Solutions for Safer ER/LA Opioid Prescribing in a New Era of Health Care Reform

Jointly provided by Postgraduate Institute for Medicine and Impact Education, LLC.

This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies. Please see for a listing of the member companies. This activity is intended to be fully compliant with ER/LA Opioid Analgesics REMS education requirements issued by the US Food & Drug Administration.

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Release date: February 29, 2016

Valid through: February 27, 2017

Specialty: Chronic pain, ER/LA Opioid Management

Media: Internet

Estimated Time to Complete Activity: 4.5 hours total (90 minutes per module)

Target Audience

The primary target audience consists of physicians, physician assistants, and nurse practitioners who currently prescribe ER/LA opioids in managed care organizations, integrated delivery systems, and Accountable Care Organizations/Patient-Centered Medical Home (ACO/PCMH) care settings. The secondary audience includes physicians, physician assistants, and nurse practitioners who have not prescribed opioids in the past 12 months but who may in the future or who are responsible for policy/procedure development in these settings, as well as the vast number of ancillary health care professionals associated with appropriate selection and monitoring of opioid therapy including registered nurses, pharmacists, medical assistants, and pharmacy technicians.

Statement of Educational Need

The core of the new accountable care ecosystem is patient-centered primary care, a model where the relationship between the provider and the patient ensures that appropriate care is structured, delivered, and coordinated around the specific needs of the patient. New care models hold tremendous promise for implementing the REMS FDA Blueprint education as a result of incentivized coordination and collaboration among various care givers. Emerging care models can improve patient care transitions that result from system failures in the transition from various health care settings and providers.

Clinicians will receive information that will allow them to improve their ability to: provide safer treatment to extended-release/long-acting (ER/LA) opioid patient populations, track and coordinate referrals, provide appropriate access and communication, plan and manage care, and measure performance improvement.

Learning Objectives

Upon completion of this activity, participants should be better able to:

  • Review current challenges in managing chronic pain and new models of care delivery to address these challenges
  • Discuss current recommendations for assessment and initiation of treatment with extended-release/long-acting (ER/LA) opioids and opportunities to integrate recommendations into new models of care delivery
  • Appropriately initiate therapy, modify dosing, and discontinue use of ER/LA opioid analgesics
  • Use techniques that improve patient/provider communication around extended release/long-acting (ER/LA) opioid therapy
  • Discuss the importance of shared decision-making and patient education for patients who need or are receiving ER/LA opioids
  • Identify best practices, resources, and opportunities to navigate difficult conversations about ER/LA prescribing with your patients
  • Use the electronic health records (EHR) to improve the management of patients taking ER/LA opioids and reduce the opportunity for diversion and abuse
  • Describe the benefits of using a state prescription drug monitoring program (PDMP) in improving management of patients receiving ER/LA opioids and reducing the risk of misuse, and diversion
  • Discuss the potential capabilities of fully integrated health information technology (HIT) for improving patient care and patient outcomes

Credits Available

  • Physicians — maximum of 4.5 AMA PRA Category 1 Credits
  • Nurses4.5 contact hours

All other healthcare professionals completing this course will be issued a statement of participation.


Paul Grundy, MD, MPH

IBM's Global Director of Healthcare Transformation
President, Patient-Centered Primary Care Collaborative

Joanna L. Starrels, MD, MS

Associate Professor of Medicine
Division of General Internal Medicine
Albert Einstein College of Medicine & Montefiore Medical Center

Melissa B. Weimer, DO, MCR

Assistant Professor of Medicine
Division of General Internal Medicine and Geriatrics
Oregon Health & Science University

William C. Becker, MD

Assistant Professor of Medicine
Yale School of Medicine

Angela Golden, DNP, FNP-C, FAANP

Family Nurse Practitioner
NP from Home, LLC

James B. Rickert, MD

Clinical Assistant Professor
Indiana University School of Medicine
Orthopedic Surgeon
Indiana University Health Southern Indiana Physicians

Christopher Harle, PhD

Associate Professor, Health Policy and Management
Richard M. Fairbanks School of Public Health
Indiana University
Purdue University, Indianapolis
Affiliated Scientist, Regenstrief Institute

David K. Nace, MD

Chief Medical Officer
MarkLogic Corporation
Board Member
Patient-Centered Primary Care Collaborative

Physician Continuing Medical Education

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine and Impact Education, LLC. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Postgraduate Institute for Medicine designates this enduring material for a maximum of 4.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This educational activity for 4.5 contact hours is provided by the Postgraduate Institute for Medicine.

Disclosures of Conflicts of Interest

The Postgraduate Institute for Medicine requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME/CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.


Paul Grundy, MD, MPH
  • Employee: IBM
Christopher Harle, PhD
  • Contracted Research: Pfizer, Inc.
David K. Nace, MD
  • Salary: McKesson Corporation and MarkLogic Corporation

The moderator, Douglas McKell, MS, has nothing to disclose.

The following faculty members have nothing to disclose.
Joanna L. Starrels, MD, MS; Melissa B. Weimer, DO, MCR; William C. Becker, MD; Angela Golden, DNP, FNP-C, FAANP; and James B. Rickert, MD

Planners and Managers

The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN and Jan Schultz, MSN, RN, CHCP have nothing to disclose. The Impact Education planners and managers, Steven Casebeer, MBA, and Keith Engelke, PhD, have nothing to disclose.

Instructions for Participation and Credit

There are no fees for participating in this educational activity. During the period February 29, 2016 through February 27, 2017, participants must read the learning objectives and faculty disclosures and study the educational activity. This activity is REMS-compliant. Upon successfully completing the post-test with a score of 75% or better and the activity evaluation, participants will receive a REMS certificate of completion suitable for framing.

Hardware and Software Requirements

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Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.