Release Date: June2008
Expiration Date: June 20, 2009

Jointly sponsored by Medical Education Collaborative, Inc. and Aventine HealthSciences.

Supported by an educational grant from Cephalon, Inc.

Purpose Statement
Chronic pain is often under treated in many cases and can be difficult to treat. Breakthrough pain (BTP) is a component of chronic pain characterized by its rapid onset, moderate-to-severe intensity, and relatively short duration. For patients with controlled persistent chronic pain, BTP is common. For patients with poorly controlled chronic pain it may be difficult to determine when BTP occurs because they are so rarely free of pain. Once perceived as a cancer pain control issue, BTP is now recognized across many pain states and chronic medical conditions. It is estimated that 64 percent of patients with cancer, and 74 percent of patients with noncancer pain conditions who are treated for chronic persistent pain will experience BTP. This activity will seek to enhance practitioners’ understanding of the impact of BTP across pain and chronic medical conditions, positioning them to achieve more positive outcomes when managing patients with chronic persistent pain. This activity will also review pharmacologic treatments for BTP, pharmacokinetics, pharmacodynamics, safety, and efficacy.

Target Audience
This activity has been designed for physicians, nurses, and pharmacists treating patients in pain.

Accreditation and Credit Designation
ACCME This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medical Education Collaborative, Inc. (MEC) and Aventine HealthSciences. MEC is accredited by the ACCME to provide continuing medical education for physicians.

Medical Education Collaborative designates this educational activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.



ACPE Medical Education Collaborative (MEC) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. MEC complies with the Criteria for Quality and Interpretive Guidelines.

This activity is approved for 2.00 contact hours (0.200 CEUs) of continuing pharmacy education ACPE # 815-999-07-181-H01-P.

ANCC Medical Education Collaborative (MEC) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This continuing nursing education activity for 1.8 contact hour(s) is provided by MEC.

Medical Education Collaborative (MEC) is approved by the California Board of Registered Nursing, Provider Number 129909 for 1.8 contact hour(s).

Educational Objectives
After completing this activity, the participant should be able to:

• Describe the incidence and prevalence of breakthrough pain across pain conditions
• Distinguish breakthrough pain from uncontrolled persistent chronic pain
• Review pharmacologic treatments for breakthrough pain and their delivery, safety, and efficacy
• Summarize traditional and emerging treatments for breakthrough pain

Faculty
Sridhar V. Vasudevan, MD
Clinical Professor of Physical Medicine and Rehabilitation
Medical College of Wisconsin
Milwaukee, WI

Martin Grabois, MD
Professor and Chair
Baylor College of Medicine
Houston, TX

B. Eliot Cole, MD, MPA – Moderator
Executive Director
American Society of Pain Educators
Montclair, NJ

Disclosure Statements
Medical Education Collaborative adheres to ACCME, ANCC, and ACPE Essential Areas and Policies, including the Standards for Commercial Support regarding industry support of continuing medical education. In order to resolve any identified conflicts of interest, disclosure information is provided during the planning process to ensure resolution of any identified conflicts. Disclosure of faculty and commercial relationships, as well as the discussion of unlabeled or unapproved use of any drug, device, or procedure by the faculty, are made known below.

Faculty Disclosures

• Dr. Vasudevan is a speaker for Pfizer Inc.
• Dr. Grabois has nothing to disclose.
• Dr. Cole is a speaker for Eli Lilly and Company and serves on advisory boards for Eli Lilly and Company, ProEthic Pharmaceuticals, Inc., and Reckitt Benckiser.

Planning Committee Managers Disclosures
Employees of Medical Education Collaborative, the accredited provider for this activity, or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interests related to the content of this CME activity for any amount during the past 12 months.

Aventine HealthSciences staff that was involved in the development of this activity has no financial relationships with any commercial interests that are relevant to this activity.

Combination of Media Used
This activity consists of an archived Web cast that can be viewed via the Internet. A course handout is available for download/printing by clicking on the link below.

Disclosure of Unlabeled Use/Investigational Use
The faculty discloses that they will not discuss any unlabeled use of drugs, devices, or procedures.

In this activity the faculty discloses that they will not discuss any investigational products or procedures.

Method of Participation and How to Obtain Credit
In order to receive credit for this activity participants must complete the online registration (registration is free). This activity should take approximately 2 hours to complete. The participant should fully review this accreditation-related information before clicking on the link to view the archived web cast. The web cast should be viewed in its entirety. Those participants who wish to receive credit must pass the online posttest and fully complete the activity evaluation immediately following the activity; no credit will be issued after June 20, 2009. Statements of credit will be processed immediately and sent to the email address you provided. (Note: If you participated in the live presentation of this activity on September 27, 2007 and received credit for it, you are not eligible for additional credit.)

• Complete the online registration (registration is free).
• Complete the online posttest and evaluation.
• Statements of credit will be processed immediately and sent to the email address you provided.

Note: There are no fees or costs associated with participating in this activity.

Release and Termination Dates
Release Date: June 20, 2008
Termination Date: June 20, 2009

Policy on Privacy and Confidentiality
Medical Education Collaborative protects the privacy of personal and other information regarding participants, educational partners, and joint sponsors. MEC and our joint sponsors will not release personally identifiable information to a third party without the individual’s consent, except such information as is required for reporting purposes to the appropriate accrediting agency.

Medical Education Collaborative and Aventine HealthSciences maintains physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Provider Contact Information
For questions about this activity, please contact:

Medical Education Collaborative
651 Corporate Circle, Suite 104
Golden, CO 80401
866.420.3252 (toll free)

Technical Assistance
If you have technical difficulties viewing the presentation or applying for credit, please contact editor@dannemiller.com

Hardware/Software Requirements
To view and participate in this educational activity you should have the following:

• Microsoft Windows 2000, Windows XP, Windows 2003, Windows Vista, or Macintosh OS X
• Display resolution of 800 x 600 pixels or greater
• For Windows: Microsoft Internet Explorer 6.0 SP1 or Firefox 2.0 AND Windows Media Player 9.0 or greater
• For Macintosh OS X: Firefox 2.0 or Safari 3 AND Microsoft Silverlight 1.0
• Broadband Internet connection recommended (256 Kbps & above)

Legal Disclaimer
The opinions expressed in this educational activity are those of the faculty and do not reflect the views of Medical Education Collaborative, Dannemiller Memorial Educational Foundation, or Aventine HealthSciences. This educational activity may discuss off-label and/or investigational uses and dosages for therapeutic products/procedures that have not been approved by the United States Food and Drug Administration (FDA). Medical Education Collaborative, Dannemiller Memorial Educational Foundation, or Aventine HealthSciences do not recommend the use of any product/procedure outside of the labeled indications. A qualified health care professional should be consulted before using any therapeutic product/procedure discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity. Please refer to the official prescribing information for each product/procedures for approved indication, contraindications, and warnings.

Copyright © 2008 Aventine HealthSciences. All Rights Reserved. Permission for accreditation use granted to Medical Education Collaborative (MEC).