including investigating pain sensitivity and the role of inflammation, the clinical epidemiology of chronic pain in individuals with HIV, and management approaches to concerning behaviors in patients prescribed long-term opioid therapy.