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Changes in Palliative Care and Pain Management

neuroscienceCME Multimedia Snack

Premiere Date: Tuesday, November 20, 2012

This activity offers CE credit for:

  1. Physicians (CME)
  2. Pharmacists (ACPE)
  3. Other

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

Credit Expiration Date:
Wednesday, November 20, 2013
Note: Credit Is No Longer Available


Amy L. Mestemaker, MDAmy L. Mestemaker, MD (Moderator)
Medical Director
HomeReach Hospice/Kobacker House
Clinical Instructor for Pain and Palliative Medicine
The Ohio State University Department of Internal Medicine
Columbus, OH

Phyllis A. Grauer, RPh, PharmD, CGP, CPEPhyllis A. Grauer, RPh, PharmD, CGP, CPE 
Clinical Consultant
HospiScript Services, LLC
Clinical Assistant Professor
The Ohio State University College of Pharmacy
Columbus, OH

Charles W. Mason, DO, CMDCharles W. Mason, DO, CMD 
Geriatric Medicine
Riverside Methodist Hospital
HomeReach Hospice
Clinical Associate Professor of Family Medicine
The Ohio University College of Osteopathic Medicine
Clinical Associate Professor of Family Medicine
Ohio State University
Columbus, OH

Statement of Need

The management of palliative pain for patients with terminal diseases is a multifaceted process that requires the frequent adjustment of both medications for pain itself, e.g., opioids, and for comorbid conditions, e.g., cancer, depression, or chronic obstructive pulmonary disease.(1) Clinicians must learn to manage complex combinations of medications in patients whose health is continuously in decline, a reality that brings to light psychosocial and family dynamics. Furthermore, in order to ensure that treatments are appropriately selected, consideration must be given to the potential for neurotoxicity, as well as to the type of pain occurring in each individual patient.

This neuroscienceCME Snack will provide an overview of the types of pain, strategies for pharmacological treatment of pain, and identification of opioid-induced neurotoxicity to optimize management of pain and quality of life for patients receiving palliative care.

  1. Brunnhuber K, Nash S, Meier DE, Weissman DE, Woodcock J. Putting evidence into practice: palliative care. BMJ Group. website Spring 2008. Accessed December 5, 2011.

Activity Goal

To educate clinicians on strategies for the effective management of pain in patients receiving palliative care.

Learning Objectives

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

  • Develop palliative care plans that utilize pharmacological and nonpharmacological modalities to manage pain and improve patient quality of life.

Financial Support

CME Outfitters, LLC, gratefully acknowledges an educational grant from Endo Pharmaceuticals and Pfizer Inc. in support of this CE activity.

Target Audience

Physicians, pharmacists, and nonphysician health care professionals interested in pain management in palliative care for patients with cancer.

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 designates this enduring material for a maximum of .5 AMA PRA Category 1 Creditâ„¢. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. .5 contact hours (0.05 CEUs)
Universal Activity Number: 0376-0000-12-026-H01-P
Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at (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

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. Mestemaker has no disclosures to report

Dr. Grauer has no disclosures to report.

Dr. Mason has no disclosures to report.

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

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

Sandra Haas Binford, MAEd (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, the faculty, Endo Pharmaceuticals, and Pfizer 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).


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