Event Program. What Every Prescriber Needs to Know. April 21, Controlled Substance Prescribing Conference. Athens, GA

Transcription

1 Event Program 2018 Controlled Substance Prescribing Conference What Every Prescriber Needs to Know April 21, 2018 Athens, GA

2 We Welcome You! Dear Friends and Colleagues, On behalf of the Conference Planning Committee, I would like to welcome you to What Prescribers Need to Know: 2018 Controlled Substances Prescribing Conference. We are truly excited about this conference and would like to thank our speakers for their participation and the UGA College of Pharmacy for their invaluable assistance in developing this conference. Pick up a medical journal or a newspaper, listen to the radio or TV, and chances are you will see or hear something about the opioid epidemic. The magnitude and trajectory of the opioid epidemic is alarming. The annual number of deaths from overdoses involving prescription and illicit opioids had increased exponentially. According to the CDC, more than 115 Americans die every day after overdosing on opioids. The cost of the opioid epidemic is huge -- more than $78.5 billion a year. As physicians, we have an obligation to do whatever is in our power to address this situation. Engagement and leadership from all segments of society is needed, especially clinicians. I hope that this conference will help to: Sharpen our prescribing practices and use the PDMP to reduce the risk of opioid misuse, overdoses, and diversion. Recognize and treat opioid-use disorder. Call for more effective approaches to opioid use disorders in our practices, health care institutions, communities, and our governments. Change how society views addiction not as a personal failing, but as a chronic disease of the brain that requires compassion and care. Thank you for attending, whether here at Piedmont Athens Regional or remotely at one of our other Piedmont facilities. It is my hope that this conference is a solid first step on how we can work together to address this escalating epidemic. Sincerely, Robert D. Sinyard, M.D. Chief Medical Officer Piedmont Athens Regional 1

3 Conference Objectives Educational Objectives At the conclusion of the conference, participants will be able to: 1. Discuss the controlled substance prescribing guidelines. 2. Outline steps to initiate, modify, and discontinue use of controlled substances. 3. State the signs of the abuse and misuse and controlled substances. 4. Summarize the controlled substance prescribing recommendations for chronic pain management. 5. Identify critical counseling points for patients and caregivers on the safe use, proper storage, and disposal of controlled substances. 6. Explain the process for the Georgia PDMP and the legal implications of its use. Educational Audience This activity was designed for Piedmont affiliated physicians, PAs, nurse practitioners, and pharmacists. This conference will meet the new Georgia Composite Medical Board Rule for three hours of CME designed specifically to address controlled substance prescribing practices. CME Credit Piedmont Athens Regional is accredited by the Medical Association of Georgia to provide continuing medical education for physicians. Piedmont Athens Regional designates this live activity for a maximum of 3.0 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To receive your CME credit, please be sure to leave your completed Course Evaluation/Attestation Form with the staff as you exit the conference. Your feedback is very important to us and helps us improve the quality of the programs we offer. Please be sure to PRINT all requested information in order to receive credit for your participation in this educational activity. For Pharmacists: Please follow the instructions found on page 6 of this program. This conference has been approved for 3.0 hours of Pharmacy CE Credits by the University of Georgia College of Pharmacy, Office of Continuing Education and Outreach. The University of Georgia College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. In order to receive credit, participants must attend the full session, participate in the active learning, and claim credit online at the conclusion of the activity. No partial credit will be awarded. 2

4 Conference Agenda 7:30 to 8 a.m. Coffee and Registration 8 to 8:15 a.m. Welcome Don Tyson, Pharm.D. - Piedmont Athens Regional 8:15 to 8:45 a.m. Controlled Substances Prescribing Guidelines Todd J. Woodard, Pharm.D., BCPP, BCPS, BCGP - Clinical Pharmacy Services Peach State Health Plan 8:45 to 9 a.m. Prescribing App and Case Scenarios Trina von Waldner, Pharm.D. - University of Georgia, College of Pharmacy 9 to 10 a.m. Recognizing Signs of the Abuse or Misuse of Controlled Substances Merrill Norton Pharm.D., D.Ph., ICCDP-D - University of Georgia, College of Pharmacy Susan Blank, M.D. - American Society of Addiction Medicine Georgia Chapter 10 to 10:15 a.m. Break 10:15 to 11 a.m. Controlled Substance Prescribing for Chronic Pain Management D. Janene Holladay, M.D. - Ancora Pain Recovery 11 to 11:30 a.m. Georgia s PDMP Program Sheila Pierce, MPA - Georgia Department of Public Health 3

5 Meet the Speakers Susan Blank, M.D. Atlanta Healing Center President, American Society of Addiction Medicine Georgia Chapter Undergraduate: Augusta College Medical School: Medical College of Georgia Residency: Sheppard Pratt Hospital Fellowship: AntiAging and Regenerative Medicine, Boca Raton, Florida Board certified in psychiatry and addiction medicine, Fellow of the APA, ASAM and ABPM Dr. Blank reports no relevant financial disclosures. D. Janene Holladay, M.D. Ancora Pain Recovery Undergraduate: Emory University Medical School: Morehouse School of Medicine Residency: Emory University Hospital Board certified in anesthesiology, pain medicine, and addiction medicine Dr. Holladay reports no relevant financial disclosures. Merrill Norton, Pharm.D.,D.Ph.,ICCDP-D Clinical Associate Professor, University of Georgia College of Pharmacy Undergraduate: University of Georgia Graduate: University of Georgia Dr. Norton reports no relevant financial disclosures. Sheila Pierce, MPA Director, Georgia PDMP Program, Georgia Department of Public Health Undergraduate: Spelman College Graduate: Georgia State University Ms. Pierce reports no relevant financial disclosures. Trina von Waldner, Pharm.D. Director, Office of Continuing Education and Outreach, University of Georgia College of Pharmacy Undergraduate: University of Georgia Graduate: University of Georgia Dr. von Waldner reports no relevant financial disclosures. Todd Woodard, Pharm.D., BCPS, BCPP, BCGP, CPE Manager, Clinical Pharmacy Services, Peach State Health Plan Adjunct Clinical Assistant Professor of Pharmacy Practice, Philadelphia College of Osteopathic Medicine Undergraduate: Florida A & M University Graduate: Florida A&M University College of Pharmacy and Pharmaceutical Sciences Residency: FAMU/Apalachee Mental Health Center, Inc. Dr. Woodard reports no relevant financial disclosures. The following members of the Conference Planning Committee report no relevant financial disclosures: Heather Alexander, RN Mark Ellison, M.D. Lori Giles, RN Linda A. Groarke, MPH, MSUP Jonathan Hsu, M.D. Ann Malanoski RN James Pippim MD, MPH Diane Todd, RN, JD Don Tyson, PharmD Trina vonwaldner, PharmD Conflict of Interest Disclosure: It is the policy of the Piedmont Athens Regional CME Program to ensure balance, independence, objectivity, and scientific rigor. All persons involved in the selection, development, and presentation of content are required to disclose any real or apparent conflicts of interest. All conflicts of interest will be resolved prior to the educational activity being delivered to learners through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the individual s control over CME content about the products or services of the commercial interest, and/or 3) validating the activity content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of drugs or services. Persons who refuse or fail to disclose are disqualified from participating in the CME activity. Participants will be asked to evaluate whether the speaker s outside interests reflect a possible bias in the planning or presentation of the activity. This information is used to plan future activities. 4

6 Please download to participate in the demonstration CDC s new Opioid Guideline App is designed to help providers apply the recommendations of CDC s Guideline for Prescribing Opioids for Chronic Pain into clinical practice by putting the entire guideline, tools, and resources in the palm of their hand. Managing chronic pain is complex, but accessing prescribing guidance has never been easier. The application includes a Morphine Milligram Equivalent (MME) calculator*, summaries of key recommendations and a link to the full Guideline, and an interactive motivational interviewing feature to help providers practice effective communications skills and prescribe with confidence. Free Download The new CDC Opioid Guideline App is now available for free download on Google Play (Android devices) and in the Apple Store (ios devices). Professional Resources For copies of the presentations, links to professional resources, and electronic versions of the handouts, please visit our website: piedmont.org/opioidprescribingpresentations To access our WiFi, use the password: ARMCGuest CME Transcripts Official CME Transcripts for attendance at Piedmont Athens Regional CME activities are available for any date range and will list the date, course title, learning format, and number of credits for each session as well as a grand total for all your credits. These are available upon request by contacting the CME program, preferably by . Contacting the CME Program For questions or other issues related to continuing medical education at Piedmont Athens Regional, please contact: Linda A. Groarke, MPH, MSUP Program Administrator, Continuing Medical Education Linda.Groarke@piedmont.org 5

7 Instructions for Claiming Continuing Pharmacy Education Credit Online 2018 Controlled Substance Prescribing Conference Release Date April 21, 2018 DEADLINE for claiming Pharmacy CE credit June 5, 2018 Coupon Code: CSEPP77492 (case sensitive) Learning Objectives - Pharmacists 1. Describe the controlled substance prescribing guidelines. 2. Outline steps to initiate, modify, and discontinue use of controlled substances. 3. State the signs of the abuse and misuse and controlled substances. 4. Summarize the controlled substance prescribing recommendations for chronic pain management. 5. Identify critical counseling points for patients and caregivers on the safe use, proper storage, and disposal of controlled substances. 6. Explain the process for the Georgia PDMP and the legal implications of its use. Instructions for claiming your continuing pharmacy education credit: From your computer, go to: Click the green Register Now button and Login to your account* Check the course box (pharmacist or pharmacy technician), then check the box to agree to the Cancellation & Refund Policy Click register for program Enter coupon code listed above when prompted. You will see a message that your registration is successful Click your account Click the program title, 2018 Controlled Substance Prescribing Conference Click claim credits on the left Enter the Session Code: DXJ34 and click submit Complete the online evaluation and award credit This program is approved for 3.0 hours of continuing pharmacy education for pharmacists. In order to receive credit, participants must attend the full session, participate in the active learning, and claim credit online at the conclusion of the activity. No partial credit will be awarded. *If you have previously received CE credit from our department, you have an account. If not, you must create an account. Your CE information is maintained indefinitely on our secure server and CE credits are uploaded to CPE Monitor within 7 days of the date you claim credit and complete the evaluation. If you wish to have your own hardcopy, you may print a Statement of Credit for each activity OR select Generate PDF CE Transcript at the bottom of your account page to print all activity credits. Remember, DEADLINE for accessing the program and claiming Pharmacy CE credit is June 5, 2018 Call Elise Fortson at or elisef@uga.edu with questions or for more information. Sponsored by: The University of Georgia College of Pharmacy, Office of Continuing Education and Outreach UAN: L01-P The University of Georgia College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 6

8 1 DEFINE SCREEN CONSIDER and DISCUSS 2 3 the source of the pain for risk of addiction with the patient all commonly accepted Thorough history and available therapeutic physical options BEFORE prescribing opioids 4 Six Point Opioid Prescribing Platform Be A Discriminating Prescriber Obtain previous medical records if available Objective studies related to the diagnosis; e.g. imaging studies, blood work, etc. Opioid Therapy Initiation and Cessation SHORTEST duration of treatment LOWEST effective dose LOWEST number of pills per Rx ALWAYS include the following in your initial assessment: Personal history of substance misuse, especially prescription opioid misuse Family history of addiction Current consumption rate of alcohol, tobacco/nicotine products, marijuana Baseline urine drug testing Avoid co-prescribing opioids and benzodiazapines Avoid initiation of pain treatment using ERLA opioid* Basic non-opioid options NSAIDs Acetaminophen Antidepressants Anticonvulsants Muscle relaxants FDA approved medical foods Non or minimally invasive Physical therapy Massage Water aerobics Stretching Core strengthening exercises (e.g., pilates, yoga) Chiropractic Acupuncture Bio/neurofeedback Avoid methadone* Avoid daily dosages > 90 MMes* Have an OPIOID CESSATION PLAN Weaning schedule Clonidine 0.1 mg TID to suppress withdrawal symptoms *Without careful risk/benefit analysis and appropriate training or experience in use 5 EDUCATE 6 MONITOR Risks/benefits/side effects of opioid use Sharing opioid medications is illegal Proper storage/disposal Make patient aware of Georgia standing order for prescription of naloxone for overdose prevention Opioid Misuse and Abuse Prescription Drug Monitoring Program (PDMP) Controlled substance agreement Drug testing (screening)/pill counts Understand the difference between physical dependence, withdrawal, tolerance, and addiction Functional and quality of life outcomes Assess and document modification of functional status and quality of life related to opioid therapy Invasive, non-surgical Structure specific injection treatment Trigger point injections Joint injection Epidural injections Surgical Interventions Developed by P. Tennent Slack, MD 2018 Medical Association of Georgia Foundation Used with permission