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Insights Into the Assessment, Prevention, and Management of Opioid-Induced Constipation

Click Here To Download Faculty Response to Questions from the Live Webcast (PDF)

Premiere Date: Thursday, June 25, 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 Credit™

Credit Expiration Date:
Saturday, June 25, 2016
Note: Credit Is No Longer Available

Faculty


Steven P. Stanos, Jr., DOSteven P. Stanos, Jr., DO 
Medical Director of Pain Medicine Services
Director of Occupational Medicine Services
Swedish Medical System
Seattle, WA

Anthony J. Lembo, MDAnthony J. Lembo, MD 
Associate Professor of Medicine
Harvard Medical School
Department of Medicine, Division of Gastroenterology
Beth Israel Deaconess Medical Center
Boston, MA

Zorba Paster, MDZorba Paster, MD 
Adjunct Professor of Family Medicine
University of Wisconsin School of Medicine and Public Health
Madison, WI

Statement of Need

Opioid-induced constipation (OIC) is a common and serious side effect from opioid use in patients with chronic and moderate-to-severe pain not relieved by non-opioid analgesics. OIC may have a significant impact on the quality of life of a patient demonstrated by discomfort, impaired work quality, missed work, an increase in physician visits, and a decrease in social activities. In one study, the majority of 80% of patients experienced at least one side effect from opioid use, the most common was constipation (41%).1

Despite guidelines from the American Pain Society (APS) and experts in gastroenterology and pain management, significant numbers of clinicians are not following these guidelines resulting in high rates of constipation, other complications, decreased quality of life, and discontinuation of opioid analgesics.

Expert faculty in this CME Outfitters Live and On Demand activity will narrow these gaps by highlighting how to implement an assessment and diagnosis of OIC, assess and select a treatment plan to include new and emerging agents, and create a strategy to proactively engage patients in conversations regarding bowel management.


  1. Gudin JL, Lembo AJ, Brennan, MJ. Evolving management of opioid-induced constipation in patients with chronic pain. Medscape Website. http://www.medscape.org/viewarticle/826041. Published June 16, 2014. Accessed April 1, 2015.


"I actually watched this program and I had a patient this morning that commented to me about constipation and I just recommended bulking agent. I am going to call the patient back and ask more about their symptoms and impact on their quality of life. A prescription agent may be appropriate and I was concerned about long term use of prescription agents for OIC and the data you presented made me change my mind. Thank you!"

Activity Goal

This educational activity centers on the CME Outfitters Make One Change statement. This statement is crafted from pertinent quality measures or clinical guidelines as a performance challenge to all participants. The Make One Change statement for this activity is:

Consistently discuss OIC with patients and select an appropriate treatment regimen for OIC in 75% of my patients taking opioids in the next three months.

Learning Objectives

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

  • Create and employ a strategy to adequately identify and diagnose opioid-induced constipation (OIC) in patients who utilize opioids.
  • Assess and select treatment options for patients with opioid-induced constipation (OIC).
  • Execute a communication plan by routinely asking patients about their bowel patterns while taking opioids in order to identify, prevent, and monitor opioid-induced constipation (OIC).

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

  • Discuss strategies to adequately identify and diagnose OIC.
  • Review treatment options for patients with OIC.
  • Evaluate a communications plan to routinely ask patients about their bowel patterns while on opioids in order to identify, prevent, and monitor OIC.

Financial Support

Supported by an educational grant from Takeda Pharmaceuticals International, Inc., U.S. Region and Sucampo.

Target Audience

Physicians, physician assistants, nurse practitioners, pharmacists, nurses, and other health care professionals who manage patients with opioid-induced constipation.

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 1.5 AMA PRA Category 1 Credits™. 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 1.5 contact hours.

Note to Nurse Practitioners and Clinical Nurse Specialists: the content of this activity pertains to pharmacology. Earn up to 1.5 contact hours of pharmacotherapeutic contact hours.

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.5 contact hours (0.15 CEUs)
Universal Activity Number: 0376-0000-15-018-L01-P (live programs)
0376-0000-15-018-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/TST7009 (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. Stanos has disclosed that he serves as a consultant to Analgesic Solutions; AstraZeneca; Collegium Pharmaceutical Inc.; myMatrixx; Pfizer Inc.; and Purdue Pharma L.P.

Dr. Lembo has disclosed that he has received research grants from Prometheus Laboratories Inc. He serves as a consultant to Actavis; Alkermes; AstraZeneca; Ironwood Pharmaceuticals, Inc.; Prometheus Laboratories Inc.; and Salix Pharmaceuticals, Inc.

Dr. Paster has disclosed that he has received research grants from Eli Lilly and Company; and Takeda Pharmaceuticals U.S.A., Inc.

Jeffery Helfand, DO, MS (peer reviewer) has no disclosures to report.

Kimberley Murray, RN, MS (peer reviewer) has no disclosures to report.

Frances C. Daniel, MPH (planning committee) has no disclosures to report.

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

Disclosures have been obtained from CME Outfitters staff: No disclosures to report.

Unlabeled Use Disclosure

Faculty of this CME/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, and Takeda Pharmaceuticals International, Inc., U.S. Region 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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