Essential Concepts in Improving Outcomes for Managing Breakthrough Cancer Pain: Opportunities and Challenges

Essential Concepts in Improving Outcomes for Managing Breakthrough Cancer Pain: Opportunities and Challenges
Program Summary

Breakthrough cancer pain (BTCP) is usually managed by oncologists, occasionally with input from specialists in hospice and palliative medicine (PLM) or pain medicine (PMD). The goal for breakthrough cancer pain management is to achieve balance in the appropriate use of opioids however the definition of “balance” is continually being modified. Palliative care professionals, pain specialists, and oncologists have long been advocating for the aggressive management of breakthrough pain for patients with advanced cancer. Some progress has been made in this arena but barriers persist. Fear of addiction by patients, family members, and oncology professionals presents a serious obstacle to the provision of adequate pain control.

This growing concern has led to more opioid regulation, which increases obstacles to pain management in the cancer patient population. Another evolving concern is whether the long-term use of opioids is safe and effective. Data from the chronic nonmalignant pain literature suggest that toxicities may result and misuse has been underestimated; yet little information is available in the cancer population. These issues lead to serious questions regarding how balance might be successfully achieved for patients in an oncology setting. Can pain relief be provided while reducing negative consequences of treatment?  Which patient should be prescribed what medications, in what situations, for what kind of pain, and who should be managing the pain?

Given the demand placed upon busy clinicians and their priority in managing disease progression, it can be difficult to stay abreast of the most recent developments and changes in managing breakthrough pain. This educational activity will help clinicians understand the rationale and data supporting available options, including efficacy and toxicity profiles, to develop a personalized strategy for each patient, based on tumor profile, clinical characteristics, and individual preferences
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Audience: This activity was planned to meet the educational needs of hematologists/oncologists, oncology nurses, advanced practice nurses, nurse practitioners, palliative care physicians, pain management specialists, pharmacists and other healthcare professionals involved in the treatment of patients with breakthrough cancer pain (BTCP).
Learning Objectives:

1. Describe the pathophysiology and characteristics of breakthrough pain, its prevalence, and the negative impact on patients
2. 
Discuss the characteristics of ideal breakthrough pain treatments, available options, and investigational agents
3. 
Evaluate the concepts of dependence, addiction, and diversion; ways to minimize risk in cancer patients taking opioids; and      strategies to address issues
4. 
Apply shared decision-making resources (SDM) to improve collaboration with clinician and patient in order to provide               optimal breakthrough cancer pain management outcomes by providing best standard of care
Accreditation Information:

In support of improving patient care, Rush University Medical Center 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.

Rush University Medical Center designates this live activity for a maximum of one (1) AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

Rush University Medical Center designates this live activity for a maximum of one (1) continuing nursing education credit(s).


Essential Concepts in Improving Outcomes for Managing Breakthrough Cancer Pain: Opportunities and Challenges is eligible for one (1) ONCC/ILNA recertification points in the following categories: Scientific Basis for Practice; Treatment Modalities.

Rush University Medical Center designates this knowledge based CPE activity for (1) contact hours for pharmacists.

Rush University designates this live activity for 1 Continuing Education credit(s).

This activity is being presented without bias and without commercial support.

Audience: This activity was planned to meet the educational needs of hematologists/oncologists, oncology nurses, advanced practice nurses, nurse practitioners, palliative care physicians, pain management specialists, pharmacists and other healthcare professionals involved in the treatment of patients with breakthrough cancer pain (BTCP).
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