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Intrathecal Management of Chronic Pain

neuroscienceCME Webcast

Premiere Date: Tuesday, December 8, 2015

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Pharmacists (ACPE)
  4. Other


All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Creditâ„¢

Credit Expiration Date:
Thursday, December 8, 2016
Note: Credit Is No Longer Available

Faculty


Michael Saulino, MD, PhDMichael Saulino, MD, PhD 
Assistant Professor
Department of Rehabilitation Medicine
Sidney Kimmel Medical College
Philadelphia, PA
Physiatrist, MossRehab
Elkins Park, PA

Statement of Need

It is estimated that chronic pain affects 20% to 30% of adults in the United States with more than half of these individuals having had pain for more than five years.1 Intrathecal (IT) therapy has become an increasingly accepted alternative to standard medical management for patients with moderate-to-severe intractable pain. Appropriate patient and treatment selections are imperative to achieving optimum outcomes.2 However, even in the right patient, the right drug may not be efficacious or may result in intolerable adverse effects if the treatment is not initiated properly. Ongoing education is warranted to build and strengthen the use of evidence-based, best practices among clinicians regarding use of IT therapy in pain management.

This activity will feature interactive and engaging faculty experts addressing how to identify patients who are appropriate candidate for IT pain management, implement evidence-based trialing strategies, and devise and implement an IT pain treatment plan that maximizes efficacy and minimizes side effects.


  1. Institute of Medicine [IOM]. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. IOM Website. http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-transforming-Prevention-Care-Education-Research.aspx. Published June 29, 2011. Accessed September 20, 2015.
  2. Mitchell AA, Sapienza-Crawford, AJ, Hanley KL, et al. Administering ziconotide and monitoring patients treated with ziconotide: expert opinion. Pain Manag Nurs. 2013;14(3):e84-e94. PMID: 23972874.

Activity Goal

Learners will implement an evidence- and best practice-based approach to the initiation of intrathecal pain management in all appropriate patients.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Use current, evidence-based, best practice criteria to guide appropriate patient selection for intrathecal (IT) pain treatment.
  • Implement best practice-based trialing strategies as a component of an individualized treatment approach to pain management.
  • Implement a slow dose-titration strategy for IT pain management that maximizes efficacy while minimizing the potential for side effects.

The following learning objectives pertain only to those requesting CNE credit:

  • Describe current, evidence-based, best practice criteria to guide appropriate patient selection for intrathecal (IT) pain treatment.
  • Explain best practice-based trialing strategies as a component of an individualized treatment approach to pain management.
  • Review a slow dose-titration strategy for IT pain management that maximizes efficacy while minimizing the potential for side effects.

Financial Support

Supported by an educational grant from Jazz Pharmaceuticals, Inc.

Target Audience

Pain specialists, physicians, physician assistants, nurse practitioners, nurses, and pharmacists, and other health care professionals who treat patients with chronic pain.

Credit Information

CME Credit (Physicians):
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 Creditâ„¢. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses):
Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.0 contact hours.

Note to Nurse Practitioners and Clinical Nurse Specialists: the content of this activity pertains to pharmacology. Earn up to 1 contact hour of pharmacotherapeutic contact hour.

CPE Credit (Pharmacists):
ACPE as a provider of continuing pharmacy education. 1.0 contact hours (0.1 CEUs)
Universal Activity Number: 0376-0000-15-030-H01-P(recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/TST19054 (requires free account activation), and participants can print their certificate or statement of credit immediately (75% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/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 CME/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. Saulino has disclosed that he has received research and grant support from Jazz Pharmaceuticals, Inc.; Mallinckrodt Pharmaceuticals; and Medtronic, Inc. He is on the speakers bureau of Jazz Pharmaceuticals, Inc. and Medtronic, Inc. He serves as a consultant for Ipsen Biopharmaceuticals, Inc. and SPR Therapeutics. He has received other financial or material support from the Board of Directors of the North American Neuromodulation Society.

Tony Graham, MD (peer reviewer) has nothing to disclose.

Kimberley Murray, RN, MS (peer reviewer) has nothing to disclose.

Robert Kennedy (planning committee) has nothing to disclose.

Sharon Tordoff, CCMEP (planning committee) has nothing to disclose.

Disclosures were obtained from the CME Outfitters, LLC staff: Nothing to disclose.

CME Outfitters, LLC, the faculty, and Jazz Pharmaceuticals, Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).

SPV-005-120815-43

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