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Connecting the Dots in Fibromyalgia: Linking the Pathophysiology to Improved Diagnostic, Treatment, and Management Decisions (Part 4 of 5)

neuroscienceCME Multimedia Snack

Premiere Date: Wednesday, November 30, 2011

This activity offers CE credit for:

1. Physicians (CME)
2. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Friday, November 30, 2012
Note: Credit Is No Longer Available

Faculty

Lesley M. Arnold, MD (Moderator) Professor of Psychiatry and Behavioral Neuroscience Director, Women's Health Research Program University of Cincinnati College of Medicine Cincinnati, OH

David A. Williams, PhD  Professor of Anesthesiology and Medicine (Rheumatology) Professor of Psychiatry and Psychology Associate Director, Chronic Pain and Fatigue Research Center University of Michigan Ann Arbor, MI

Patrick B. Wood, MD  Clinical Physician Pacific Rheumatology Associates, Inc. PS Renton, WA

Statement of Need

Fibromyalgia is a complex syndrome, and many clinicians are not prepared to either undertake the necessary, comprehensive evaluation for its differential diagnosis or to manage a challenging, frequently misunderstood disorder. In a subscriber survey via the neuroscienceCME Clinical Compassâ„¢, 62.8% of physician respondents lacked confidence in their ability to diagnose and manage fibromyalgia. Fibromyalgia is common, affecting 5 million Americans,(1) and is characterized by widespread muscular and soft tissue pain of varying intensities over time. Evidence-based, thoughtful management treats additional symptoms and comorbidities experienced by many patients with fibromyalgia; most patients present to primary care physicians with a set of complex, overlapping symptoms that are challenging to identify and treat in a timely manner.(2)

This neuroscienceCME Snack will communicate specific, appropriate pharmacotherapeutic options whose selection is based on the biology of fibromyalgia. It will further address diverse symptom domains, including comorbid medical and psychiatric conditions. Faculty experts also discuss influences of catastrophic thinking about pain on pain processing in FM, as well as evidence for chronic pain as a neurodegenerative disease.

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1. Lawrence RC, Felson DT, Helmick CG, et al; for the National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008;58(1):26-35. PMID: 18163497.
2. Russell IJ, Raphael KG. Fibromyalgia syndrome: presentation, diagnosis, differential diagnosis, and vulnerability. CNS Spectr 2008;13:6-11.

Activity Goal

To change clinical thinking to account for the pathophysiology, complexities of contributing factors, and comorbidities of patients with fibromyalgia, enabling participants to improve self-efficacy in fibromyalgia management and apply multimodal and multidisciplinary approaches to treatment that addresses patient expectations and individualizes treatment needs.

Learning Objectives

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

• Accomplish a comprehensive differential diagnosis for each person suspected of having fibromyalgia, one that matches specific manifestations and symptoms of pain to the respective pathophysiological patterns of different kinds of pain, and distinguishes fibromyalgia pain from other contributing factors and the one or more types of pain present in any comorbid illnesses.
• Address patient expectations by optimizing treatment design with combined, multimodal and multidisciplinary approaches that are individualized to pain mechanism, intensity, function, and presence of comorbidities (e.g., depression, fatigue, and sleep disturbances).
• Share a confirmed fibromyalgia diagnosis with patients as soon as possible and immediately initiate patient education regarding the positive impacts of pharmacological and nonpharmacological approaches to treatment of pain associated with fibromyalgia.

Financial Support

Funding for this CME activity is provided by CME Outfitters, LLC.

Target Audience

Physicians and nonphysician health care professionals interested in pain management.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, 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.

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/test (requires free account activation), and participants can print their certificate or statement of credit immediately (80% 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 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 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. Arnold has disclosed that she receives grants/research support from Allergan, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Cypress Bioscience, Inc., Eli Lilly and Company, Forest Laboratories, Inc., Pfizer Inc., and Wyeth Pharmaceuticals. She serves as a consultant to Allergan, Inc., AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Cypress Bioscience, Inc., Eli Lilly and Company, Forest Laboratories, Inc., Pfizer Inc., Sanofi-aventis, Takeda Pharmaceuticals North America, Inc., Theravance, Inc., UCB Pharma, and Wyeth Pharmaceuticals.

Dr. Williams has disclosed that he receives a consulting fee from Cypress Bioscience, Inc., Eli Lilly and Company, Forest Laboratories, Inc., Jazz Pharmaceuticals, and Pfizer Inc. He receives honoraria from Eli Lilly and Company and Forest Laboratories, Inc.

Dr. Wood has disclosed that he serves as the Chief Medical Officer of Angler Biomedical Technologies, LLC.

Tony Graham, MD (content/peer review) has no disclosures to report.

Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Unlabeled Use Disclosure

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC and the faculty, 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).