the American Academy of Pain Medicine the governing voices of pain: medicine, science, and government M a r c h 2 4 вЂ“ 2 7 , 2 0 11 Gaylord National Hotel & Convention Center National Harbor, MD AA P M 27 TH A n n u a l M e e t i n g вЂў p r o g r am b o o k Join us for an Official Independent CME Satellite Lunch Symposium OSTEOARTHRITIS From Biomarkers to New Strategies for Pain Management Friday, March 25, 2011 NOON to 1:15 PM Woodrow Wilson Ballroom A Hotel Ballroom Level 2 Gaylord National Hotel & Convention Center Program Chair F. Michael Gloth III, MD, FACP, AGSF Associate Professor of Medicine Division of Geriatric Medicine & Gerontology The Johns Hopkins University School of Medicine Adjunct Associate Professor of Medicine Department of Epidemiology and Preventive Health University of Maryland School of Medicine Baltimore, Maryland Registration There is no registration fee for attending this symposium; however, seating is limited. Preregistration may be available on-site, at the AAPM registration area, space permitting. Preregistration does not guarantee seating. We recommend arriving at the symposium location early. AMA Credit Designation This activity has been approved for AMA PRA Category 1 Credits TM. This educational activity is jointly sponsored by the Postgraduate Institute for Medicine and Miller Medical Communications, LLC. MM Miller Medical Communications, LLC. An official independent satellite symposium held in conjunction with The American Academy of Pain MedicineвЂ™s 27th Annual Meeting. COMP image courtesy of The PyMOL Molecular Graphics System, Version 1.3, SchrГ¶dinger, LLC. This activity is supported by an educational grant from Endo Pharmaceuticals Inc. AAPMed ad-012111_Layout 1 1/31/11 2:41 PM Page 1 Rational Selection of Adjuvant Analgesics in Chronic Pain Management: MOVING FROM SYMPTOM CONTROL TOWARD A MECHANISM-BASED APPROACH Wednesday, March 23, 2011 Washington, DC вЂў Gaylord National Hotel and Convention Center вЂў Woodrow Wilson Ballroom A Registration/Lunch: 11:30 AM-11:45 AM вЂў Symposium: 11:45 AM-1:00 PM Faculty Scott M. Fishman, MD Chairman Professor and Chief, Division of Pain Medicine Vice Chair, Anesthesiology and Pain Medicine University of California, Davis School of Medicine Sacramento, California Ajay D. Wasan, MD, MSc Director of Clinical Pain Research Brigham and WomenвЂ™s Hospital Assistant Professor of Anesthesiology and Psychiatry Harvard Medical School Boston, Massachusetts Agenda 11:30AM-11:45AM 11:45AM-11:50AM Registration/Lunch Welcome Scott M. Fishman, MD, Chairman 11:50AM-12:00PM Overview of Chronic Pain and Effective Pain Assessment as the Cornerstone to Optimal Management Scott M. Fishman, MD 12:00PM-12:20PM New Insights in the Neuropathology of Chronic Pain: The Good, the Bad, and the Ugly Ajay D. Wasan, MD, MSc 12:20PM-12:45PM Adjuvant Analgesics in Chronic Pain Management: A Mechanism-based Rational Approach Scott M. Fishman, MD 12:45PM-1:00PM Question and Answer Session All Faculty Register Now at www.symposiareg.org/aapm or contact Cathy Rickert at (847) 375-4798 or [email protected] Program Overview Chronic pain is widespread and often poorly managed. As our understanding of chronic pain neurobiology continues to expand and novel neuromodulatory approaches emerge specifically targeting the pathophysiological underpinnings of chronic pain, clinicians who manage patients with chronic pain must be aware of these advances in science and medicine in order to provide the best possible care for their patients. Thus, this activity will begin with an overview of the prevalence and morbidity associated with chronic pain conditions and barriers that exist in effectively treating patients suffering from pain. Next, the faculty will review the current understanding and latest findings in the pathophysiology of chronic pain and highlight potential neuromodulatory targets for treatment. They will then go on to discuss a paradigm shift in the chronic pain management approach from an empirical methodology of trying-and-rejecting and symptom control towards mechanism-specific intervention and rational selection of analgesics in individual patients. Furthermore, they will discuss recent clinical trial data demonstrating efficacy and safety data of adjuvant analgesics in managing chronic pain effectively. The activity will conclude with an interactive question and answer session. Learning Objectives At the conclusion of this activity, participants should be better able to: 1. Identify appropriate pain assessment tools as an integral component of effective pain management 2. Describe the molecular and cellular mechanisms of chronic pain as they relate to rational selection of adjuvant analgesics 3. Summarize the efficacy and safety data of adjuvant analgesics in the management of chronic pain Target Audience This activity is designed for pain specialists, including anesthesiologists, physiatrists, psychiatrists, neurologists, and other healthcare professionals interested in the management of patients with chronic pain conditions. Physician Continuing Medical Education Accreditation Statement 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 the Postgraduate Institute for Medicine and ACCELMED. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians. Credit Designation The Postgraduate Institute for Medicine designates this live activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)в„ў. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure of Conflicts of Interest Postgraduate Institute for Medicine (PIM) 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 they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. Americans with Disabilities Act Event staff will be glad to assist you with any special needs (ie, physical, dietary, etc). Please contact ACCELMED prior to the live event at (877) 374-8323. An official independent satellite symposium held in conjunction with the American Academy of Pain MedicineвЂ™s 27th Annual Meeting. Jointly sponsored by the Postgraduate Institute of Medicine and ACCELMED This activity is supported by an educational grant from Lilly USA, LLC. Please Join Us for a Product Theater Dinner Presentation American Academy of Pain Medicine NEW PERSPECTIVES ON ACUTE PAIN: Focusing on Efficacy and Tolerability Friday, March 25, 2011 7:00 pm вЂ“ 8:15 pm Dinner will be served Gaylord National Hotel & Convention Center Meeting Room: Woodrow Wilson A Washington, DC Perry G. Fine, MD Professor of Anesthesiology Pain Research Center University of Utah School of Medicine Salt Lake City, Utah Sunil J. Panchal, MD President National Institute of Pain Lutz, Florida This promotional educational activity is not accredited. The program content is developed by PriCara Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. Speakers present on behalf of the company and are required to present information in compliance with FDA requirements for communications about its medicines. If you are licensed in any State or other jurisdiction, or an employee or contractor of any organization or governmental entity, that limits or prohibits meals from pharmaceutical companies, please identify yourself so that you (and we) are able to comply with such requirements. Your name, the value, and purpose of any educational item, meal, or other items of value you received may be reported as required by state or federal law. Once reported, this information may be made available for public review. Thank you for your cooperation. В© Ortho-McNeil-Janssen Pharmaceuticals, Inc. 2011 An official independent satellite symposium held in conjunction with the American Academy of Pain MedicineвЂ™s 27th Annual Meeting. Preregistration: There is no registration fee for attending this symposium; however, seating is limited. To preregister for this satellite symposium, please register online at www.symposiareg.org/aapm or contact Cathy Rickert at 847-375-4881. Preregistration does not guarantee seating. We do recommend arriving at the symposium location early. March 2011 Sponsored by 02TL11008E AAAmerican P M 2 0 11 Ann u a l Mofe ePain t i ngMedicine вЂў 27th Annual Meeting the Academy 3 Contents General Information Welcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 27th Annual Meeting Supporters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2010вЂ“2011 Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Program Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2011 AAPM Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Past Award Recipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Convention Center Floor Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Schedule of Events Schedule at a Glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Preconference Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Plenary Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Concurrent Scientific Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 AAPM Faculty List and Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Satellite Symposia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Non-CME Corporate Symposia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Exhibits Corporate Showcase Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Exhibit Hall Floor Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 List of Exhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Exhibit Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Exhibitors By Product Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Exhibitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Corporate Relations Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Index of Advertisers Endo Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC Eli Lilly & Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 PriCaraВ®, A Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Medtronic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5 Mallinckrodt Inc., A Covidien Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Purdue Pharma L.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64вЂ“68, BC Exclusive MRI Labeling Only Medtronic premium neurostimulators are FDA conditionally approved for 1.5-Tesla MRI head scan* Only Medtronic SynchroMedВ® infusion systems are FDA conditionally approved for 3.0-Tesla MRI full body scan Visit professional.medtronic.com/mri for more information. Visit us at Booth #117. *Except ItrelВ® 3 NeurostimulatioN systems for paiN therapy Brief summary: product technical manuals and programming Guides must be reviewed prior to use for detailed disclosure. Be a Part of the Premier Association for Pain indication for use - Chronic, intractable pain of the trunk and/or limbs-including unilateral or bilateral pain. Contraindications: Diathermy. Warnings: Defibrillation, diathermy, electrocautery, MRI, RF ablation, & therapeutic ultrasound can result in unexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. precautions: The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation system. EMI, postural changes, & other activities may cause shocking/jolting. adverse events: Undesirable change in stimulation; hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult MedtronicвЂ™s website at www.medtronic.com. USA Rx Only Rev 0209 syNChromedВ® ii druG iNfusioN system Brief summary: product technical manuals and the appropriate drug labeling must be reviewed prior to use for detailed disclosure. indications: US: Chronic intraspinal (epidural and intrathecal) infusion of preservativefree morphine sulfate sterile solution in the treatment of chronic intractable pain, chronic intrathecal infusion of preservative-free ziconotide sterile solution for the management of severe chronic pain, and chronic intrathecal infusion of LioresalВ® Intrathecal (baclofen injection) for the management of severe spasticity; chronic intravascular infusion of floxuridine (FUDR) or methotrexate for the treatment of primary or metastatic cancer. Outside of US: Chronic infusion of drugs or fluids tested as compatible and listed in the product labeling. Contraindications: Infection; implant depth greater than 2.5 cm below skin; insufficient body size; spinal anomalies; drugs with preservatives, drug contraindications, drug formulations with pH в‰¤3, use of catheter access port (CAP) kit for refills or of refill kit for catheter access, blood sampling through CAP in vascular applications, use of Personal Therapy Manager to administer opioid to opioid-naГЇve patients or to administer ziconotide. Warnings: Non-indicated formulations may contain neurotoxic preservatives, antimicrobials, or antioxidants, or may be incompatible with and damage the system. failure to comply with all product instructions, including use of drugs or fluids not indicated for use with system, or of questionable sterility or quality, or use of non-medtronic components or inappropriate kits, can result in improper use, technical errors, increased risks to patient, tissue damage, damage to the system requiring revision or replacement, and/ or change in therapy, and may result in additional surgical procedures, a return of underlying symptoms, and/or a clinically significant or fatal drug under- or overdose. Refer to appropriate drug labeling for indications, contraindications, warnings, precautions, dosage and administration information, screening procedures and underdose and overdose symptoms and methods of management. Physicians must be familiar with the drug stability information in the product technical manuals and must understand the dose relationship to drug concentration and pump flow rate before prescribing pump infusion. Implantation and ongoing system management must be performed by individuals trained in the operation and handling of the infusion system. An inflammatory mass that can result in serious neurological impairment, including paralysis, may occur at the tip of the implanted catheter. Clinicians should monitor patients on intraspinal therapy carefully for any new neurological signs or symptoms, change in underlying symptoms, or need for rapid dose escalation. Inform patients of the signs and symptoms of drug under- or overdose, appropriate drug warnings and precautions regarding drug interactions, potential side effects, and signs and symptoms that require medical attention, including prodromal signs and symptoms of inflammatory mass. Failure to recognize signs and symptoms and seek appropriate medical intervention can result in serious injury or death. Instruct patients to notify their healthcare professionals of the implanted pump before medical tests/procedures, to return for refills at prescribed times, to carry their Medtronic device identification card, to avoid manipulating the pump through the skin, to consult with their clinician if the pump alarms and before traveling or engaging in activities that can stress the infusion system or involve pressure or temperature changes. Strong sources of electromagnetic interference (EMI), such as short wave (RF) diathermy and MRI, can negatively interact with the pump and cause heating of the implanted pump, system damage, or changes in pump operation or flow rate, that can result in patient injury from tissue heating, additional surgical procedures, a return of underlying symptoms, and/or a clinically significant or fatal drug underdose or overdose. Avoid using shortwave (RF) diathermy within 30 cm of the pump or catheter. Effects of other types of diathermy (microwave, ultrasonic, etc.) on the pump are unknown. Drug infusion is suspended during MRI; for patients who can not safely tolerate suspension, use alternative drug delivery method during MRI. Patients receiving intrathecal baclofen therapy are at higher risk for adverse events, as baclofen withdrawal can lead to a life threatening condition if not treated promptly and effectively. Confirm pump status before and after MRI. Reference product labeling for information on sources of EMI, effects on patient and system, and steps to reduce risks from EMI. precautions: Monitor patients after device or catheter replacement for signs of underdose/overdose. Infuse preservative-free (intraspinal) saline or, for vascular applications, infuse heparinized solutions therapy at minimum flow rate if therapy is discontinued for an extended period of time to avoid system damage. EMI may interfere with programmer telemetry during pump programming sessions. EMI from the SynchroMed programmer may interfere with other active implanted devices (e.g., pacemaker, defibrillator, neurostimulator). adverse events: Include, but are not limited to, spinal/vascular procedure risks; infection; bleeding; tissue damage, damage to the system or loss of, or change in, therapy that may result in additional surgical procedures, a return of underlying symptoms, and/or a clinically significant or fatal drug underdose or overdose, due to end of device service life, failure of the catheter, pump or other system component, pump inversion, technical/programming errors, or improper use, including use of non-indicated formulations and/or not using drugs or system in accordance with labeling; pocket seroma, hematoma, erosion, infection; post-lumbar puncture (spinal headache); CSF leak and rare central nervous system pressure-related problems; hygroma; radiculitis; arachnoiditis; spinal cord bleeding/ damage; meningitis; neurological impairment (including paralysis) due to inflammatory mass; potential serious adverse effects from catheter fragments in intrathecal space, including potential to compromise antibiotic effectiveness for CSF infection; anesthesia complications; body rejection phenomena; local and systemic drug toxicity and related side effects; potential serious adverse effects from catheter placement in intravascular applications. USA Rx Only Rev 1009 As a member of AAPM, you will have access to the following benefits: вЂў Pain MedicineвЂ”AAPMвЂ™s journal (members receive a complimentary subscription) вЂў AAPM e-NewsвЂ”biweekly e-newsletter that provides the most current information on pain medicine, advocacy related to pain as a specialty, clinical trials, members in the news, and AAPM updates вЂў Discounted registration rates for AAPMвЂ™s Annual Meetings and Online Education and CME Portal, where you can receive trusted, quality education by top physicians and researchers in the field t h e A M E R I C A N A C A D E M Y o f PA I N M E D I C I N E PAIN MEDICINE P h y s i c i a n s D e d i c a t e d t o R e l i e v i n g P a i n Vol. 25, No. 1 вЂў Summer/Fall 2010 Chester вЂ�TripвЂ™ Buckenmaier: On the Frontline of Pain Management Jane Martinsons, Staff Writer Pain Medicine Network recently had the opportunity to speak with Chester вЂ�TripвЂ™ Buckenmaier III, MD COL MC, about his involvement with the U.S. ArmyвЂ™s Pain Management Task Force, the Military Advanced Regional Anesthesia and Analgesia Handbook he coauthored, and his new position as editor-in-chief of U.S. Medicine magazine. Dr. Buckenmaier is Chief of the Army Regional Anesthesia and Pain Management Initiative at the Walter Reed Army Medical Center in Washington, DC, and Associate Professor at the Uniformed Services University of the Health Sciences in Bethesda, MD. Dr. Buckenmaier at a medical facility in Camp Bastion, Afghanistan Q The U.S. ArmyвЂ™s Pain Management Task Force Final Report, which provides recommendations for a substantial overhaul of pain services in the military, has been approved. Is there anything you would like to say about the report? Dr. Buckenmaier: In the reportвЂ™s executive summary is an excellent introduction that includes U.S. Army Surgeon General [Eric B.] SchoomakerвЂ™s vision of the task force (see www.painmed.org). While there [are] many centers around the country where pain providers are doing very good work in the military system, [Schoomaker] recognizes the system is fragmented and not necessarily consistent throughout the entire continuum. A major [responsibility] of the task force was to provide a holistic, interdisciplinary, but, most importantly, integrated approach to pain throughout the continuumвЂ”from point of injury back to the United States, so that a soldier Continued on page 4 вЂў AAPMвЂ™s websiteвЂ” continuously updated, it contains a growing library of pain medicine resources, an interactive MembersвЂ™ Community, information on upcoming meetings, and much more. InsideвЂ¦ AAPM Leaders Speak Out on REMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Tamper-Resistant Dosage Forms Do Not Translate to Abuse Deterrents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Time Is on Your Side: How to Use Time-Based Coding for E/M Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Managing the Claim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 AAPMвЂ™s Website Redesign Offers a More Engaging and Interactive Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 AAPM Announces New Strategic Plan . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Avoid DenialвЂ”Follow These Signature Guidelines for a Medical Record Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 вЂў Patient education materials вЂў Online career center вЂў Practice management assistance вЂў Membership directory For more information, visit www.PainMed.org. Contact AAPM at [email protected] or 847.375.4731 6 AAEL W PM C O2011 M E Ann u a l M e e t i ng Welcome! As co-chairs of AAPMвЂ™s 27th Annual Meeting Planning Committee, we would like to extend a welcome to all attendees and provide an overview of what this meeting has to offer. In concert with AAPMвЂ™s tradition of focusing on emerging issues in pain medicine, this Annual Meeting features a multitude of expert faculty who will address the latest science and most relevant topics facing physicians who treat pain. вЂњThe Governing Voices of Pain: Medicine, Science, and GovernmentвЂќ boasts an outstanding array of sessions, in both the science and practice of pain medicine. Below are just a few of the meetingвЂ™s highlights. Preconference Sessions On the onset of AAPMвЂ™s Annual Meeting, 2 days of world-class preconference educational opportunities include the renowned вЂњEssential Tools for Treating the Patient in PainTMвЂќ course, the 2-day Cadaver Workshop, вЂњUltrasound Guidance for the Pain Physician,вЂќ and a practice management preconference session. Keynote Plenary Speaker, Regina E. Herzlinger, PhD Named AmericaвЂ™s leading advocate for market-driven, consumer-oriented health reform, Regina E. Herzlinger, PhD, is one of the countryвЂ™s most respected healthcare economists. She is widely recognized for the groundbreaking role she played in pointing the way toward a bold, new healthcare plan. Herzlinger has been dubbed by Money Magazine as the вЂњgodmotherвЂќ of consumer-driven health care and has been listed by Modern Healthcare as one of the nationвЂ™s 100 most powerful people since 2003. All New Patient-Centered Scientific Sessions New this year, AAPM offers a progressive and innovative patient-centered pain track that runs concurrent with a fully developed track on practice management. The new patient-centered scientific sessions bridge together the most advanced medical management therapies and protocols of specific pain disease states with the very latest advancements on the interventional pain frontier. Scientific Research The Academy continues to advance the science of pain medicine through its presentation of cutting-edge scientific-research abstracts. The 2011 Scientific Poster Review Committee has selected six of the highest ranking poster submissions to be delivered in a plenary venue. In addition to attending this session, please visit the poster presentations in the exhibit hall Thursday evening through Saturday morning (there will be two sets of poster displays and presentations, so be sure to visit every day). Networking With Colleagues The meeting offers a tremendous opportunity to network with fellow pain medicine practitioners. Face-to-face dialogue with world-class pain medicine experts and colleagues is a professional benefit for all. In addition, you also will receive a first look at the latest and greatest new products on the pain medicine market and much, much more. We are certain you will find this educational experience personally and professionally rewarding. We are delighted to extend this welcome to AAPMвЂ™s 27th Annual Meeting. Tim J. Lamer, MD Associate Professor, Department Chair Mayo Clinic Rochester, MN Sunil J. Panchal, MD President National Institute of Pain and the COPE Foundation Lutz, FL 2 7 t h Ann u a l M e e t i ng S u pp o r t e r s 7 Annual meeting Supporters Platinum Level GOLD Level Silver Level SM Bronze Level Preconference Supporters Cadaver Workshop Boston Scientific Cosman Epimed International, Inc. Essentials Course Cephalon, Inc. Eli Lilly and Company Endo Pharmaceutical Inc. GE Healthcare Globus Medical Ultrasound Course Kimberly-Clark Kyphon Inc. Biosound Esaote Ultrasound Esaote North America Medtronic, Inc. GE Healthcare MinSurg Corp. SonoSite, Inc. NeuroTherm Terason Ultrasound St. Jude Medical Stryker International Spine Vertos Medical 8 2010вЂ“2011 leadership 2010-2011 Board of Directors President Eduardo M. Fraifeld, MD Vice President for Scientific Affairs Martin Grabois, MD President-Elect Perry G. Fine, MD Immediate Past President Rollin M. Gallagher, MD MPH Treasurer Lynn R. Webster, MD Editor, Pain Medicine Rollin M. Gallagher, MD MPH Secretary Zahid H. Bajwa, MD Directors-at-Large Donna Marie Bloodworth, MD Timothy R. Deer, MD Gilbert Fanciullo, MD, MS Scott M. Fishman, MD Sean Mackey, MD PhD Bill McCarberg, MD Jerome Schofferman, MD ABPM Liaison Director Michel Y. Dubois, MD Representative of Past Presidents Richard L. Stieg, MD Executive Director Philip A. Saigh, Jr. 2011 Program Committee Conference Co-Chairs Tim J. Lamer, MD Associate Professor, Department Chair Mayo Clinic Rochester, MN Nothing to disclose Sunil J. Panchal, MD President National Institute of Pain and the COPE Foundation Lutz, FL King (consultant); Purdue (consultant); Endo (speaker) Essential Tools for Treating the Patient in Painв„ў Co-Chairs Zahid H. Bajwa, MD Director, Education and Clinical Pain Research Beth Israel Deaconess Medical Center Boston, MA Allergan, Inc. (research grantвЂ”co-principal investigator); EndoPharmaceuticals (research grantвЂ”co-principal investigator); King Pharmaceuticals, Inc. (speakerвЂ™s bureauвЂ”speakerвЂ™s training), Merck & Co., Inc. (research grantвЂ”co-principal investigator), Pfizer, Inc. (consultant); Xanodyne Pharmaceuticals, Inc. (consultantвЂ”speaker training) Salim M. Ghazi, MD Chair, Department of Pain Medicine Mayo Clinic Jacksonville, FL Nothing to disclose Scientific Poster Session Chair Jeffrey M. Tiede, MD Columbia Interventional Pain Center Columbia, MO Committee Members Michael A. Ashburn, MD MBA MPH Director, Penn Pain Medicine Philadelphia, PA Philip S. Kim, MD Director, Pinnacle Mid-Atlantic Pain Medicine, PC Newtown Square, PA ZARS Pharma, Inc. (stockholder) Elan Corporation plc (speaker); Medtronic, Inc. (speaker); Stryker Instruments (speaker) Edward T. Bope, MD ABFP (AAFP) Primary Care Residency Program, Director Chalmers P. Wylie VeteranвЂ™s Affairs Ambulatory Care Center Columbus, OH Robert M. Levy, MD PhD Professor, Neurosurgical Surgery Northwestern University Chicago, IL Nothing to disclose Chester C. Buckenmaier, III, MD COL MC USA Chief, Army Regional Anesthesia and Pain Management Initiative Walter Reed Army Medical Center Washington, DC Nothing to disclose Timothy R. Deer, MD Past Co-Chair President and CEO The Center for Pain Relief Charleston, WV Azur (consultant); Bioness, Inc. (consultant/research); Medasys, Incorporated (consultant/research); Medtronic (consultant); Spinal Modulation, Inc. (consultant); Stryker Instruments (consultant); St. Jude Medical, Inc. (consultant); Vertos Medical Inc. (consultant) Martin Grabois, MD Professor and Chairman, Department of Physical Medicine and Rehabilitation Baylor College of Medicine Houston, TX Endo Pharmaceuticals (speaker, advisory board); King Pharmaceuticals, Inc. (speaker, advisory board); Purdue Pharmaceuticals (advisory board) Michael W. Hooten, MD Assistant Professor, Mayo Clinic College of Medicine Rochester, MN Nothing to disclose Bioness, Inc. (speaker, education, consulting); Codman Shurtleff, Inc. (speaker, education, consulting); Medtronic Neurological (speaker, education, consulting); Spinal Modulation (speaker, education, consulting); St. Jude Medical, Inc. (speaker, education, consulting); Stryker Instruments (speaker, education, consulting); Vertos Medical, Inc. (speaker, education, consulting) Sean Mackey, MD PhD Director, Stanford University Medical Center Palo Alto, CA Nothing to disclose John D. Markman, MD Associate Professor, University of Rochester Rochester, NY Afferent Pharmaceuticals (consultant); Alkermes, Inc. (consultant); Endo Pharmaceuticals (researcher); U.S. Food and Drug Administration (special government employee); Infinity Pharmaceuticals, Inc. (consultant, speaker); NeurogesXВ® (consultant); Pfizer, Inc. (researcher) Joseph J. Ruane, DO Medical Director, McConnell Heart Health Center Cleveland, OH Genzyme Biosurgery (honorarium, speaker/consultant); Pfizer, Inc. (honorarium, speaker) Ajay D. Wasan, MD MSc Director, Brigham and WomenвЂ™s Hospital Chestnut Hill, MA Eli Lilly and Company (consultant); Medtronic, Inc. (consultant) 2010вЂ“2011 leadership 9 Lynn R. Webster, MD Medical Director, Lifetree Clinical Research and Pain Clinic Salt Lake City, UT Adolor Corporation (research); Alkermes, Inc. (research); Alko (research); Ameritox (advisory board); AstraZeneca (consultant); Bayer (research); Boston Scientific (consultant, research); Cephalon, Inc. (consultant, research); Collegium Pharmaceutical (research); Elan Corporation, plc (consultant); Endo Pharmaceuticals (research); Forest Pharmaceuticals, Inc. (research); Hisamitsu Pharmaceutical Co., Inc. (research); HoffmanLaRoche LTP (research); King Pharmaceuticals, Inc. (research, advisory board); Medtronic, Inc. (consultant, research, advisory board); Myriad Genetics, Inc. (research); Nektar (advisory board); NeurAxon (research); NeurogesXВ® (advisory board); Neuromed (advisory board); Nevro Corp. (consultant); Pfizer Inc. (research); Purdue Pharma LP (consultant, advisory board); QRxPharma Limited (research); Reckitt Benckiser Group plc (research); Recro Pharma, Inc. (research); Regeneron Pharmaceuticals, Inc. (research); Theravance (research); Wyeth (research, advisory board) Michael L. Whitworth, MD President, Advanced Pain Management Surgery Columbus, IN Advisors Perry G. Fine, MD Professor, Department of Anesthesia Pain Research Center University of Utah Salt Lake City, UT Ameritox (consultant, advisory board); Cephalon, Inc. (consultant, advisory board); Covidien (consultant, advisory board); King Pharmaceuticals, Inc. (consultant, advisory board); MEDA Pharmaceuticals, Inc. (consultant, advisory board); PriCaraВ®, a Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. (consultant, advisory board); Janssen/ Johnson & Johnson Services, Inc. (consultant, advisory board) Scott M. Fishman, MD Chief, Division of Pain Medicine University of CaliforniaвЂ“Davis School of Medicine Sacramento, CA American Pain Foundation (president, chairman of board) Nothing to disclose Council of Past Presidents 1985 Benjamin L. Crue, Jr., MD FACS 1998 J. David Haddox, DDS MD (Vice-Chair) 1986 Joel L. Seres, MD 1999 Norman J. Marcus, MD 1987 Robert G. Addison, MD 2000 Edward C. Covington, MD 1988 Philipp M. Lippe, MD 2001 Albert Ray, MD 1989 Jack J. Pinsky, MD 2002 Marc B. Hahn, DO 1990 Andrew G. Shetter, MD 2003 Melvin C. Gitlin, MD (Chair) 1991 Sridhar V. Vasudevan, MD 2004 Samuel J. Hassenbusch, MD PhD (Deceased) 1992 E. Richard Blonsky, MD (Deceased) 2005 Scott M. Fishman, MD 1993 Peter R. Wilson, PhD MBBS 2006 Frederick W. Burgess, MD PhD 1994 Richard L. Stieg, MD 2007 B. Todd Sitzman, MD MPH 1995 Hubert L. Rosomoff, MD DMedSc FAAPM (Deceased) 2008 Kenneth A. Follett, MD PhD 1996 Steven D. Feinberg, MD 2009 Rollin M. Gallagher, MD MPH 1997 Gerald M. Aronoff, MD 10 program information Schedule of Events Please note that the schedule of events included in this program book was current at the time of publication and includes several program changes that have occurred since the mailing of the meeting brochure. Please check the day-at-a-glance schedule, available at the registration desk, for room locations and any last-minute program changes. Objectives After attending this meeting, participants should be better able to вЂў assess, diagnose, and evaluate patients with a variety of acute and chronic pain disorders вЂў develop appropriate treatment and rehabilitation plans for patients with acute and chronic pain, and identify when to refer patients вЂў identify, treat, or appropriately refer patients with addiction вЂў implement new therapies, techniques, and diagnostic procedures in pain management вЂў improve safety and decrease risks associated with established pain medicine interventions вЂў improve the assessment, evaluation, and treatment of chronic pain patients with psychological issues вЂў evaluate the legal, ethical, and regulatory issues surrounding the practice of pain medicine вЂў implement strategies and processes for providing patient-centered pain care in a changing healthcare environment вЂў maximize efficiencies and improve the business model of pain medicine. Continuing Medical Education Credits Accreditation Council for Continuing Medical Education The American Academy of Pain Medicine (AAPM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education (CME) for physicians. AAPM designates all AAPM CME activities associated with the 27th Annual Meeting for a maximum of 28.75 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. AAPM 27th Annual Meeting and Related Education Programs 27th Annual Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.75 credits Essential Tools for Treating the Patient in Painв„ў . . . . . . . . . . . . . . . 16 credits Cadaver Workshop . . . . . . . . . . . . . . . . . . . . . . . . . . Not eligible for CME credits Ultrasound Guidance for the Pain Physician . . . . . . . . . . . . . . . . . . . 4 credits Taking Control of Your Interventional Pain Practice: Accessing and Improving Practice Management Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 credits Note. Attendees cannot receive credit for simultaneous sessions, including preconference sessions and concurrent workshops. The highest number of credits can be earned by combining the 27th Annual Meeting and Essential Tools for Treating the Patient in Painв„ў, which will provide a maximum of 28.75 CME credits. American Academy of Family Physicians (AAFP) The AAPM is approved by the American Academy of Family Physicians (AAFP) to offer continuing medical education for the 27th Annual Meeting. This activity has been reviewed and is acceptable for up to 12.75 prescribed credits by the AAFP. American Academy of Physician Assistants (AAPA) AAPA accepts Category 1 CME credit from the American Osteopathic Association Council on Continuing Medical Education (AOACCME), prescribed credit from AAFP, and AMA PRA Category 1 creditв„ў for the PRA organizations accredited by ACCME. How to Obtain CME Credit An evaluation form of the 27th Annual Meeting will be available online to each registrant. To receive CME credit for each session you attend, you must evaluate that session in the appropriate section of the online evaluation. You will be able to print your certificate once you complete the evaluation. Commercially Supported Satellite Symposia Satellite symposia will be offered during breakfast, lunch, and dinner hours during the annual meeting. These independently managed satellite symposia are supported by AAPMвЂ™s Corporate Relations Council members. The programs have been reviewed by the AAPM Program Committee and approved for presentation as part of the Satellite Symposia program. These sessions are offered free of charge to all meeting registrants; however, those who have preregistered will be seated first. A limited number of seats will also be available on a first-come, first-served basis. Check for availability at the registration desk outside the session room 30 minutes before the scheduled start of the program. Disclosure It is the policy of AAPM to plan and implement educational activities in accordance with ACCMEвЂ™s Essential Areas and Elements to ensure balance, independence, objectivity, and scientific rigor. As an ACCMEAccredited Provider, AAPM is eligible to receive commercial support from commercial interests but cannot receive guidance, either nuanced or direct, on the content of the activity or on who should deliver the content. All program faculty and planners are required to disclose all financial relationships they may have or have had within the last 12 months with commercial interests whose products or services are related to the subject matter of the presentation. Any real or apparent conflicts of interest must be resolved prior to the presentation. Planning committee disclosures are listed in this brochure. All confirmed faculty disclosure information will be made available to attendees on the AAPM Annual Meeting website and in the program book. Faculty will also be expected to disclose this information to the audience both verbally and in print (slide presentation) at the beginning of each presentation. Faculty is also required to inform program participants if any unlabeled uses of products regulated by the U.S. Food and Drug Administration will be discussed. evaluations 11 Attendees will be asked to submit evaluations online for the 2011 AAPM Annual Meeting. Please use the space provided to make any notes about the sessions you attend to help you fill out the online evaluation form, which will be provided to all meeting attendees. WEDNESDAY, MARCH 23 7:30 amвЂ“5 pm Essential Tools for Treating the Patient in Painв„ў: What Every Primary Care and Pain Specialist Needs to Know: Day 1 Salahadin Abdi, MD PhD; Zahid H. Bajwa, MD; Edward T. Bope, MD; Paul J. Christo, MD MBA; Salim M. Ghazi, MD; Philip S. Kim, MD; John D. Markman, MD THURSDAY, MARCH 24 7:30 amвЂ“5 pm Essential Tools for Treating the Patient in Painв„ў: What Every Primary Care and Pain Specialist Needs to Know: Day 2 Paul J. Christo, MD MBA; Steven P. Cohen, MD; Oscar A. De Leon-Casasola, MD; Scott M. Fishman, MD; Rollin M. Gallagher, MD MPH; Salim M. Ghazi, MD; Aaron M. Gilson, MS MSSW PhD; Bill H. McCarberg, MD; Ben A. Rich, JD PhD; Mark D. Sullivan, MD PhD; Ajay D. Wasan, MD MSc 7:30вЂ“11:30 am Ultrasound Guidance for the Pain Physician (001) Mark F. Hurdle, MD; Susan M. Moeschler, MD; Steven J. Wisniewski, MD 1вЂ“5 pm Taking Control of Your Interventional Pain Practice: Accessing and Improving Practice Management Protocols (002) Trish Bukauskas, CMM CPC CMSCS CMPA; Amy G. Mowles; Linda M. VanHorn, MBA 12 evaluations FRIDAY, MARCH 25 8:45вЂ“9:30 am Plenary Session Consumer-Driven Health Care: Implications for the Pain Physician (102) Regina E. Herzlinger, PhD 10:30вЂ“11 am AMA President-Elect Address (103) Peter W. Carmel, MD; Richard Deem, MD 11вЂ“11:45 am Medical Specialties Converge: Future Perspectives of Interventional Pain Physicians and Spine Surgeons (104) Timothy R. Deer, MD; Robert M. Levy, MD PhD 1:30вЂ“2:30 pm CRPS: Innovative Management Strategies (201) May L. Chin, MD; Mehul J. Desai, MD MPH; John C. Rowlingson, MD 1:30вЂ“2:30 pm Improving Outcomes of Interventional Pain Procedures (202) Charles N. Aprill, MD; Michael L. Whitworth, MD 1:30вЂ“2:30 pm Guidelines for the Treatment of Low Back Pain (203) Ray M. Baker, MD; Laxmaiah Manchikanti, MD; Richard W. Rosenquist, MD 1:30вЂ“2:30 pm Legal and Ethical Aspects of Pain Care (204) Lora L. Brown, MD; Alex Cahana, MD; Larry C. Driver, MD; Ben A. Rich, JD PhD evaluations FRIDAY, MARCH 25 (continued) 3вЂ“4 pm Army Pain Management: From Injury to Home (205) Chester C. Buckenmaier III, MD; Rollin M. Gallagher, MD MPH; Kevin T. Galloway, MHA BSN RN 3вЂ“4 pm Physical Therapy for Non-Physiatrists (206) Donna M. Bloodworth, MD; Gagan Mahajan, MD; Steven P. Stanos, DO 3вЂ“4 pm Blurring the Line Between Surgeons and Pain Physicians (207) Richard G. Bowman II, MD; Timothy R. Deer, MD; Leonardo Kapural, MD PhD 3вЂ“4 pm Using Outcomes Data to Improve Patient Care (208) Michael A. Ashburn, MD MBA MPH; Martin D. Cheatle, PhD; Fred N. Davis, MD; Gilbert J. Fanciullo, MD 4:30вЂ“5:30 pm Pelvic Pain: A New Approach (209) Leonardo Kapural, MD PhD; Tamer M. Yalcinkaya, MD 4:30вЂ“5:30 pm Regenerative Therapies: Clinical Applications and Evidence-Based Review (210) Ronald W. Hanson, MD; Joseph J. Ruane, DO 4:30вЂ“5:30 pm Myofascial Pain: Bench to Bedside (211) Mehul J. Desai, MD MPH; Jay P. Shah, MD 13 14 evaluations FRIDAY, MARCH 25 (continued) 4:30вЂ“5:30 pm Patient-Centered Pain Care: Who is Driving the Bus? (212) Alex Cahana, MD; Bernice R. Hecker, MD MHA FACC; Mark D. Sullivan, MD PhD SATURDAY, MARCH 26 8:30вЂ“9:30 am Plenary Research Highlights (105) Adnan Al-Kaisy, MB, ChB, FRCA; Edward J. Bilsky, PhD; Julie Cunningham, PharmD AAMP CPNP; Timothy R. Deer, MD; Rosemary C. Polomano, PhD RN; Hoameng Ung, BS 10:30вЂ“11:15 am Plenary Session Pain Care Reform (106) Vice Admiral Regina Benjamin, MD MBA, U.S. Surgeon General (Invited Faculty) 1:45вЂ“2:45 pm When Acute Pain Becomes Chronic (301) Ian R. Carroll, MD MS; Sean Mackey, MD PhD 1:45вЂ“2:45 pm Evidence-Based Therapies in Cancer Pain Management (302) Allen W. Burton, MD; Vitaly Gordin, MD 1:45вЂ“2:45 pm The Value Proposition in Health Care: Do You Want to Get Paid for What You Do? (303) David W. Polly, MD evaluations SATURDAY, MARCH 26 (continued) 3вЂ“4 pm All About Opioids (304) Martin S. Angst, MD; Annika Rhodin, MD PhD; Lynn R. Webster, MD 3вЂ“5:15 pm Pain Treatment Debate: Mock Trial (305) Richard G. Bowman, II, MD; Timothy R. Deer, MD; Leonardo Kapural, MD PhD; Robert M. Levy, MD PhD; Sunil J. Panchal, MD; William M. Tiano, Esq. 3вЂ“4 pm Contracting with Payors (306) Trish Bukauskas, CMM CPC CMSCS CMPA 4:15вЂ“5:15 pm Opioid Misuse in Cancer Patients: A Growing Problem (307) Dhanalakshmi Koyyalagunta, MD; Diane M. Novy, PhD; Steven D. Passik, PhD 4:15вЂ“5:15 pm 2011: Coding Update and Beyond (308) Fred N. Davis, MD; Emily H. Hill, PA 15 16 evaluations SUNDAY, MARCH 27 8:30вЂ“9:30 am REMS UpdateвЂ”E-Prescribing (401) Scott M. Fishman, MD; Aaron M. Gilson, PhD MS MSSW 8:30вЂ“9:30 am Medical Marijuana for the Treatment of Chronic Pain (402) Mike W. Hooten, MD; Joshua B. Murphy, JD; Terry D. Schneekloth, MD; Ajay D. Wasan, MD MSc 8:30вЂ“9:30 am Spine Imaging: The Significance of Structure and Morphology (403) Timothy P. Maus, MD 9:45вЂ“10:45 am National Institutes of Health (NIH) Pain Research: Optimizing Funding Through Grant Writing (404) Yu (Woody) Lin, MD PhD; Sean Mackey, MD PhD; Weijia Ni, PhD 9:45вЂ“10:45 am Social Media Revolution: Marketing in the Decade Ahead (405) Linda M. VanHorn, MBA 9:45вЂ“10:45 am Chronic Daily Headache (406) Zahid H. Bajwa, MD evaluations SUNDAY, MARCH 27 (continued) 11 amвЂ“Noon Optimizing Clinical Research Opportunities and Publishing in Pain Medicine (407) Rollin M. Gallagher, MD MPH; Ajay D. Wasan, MD MSc 11 amвЂ“Noon Cost Effectiveness of Spinal Cord Stimulation and Intrathecal Polyanalgesia in the Management of Chronic Non-Malignant Pain (408) Sharon Bishop, MHlthSci BNurs; Krishna Kumar, MD MBBS MS FRCS 11 amвЂ“Noon Psychological Therapies for Chronic Pain (409) Mary Elena Collazo, PsyD; Albert L. Ray, MD 17 18 2 0 1 1 A A P M A wa r ds Philipp M. Lippe, MD, Award The Philipp M. Lippe, MD, Award is given to a physician for outstanding contributions to the social and political aspect of pain medicine. Social and political accomplishments could be those that benefit the science, practice, or recognition of the specialty. This . award is supported by Douglas Throckmorton, MD Douglas Throckmorton, MD, is deputy center director of the U.S. Food and Drug Administration (FDA) Center for Drug Evaluation and Research (CDER). He also serves the FDA as division director of cardiac and renal drug products. Dr. Throckmorton began his career with the FDA in 1997 as medical officer of the division of cardiac and renal drug products. Before his career at the FDA, Dr. Throckmorton served as an academic nephrologist at the Medical College of Georgia for 3 years. During that time, he simultaneously worked as staff physician at the VeteranвЂ™s Administration Medical Center in Augusta, GA. Dr. Throckmorton received his doctor of medicine degree from the University of Nebraska Medical School and completed clinical and research fellowships in nephrology at Yale-New Haven Hospital. He is board certified by the National Board of Medical Examiners and the American Board of Internal Medicine and subspecialty certified in nephrology through the American Board of Internal Medicine. Dr. Throckmorton holds membership on multiple FDA working groups and committees, including the Medical Policy Coordinating Committee, the Active Controls Working Group, the Problem Labeling Working Group, the Arthritis and Rheumatology Working Group, the Material Facts Assessment Subcommittee, the Reviewer for USP monographs, and the Office of Drug Safety Pediatrics Working Group. He also is chair of the QT Working Group and co-chair of the Drug-Device Working Group. Dr. Throckmorton is the recipient of more than 30 prestigious awards, including the SecretaryвЂ™s Award for Distinguished Service, the FDA Outstanding Service Award, the CommissionerвЂ™s Special Citation, the Center DirectorвЂ™s Special Citation, and the Leveraging/Collaboration Award. 20 1 1 A A P M A wa r ds 19 Founders Award The Founders Award is given to an individual for outstanding contributions to the science or practice of pain medicine. This award is given for continued contributions for the basic or clinical science of pain medicine or for demonstration of clinical excellence or innovation in the practice of pain medicine. Daniel B. Carr, MD Daniel B. Carr, MD, serves as the Saltonstall Professor of Pain Research in the department of anesthesia at Tufts Medical Center in Boston. He is co-founder and director of the pain research, education, and policy certificate and degree programs at Tufts University School of Medicine. Known internationally for his contributions to pain research and education, evidence-based pain medicine, and social and political aspects of pain relief, Dr. Carr co-chaired and drafted major portions of the first U.S. Federal Clinical Practice Guidelines on Acute and Cancer Pain Management and has served as an advisor or board member for many subsequent governmental and nongovernmental pain-related programs, initiatives, and societies. He led the formation of comprehensive multidisciplinary pain treatment centers and their accredited fellowship programs at the Massachusetts General Hospital, Tufts Medical Center, and Caritas-St. ElizabethвЂ™s Medical Center. Dr. Carr also co-developed a novel outcomes instrument (вЂњTOPSвЂќ) for patients with chronic pain. Dr. Carr has edited and otherwise contributed to numerous books and peer-reviewed publications in the field. In addition to serving as founding editor of the International Association for the Study of PainвЂ™s newsletter, Pain: Clinical Updates, Dr. Carr was the lead editor for pain trials within the Cochrane collaborative review group on Pain, Palliative, and Supportive Care, and serves as a referee and on the editorial boards of several journals. He has advised numerous firms, holds analgesics-related patents, and served as chief medical officer of Javelin Pharmaceuticals before it was acquired by Hospira in 2010. Dr. Carr is the recipient of numerous awards, including the Bernard Schoenberg Award of the American Institute of LifeThreatening Illness and Loss, the American Pain SocietyвЂ™s Distinguished Service and Fordyce Awards, and AAPMвЂ™s Philipp M. Lippe, MD, Award. He is an honorary fellow for the Faculty of Pain Medicine of the Australia and New Zealand College of Anaesthetists. 20 2 0 1 1 A A P M A wa r ds Distinguished Service Award The Distinguished Service Award is given to an individual for commitment and contributions to the American Academy of Pain Medicine. This award is given to an individual for specific outstanding contributions. Timothy R. Deer, MD Timothy R. Deer, MD, is the president and chief executive officer of The Center for Pain Relief in Charleston, WV. He is a clinical professor of anesthesiology at the West Virginia University School of Medicine and an Alpha Omega Alpha graduate of West Virginia University School of Medicine. He completed his training in anesthesiology and pain medicine at the University of Virginia. In addition to his involvement with a busy private practice, Dr. Deer maintains a demanding research schedule. His publications have involved extensive work regarding injection techniques, minimally invasive disc procedures, intrathecal drug delivery, spinal cord stimulation, and peripheral nerve stimulation. Dr. Deer has lectured at many national and international symposia and has been involved in the hands-on training of more than 1,000 interventional pain specialists. His current work in organized medicine includes serving as a member of the board of directors for the North American Neuromodulation Society and the American Academy of Pain Medicine, immediate past chair of the Committee on Pain Medicine for the American Society of Anesthesiologists, member of the Neuromodulation Editorial Board, president of the West Virginia Society of Interventional Pain Physicians, and member of several other boards and committees. Dr. Deer has authored numerous journal articles, book chapters, and review articles. Dr. Deer has served as faculty at numerous prestigious meetings, most recently the American Society of Anesthesiologists Annual 2010 Meeting, the 17th Annual Napa Pain Conference, and the 18th Annual International Spine Intervention Society Meeting. 20 1 1 A A P M A wa r ds 21 Patient Advocacy Award The Patient Advocacy Award recognizes activity of an individual in advocating for appropriate evaluation and treatment of patients suffering from pain. This award was created to honor those healthcare professionals whose deeds reflect their recognition of the importance and impact of the specialty of pain medicine. Will Rowe Will Rowe began his career at the American Pain Foundation (APF) in 2003 as executive director and was subsequently appointed chief executive officer of the organization in 2008. Under his leadership the APF has doubled in size and emerged as one of the leading pain advocacy organizations in the country. The APF has developed a nationwide grassroots pain advocacy structure, the вЂњAction Network,вЂќ which has been effectively engaged in advancing positive state and national pain policy. Mr. Rowe is also one of the founders of the Pain Care Forum, which now has 62 member organizations addressing national pain policy priorities. His work was instrumental in the passage of the Military and Veterans Pain Acts and in ensuring inclusion of the pain provisions in the Affordable Health Care Act. He has also chaired multiorganizational committees addressing risk evaluation and mitigation strategy (REMS) and the FDAвЂ™s concerns regarding the safe use of acetaminophen. Mr. Rowe is committed to creating a massive pain advocacy movement involving all pain practitioners and the millions of people who are affected by pain. 22 2 0 1 1 A A P M A wa r ds Presidential Commendations Colonel Chester C. Buckenmaier, MD Colonel Chester C. Buckenmaier, MD, serves as chief of the Army Regional Anesthesia & Pain Management Initiative at Walter Reed Army Medical Center. He also serves as program director of the National Capital ConsortiumвЂ™s Acute Pain Medicine and Regional Anesthesia Fellowship Program and as assistant professor of anesthesiology at the Uniformed Services University of the Health Services. Over the course of his time in the army, Dr. Buckenmaier has been the recipient of numerous awards, including the Military Medicine вЂњAвЂќ Designator, the Legion of Merit Meritorious Service Medal, the Army Achievement Medal, and the National Defense Service Medal. Dr. Buckenmaier has been instrumental in developing pain services in the military, includingВ the Defense Veterans Pain Management Initiative (DVPMI)В and theВ Army Pain Management Task Force. He successfully launched the Acute Pain Section of Pain Medicine and serves as editor of Military Medicine. Dr. Buckenmaier has contributed to numerous publications and serves as consultant reviewer for Regional Anesthesia and Pain Medicine, Anesthesia & Analgesia, and the British Journal of Anaesthesia. Colonel Kevin Galloway, AN Colonel Kevin Galloway, AN, is a career Army officer with more than 22 years of service. He serves as the chief of staff of the ArmyвЂ™s Pain Management Task Force and as action officer for the ArmyвЂ™s Comprehensive Pain Management Campaign Plan. He is also the chief of the Support Branch in the Rehabilitation and Reintegration Division (R2D) at the United States Army Office of The Surgeon General (OTSG). Col. Galloway has a bachelors of science in nursing degree from the Catholic University of America and a graduate degree in Health Care Administration from the United States Army-Baylor University Graduate Program. Col. Galloway was commissioned as an Army Nurse Corps officer in 1988. His career has included a variety of clinical and administrative assignments in both fixed facility hospitals and military field hospitals. He has served in staff and leadership roles in several military emergency departments, ambulatory care clinics, and troop medical clinics. Prior to his current assignment at OTSG, Col. Galloway served as the strength management, education, and training officer at Army Nurse Corps Branch, U.S. Army Human Resources Command, the ArmyвЂ™s personnel headquarters. Col. GallowayвЂ™s military awards include the Bronze Star Medal, Meritorious Service Medal (X4), Army Commendation Medal (X6), Joint Service Achievement Medal, and the Army Achievement Medal (X6). He is a recipient of the Order of Military Merit and the Army Surgeon GeneralвЂ™s вЂњAвЂќ Proficiency designator, an award given to recognize the accomplishments of senior medical leaders who have made significant contributions to the Army Medical Department. 20 1 1 A A P M A wa r ds 23 Presidential Commendations Lieutenant General Eric B. Schoomaker, MD PhD Brigadier General Richard W. Thomas, MD DDS FACS Lieutenant General Eric B. Schoomaker, MD PhD, was sworn in as the 42nd Army Surgeon General and assumed command of U.S. Army Medical Command in 2007. He had previously served as the commanding general of Walter Reed Army Medical Center and the North Atlantic Regional Medical Command. Brigadier General Richard W. Thomas, MD DDS FACS, is an Army physician and serves as the U.S. Army assistant surgeon general (Force Projection) in the Office of the Surgeon General in Washington, DC. Ltg. Schoomaker completed his internship and residency in internal medicine at Duke University Medical Center, followed by a fellowship in hematology at Duke University Medical Center. He also completed his PhD in human genetics. He is certified by the American Board of Internal Medicine in both internal medicine and hematology. The Army Surgeon General appointed Ltg. Schoomaker to the position of chief of the Army Medical Corps when he assumed command of the Southeast Regional Medical Command/ Dwight David Eisenhower Army Medical Center from June 2002 to June 2005. Before commanding the North Atlantic Regional Medical Command, he was the commanding general of the U.S. Army Medical Research and Materiel Command and Fort Detrick, MD. His awards and decorations include the Distinguished Service Medal with one oak leaf cluster, the Legion of Merit with four oak leaf clusters, the Meritorious Service Medal with two oak leaf clusters, the Joint Service Commendation Medal, the Army Commendation Medal, the Army Achievement Medal, and the Humanitarian Service Medal. He has been honored with the Order of Military Medical Merit and the вЂњAвЂќ Proficiency Designator and holds the Expert Field Medical Badge. Bg. Thomas earned a bachelors degree from West Virginia University (WVU). A distinguished military graduate, he was commissioned through the Reserve Officer Training Corps. Upon graduation from the WVU School of Dentistry, he began his career with the Army Medical Department as a Dental Corps officer. Following assignments in Panama and with the 82D Airborne Division, Bg. Thomas returned to the WVU School of Medicine. After receiving his medical degree, he completed an internship at Brooke Army Medical Center, Fort Sam Houston, TX, and residency in otolaryngology/head and neck Surgery at Madigan Army Medical Center in Fort Lewis, WA. He is certified by the American Board of Otolaryngology/Head & Neck Surgery and is a fellow of the American College of Surgeons. Bg. ThomasвЂ™s military education includes the Army War College, the Army Command and General Staff College, the Army Medical Department Officer Advanced and Basic Courses, the Combat Casualty Care Course, the U.S. Army Airborne School, the Air Assault School, and the U.S. Army Jumpmaster and Flight Surgeon Courses. Bg. ThomasвЂ™s many awards, decorations, and honors include the Legion of Merit with two oak leaf clusters, the Bronze Star Medal with one oak leaf cluster, the Meritorious Service Medal with two oak leaf clusters, the Air Medal, the Army Commendation Medal with two oak leaf clusters, the Army Achievement Medal with three oak leaf clusters, the Armed Forces Expeditionary Medal and various campaign medals. The Army Surgeon General has bestowed upon him the вЂњAвЂќ proficiency designator for expertise in his medical specialty and he has been honored with the Order of Military Medical Merit. 24 2 0 1 1 A A P M A wa r ds Presidential Commendations Lisa A. Robin Jeffrey M. Tiede, MD Lisa A. Robin is senior vice president, advocacy and member services for the Federation of State Medical Boards (FSMB), a position she has held since 2007. She began her career with FSMB in 1994 as associate of Leadership Support Services. Ms. Robin received both her bachelorвЂ™s degree and her masterвЂ™s of liberal arts from Texas Christian University. Jeffrey M. Tiede, MD, received his medical degree from St. Louis University, where he graduated summa cum laude and Alpha Omega Alpha. He completed his anesthesiology residency at Mayo Graduate School of Medicine in Rochester, NY, where he was named the most outstanding resident in his class. Dr. Tiede continued his training at Mayo with a fellowship in pain medicine.В In her role at FSMB, Ms. Robin manages public policy, government relations, education, library services, and public affairs for a national association of 70 state medical licensing and disciplinary boards, developing public policy positions, reports, and recommendations for the board of directors and general membership consideration. Ms. Robin served as principal investigator for the Office for the Advancement of Telehealth, License Portability Grant Program, and the Attorney General Prescriber and Consumer Grant Program, Online Prescriber Education Network. She has also served as project director for the initiatives: Responsible Opioid Prescribing, a PhysicianвЂ™s Guide; Promoting Balance and Consistency in the Regulatory Oversight of Pain Care; and the Centers for Disease Control and PreventionвЂ™s Collection of Physician Contact Information. Dr. Tiede has served as managing partner of Columbia Interventional Pain Center, LLC, since 2007, where he oversees 16 staff members and thousands of active patients. Previously, he served as chair of the department of pain medicine at Mayo Clinic in Jacksonville, FL, and as medical director for the department of pain medicine at Mayo Clinic in Rochester. He has also previously served as assistant professor of anesthesiology at the Mayo Clinic. Dr. Tiede has served as an invited lecturer for Pfizer, MinSurg, St. Jude Medical, and Boston Scientific on topics such as Lyrica and minimally invasive spine surgery. He has also served as faculty for the numerous other pain conferences. He is an American Board of Pain Medicine Diplomate and is certified by the American Board of Anesthesiology in Anesthesiology and Pain Management. Dr. Tiede serves as a Program Committee member and Scientific Poster Committee chair for AAPM. Pas t A wa r d R e c i p i e n t s Philipp M. Lippe, MD, Award 1995 Philipp M. Lippe, MD 1996 Joel Saper, MD 1997 Richard Stieg, MD 1998 Sridhar Vasudevan, MD 1999 Hubert Rosomoff, MD 2000 J. David Haddox, DDS MD 2001 Kathleen M. Foley, MD 2002 Michael Ashburn, MD MPH 2003 Daniel B. Carr, MD 2004 Robert G. Addison, MD 2005 Kenneth A. Follett, MD PhD 2006 Samuel J. Hassenbusch, MD PhD 2007 Scott M. Fishman, MD 2008 Benjamin L. Crue, Jr., MD FACS 2009 Albert L. Ray, MD 2010 Michel Y. Dubois, MD Founders Award 1995 Benjamin Crue, MD 1996 Wilbert Fordyce, PhD 1997 Peter Wilson, MBBS PhD 1998 Tony Yaksh, PhD 1999 Steven Feinberg, MD 2000 Rollin M. Gallagher, MD MPH 2001 Gary J. Bennett, PhD 2002 Russell Portenoy, MD 2003 Donald D. Price, PhD 2004 James C. Eisenach, MD 2005 Edward C. Covington, MD 2006 Gerald F. Gebhart, PhD 2007 Richard B. North, MD 2008Michael J. Cousins, MBBS MD DSc FANZCA FRCA FAChPM(RACP) FFPMANZCA 2009 Nikolai Bogduk, MD PhD DSc 2010 David Joranson, MSSW 25 Distinguished Service Award 1996 Patricia Owen 1997 Not Awarded 1998 Paul Gebhard, JD; Kristie Haley 1999 Peter Wilson, MBBS, PhD; Ruth Tiernan 2000 Not Awarded 2001 Joel R. Saper, MD FACP FAAN 2002 Elliot Krames, MD 2003 Samuel J. Hassenbusch, MD PhD; Jeffrey W. Engle 2004 Albert L. Ray, MD 2005 Rollin M. Gallagher, MD MPH 2006 Edward C. Covington, MD 2007 Eduardo M. Fraifeld, MD 2008 David A. Fishbain, MD DFAPA 2009 Colleen M. Healy 2010 Scott M. Fishman, MD Patient Advocacy Award 2001 Warner Wood, MD 2002 Robert Biscup, MS DO 2003 Not Awarded 2004 Kenneth Moritsugu, MD MPH 2005 John (Jack) C. Lewin, MD 2006 Not Awarded 2007 Louis W. Sullivan, MD 2008 Robert D. Kerns, PhD 2009 Not Awarded 2010 Myra Christopher 26 AA P M 2011 Ann u a l M e e t i ng Cyber CafГ© Program Evaluation Tool Keep in touch with your home or office during the annual meeting. Visit the Cyber CafГ© located near the AAPM Registration Desk. Several computers will be available with Internet access to check your e-mail. The Cyber CafГ© is sponsored by Purdue Pharma, LP. AAPM offers its meeting evaluation in an online format. Meeting registrants can access the evaluation by visiting the AAPM website, www.painmed.org/dc, and clicking on the Evaluation link. The online evaluation may be completed during the meeting or after attendees have returned home. Participants will receive their continuing medical education certificate immediately when they submit their evaluations online. Certificates also can be sent from the system to participantsвЂ™ e-mail addresses for printing later or saving electronically. All attendees are encouraged to complete the meeting evaluation regardless of whether they are seeking continuing education credits. If you have any questions, please call 847.375.4731. Virtual Exhibit Hall The final exhibitor list and floor plan can be found at www. awebsource.com/expocad/shows/aapm2011/start.html. The AAPM virtual floor plan allows you to search by company, product type, or booth location. Links to the exhibitor websites are also available on this page. The floor plan and exhibit list will be posted for 3 months following the meeting. Paperless Meeting Registrants are able to view, download, and print faculty slides and presentation information at www.painmed.org/dc 1 week prior to the 27th AAPM Annual Meeting and after the meeting. A printed schedule of sessions and events will be provided to each attendee at registration. Networking Opportunities Thursday, March 24 Friday, March 25 Friday, March 25 Saturday, March 26 5вЂ“6:30 pm 8:30вЂ“8:45 am 5:30вЂ“7 pm 12:45вЂ“1:30 pm Welcome Reception Join friends and colleagues for the Welcome Reception in Prince GeorgeвЂ™s Exhibit Hall C. Exhibits and poster sessions (Group 1) will be available for visitation. AAPM Welcome Address 10:30вЂ“11 am AMA Address Reception Visit the exhibits and poster sessions (Group 2) in Prince GeorgeвЂ™s Exhibit Hall C. AAPM MembersвЂ™ Business Meeting and AAPM Awards Presentation Convention Center Floor Plan 27 28 Schedule at a Glance WEDNESDAY, MARCH 23, Preconference Sessions, Day 1 7:30вЂ“11:30 am Essential Tools for Treating the Patient in Painв„ў: What Every Primary Care and Pain Specialist Needs to KnowвЂ”Day 1 (PME) 11:45 amвЂ“1 pm Satellite Luncheon Symposium 1.25 CME Essential Tools for Treating the Patient in Painв„ў: What Every Primary Care and Pain Specialist Needs to KnowвЂ”Day 1 (PME) 1вЂ“5 pm Thursday, March 24, Preconference Sessions, Day 2 7:30вЂ“11:30 am Essential Tools for Treating the Patient in Painв„ў: What Every Primary Care and Pain Specialist Needs to KnowвЂ”Day 2 (PME) 11:45 amвЂ“1 pm 1вЂ“5 pm Cadaver Workshop (CW11) Ultrasound Guidance for the Pain Physician (001) Satellite Luncheon Symposium 1.25 CME Essential Tools for Treating the Patient in Painв„ў: What Every Primary Care and Pain Specialist Needs to KnowвЂ”Day 2 (PME) Cadaver Workshop (CW11) Taking Control of Your Interventional Pain Practice: Accessing and Improving Practice Management Protocols (002) AAPM 27th Annual Meeting Welcome Reception Exhibits and Poster Sessions (Group 1) 5вЂ“6:30 pm 6:30вЂ“7:45 pm Satellite Dinner Symposium 1.25 CME Friday, March 25, Meeting Day 1 7вЂ“8:15 am Satellite Breakfast Symposium 1.25 CME 8:30вЂ“8:45 am AAPM Welcome Address (101) 8:45вЂ“9:30 am Plenary Session Consumer-Driven Health Care: Implications for Pain Physicians (102) Regina E. Herzlinger, PhD 9:30вЂ“10:30 am Break Exhibits and Poster Sessions (Group 1) 10:30вЂ“11 am American Medical Association President-Elect Address (103) 11вЂ“11:45 am Medical Specialties Converge: Future Perspectives of Interventional Pain Physicians and Spine Surgeons (104) NoonвЂ“1:15 pm Satellite Luncheon Symposium 1.25 CME Practice Management Sessions Patient-Centered Care Sessions 1:30вЂ“2:30 pm CRPS: Innovative Management Strategies (201) Improving Outcomes of Interventional Pain Procedures (202) 2:30вЂ“3 pm 3вЂ“4 pm 4вЂ“4:30 pm Guidelines for the Treatment of Low Back Pain (203) Break Army Pain Management: From Injury to Home (205) Patient-Centered Care Sessions Practice Management Sessions Physical Therapy for Non-Physiatrists (206) Using Outcomes Data to Improve Patient Care (208) Blurring the Line Between Surgeons and Pain Physicians (207) Break Practice Management Sessions Patient-Centered Care Sessions 4:30вЂ“5:30 pm Legal and Ethical Aspects of Pain Care (204) Regenerative Therapies: Clinical Pelvic Pain: A New Approach (209) Applications and Evidence-Based Review (210) Myofascial Pain: Bench to Bedside (211) 5:30вЂ“7 pm AAPM 27th Annual Meeting Reception Exhibits and Poster Sessions (Group 2) 7вЂ“8:15 pm Satellite Dinner Symposium Non-CME Event Patient-Centered Pain Care: Who Is Driving the Bus? (212) Schedule at a Glance 29 Saturday, March 26, Meeting Day 2 7вЂ“8:15 am Satellite Breakfast Symposium 1.25 CME 8:30вЂ“9:30 am Plenary Research Highlights (105) 9:30вЂ“10:30 am BREAK Exhibits and Poster Sessions (Group 2) 10:30вЂ“11:15 am Pain Care Reform (106) Invited FacultyвЂ”Vice Admiral Regina Benjamin, MD MBA, U.S. Surgeon General 11:30 amвЂ“12:45 pm Satellite Luncheon Symposium 1.25 CME AAPM MembersвЂ™ Business Meeting AAPM Awards Presentation 12:45вЂ“1:30 pm Patient-Centered Care Sessions 1:45вЂ“2:45 pm When Acute Pain Becomes Chronic (301) 2:45вЂ“3 pm Evidence-Based Therapies in Cancer Pain Management (302) All About Opioids (304) Practice Management Sessions Pain Treatment Debate: Mock Trial, Part 1 (305) 4вЂ“4:15 pm Contracting with Payors (306) Break Patient-Centered Care Sessions 4:15вЂ“5:15 pm The Value Proposition in Health Care: Do You Want to Get Paid for What You Do? (303) Break Patient-Centered Care sessions 3вЂ“4 pm Practice Management Sessions Opioid Misuse in Cancer Patients: A Growing Problem (307) Practice Management Sessions Pain Treatment Debate: Mock Trial, Part 2 (305) 2011: Coding Update and Beyond (308) Satellite Dinner Symposium non-cme event 5:30вЂ“6:45 pm Sunday, March 27, Meeting Day 3 7вЂ“8:15 am Satellite Breakfast Symposium (Event is not confirmed at time of printing; check on site for announcements.) Patient-Centered Care Sessions 8:30вЂ“9:30 am REMS UpdateвЂ”E-Prescribing (401) Medical Marijuana for the Treatment of Chronic Pain (402) Patient-Centered Care Sessions Practice Management Sessions Patient-Centered Care Sessions National Institutes of Health (NIH) Pain Research: Optimizing Funding Through Grant Writing (404) Social Media Revolution: Marketing in the Decade Ahead (405) Chronic Daily Headache (406) Break 9:30вЂ“9:45 am 9:45вЂ“10:45 am 10:45вЂ“11 am Spine Imaging: The Significance of Structure and Morphology (403) Break Patient-Centered Care sessions 11 amвЂ“Noon Optimizing Clinical Research Opportunities and Cost Effectiveness of Spinal Cord Stimulation Psychological Therapies for Chronic Pain (409) Publishing in Pain Medicine (407) and Intrathecal Polyanalgesia in the Management of Chronic Non-Malignant Pain (408) 30 Schedule at a Glance Registration and Cyber Central Speaker Ready Room Tuesday, March 22 Wednesday, March 23 Thursday, March 24 Friday, March 25 Saturday, March 26 Sunday, March 27 Tuesday, March 22 Wednesday, March 23 Thursday, March 24 Friday, March 25 Saturday, March 26 Sunday, March 27 5вЂ“7 pm 6:30 amвЂ“5 pm 6:30 amвЂ“6 pm 7:30 amвЂ“6 pm 8 amвЂ“5 pm 8 amвЂ“Noon 4вЂ“7 pm 6:30 amвЂ“6 pm 6:30 amвЂ“6 pm 7 amвЂ“6 pm 7:30 amвЂ“5:15 pm 7:30 amвЂ“Noon Exhibits Opening Reception with Exhibits and Posters (see poster schedule below) Thursday, March 24, 5вЂ“6:30 pm Exhibits Open Friday, March 25, 9:30 amвЂ“Noon, 2:30вЂ“7 pm (Reception and posters, 5:30вЂ“7 pm; see poster schedule below) Exhibits Open Saturday, March 26, 9:30вЂ“11:30 am Posters In an effort to be more ecologically friendly, AAPM will not be listing the poster abstracts in the printed program book. Instead, abstracts are posted on the AAPM website at www.painmed.org and in Pain Medicine (volume 12, issue 3). Scientific posters will be on display in Prince GeorgeвЂ™s C. The six highest ranking poster authors have been selected to present their posters at a plenary research highlights session. This session will be held on Saturday, March 26, from 8:30вЂ“9:30 am. Group 1. Posters will be on display Thursday, March 24, 5 pm, through Friday, March 25, 11 am. The presentation group includes posters categorized by the following clinical topics вЂў Epidemiology/Health Policy/Education вЂў Pharmacological вЂў Psychosocial/Rehabilitation Author-Attended Sessions Welcome Reception with Poster Session Thursday, March 24, 5вЂ“6:30 pm Exhibit and Poster Break Friday, March 25, 9:30вЂ“10:30 am Group 2. Posters will be on display Friday, March 25, 5:30 pm, through Saturday, March 26, 10:30 am. This presentation group includes posters categorized by the following clinical topics: вЂў Procedures (Interventional) вЂў Translational Author-Attended Sessions Reception with Poster Session Friday, March 25, 5:30вЂ“7 pm Exhibit and Poster Break Saturday, March 26, 9:30вЂ“10:30 am the American Academy of Pain Medicine Letter from AAPM Membership Co-ChairsВ Keep Your M embership Active and G et Involved in AAPM Dear Colleag ue, The whole pr actice of pain medicine is ch specialty all to anging, cultu itself, focused rally and pol on treating th the clinical w itically. It has e pain patient isdom and ex become a med with вЂњconsult perience of a ical of social and ant gradeвЂќ ca la rge number of intellectual co p ab il it y. in d In iv te m idual medical grating plexity. Gover and society at specialties ca nmental agen large are all sl n be full cies, insurance owly discove To accomplis carriers, fello ring the talent h this succes w physicians, s and needs fo sfully takes ad certif ication) r th e pain medic vo ca cy and educat , and commit ine specialist ion, quality as ment to clinic . surance (by w al excellence. It is the goal ay of board of the Americ an Academy pain medicin of Pain Medic e specialist w ine to foster ith the profession al developmen вЂў educational t of the opportunitie s, such as AAPM plenary, and вЂ™s Annual Mee concurrent se ting, includin ssions on the g preconferen latest pain th ce workshop er apies and pro вЂў access to cu s, cedures rrent inform ation, by mea ns of a dynam ic website вЂў social, pol itical, and pro fessional advo Association, cacy, such as giving you a formal represe voice in thes ntation with sentation and e changing tim the American advocacy in W es ; th e Medical P ai as n hington, DC Care Coalition AAPM websi ; and patient , providing re te education m preaterials, such as videos on вЂў a world-cla the ss medical jo urnal, Pain M mentary on th ed ic in e, the premie e multidiscip r source of p linary clinical eer-reviewed practice of p research and ain medicine вЂў interaction comwith other sk il led pain med and national icine physicia levels in AAP ns with shared MвЂ™s new Mem goals and con ber Commun cerns, on loca ity. We encourage l, state, you to take a m or e active role in organization as we seek to 2011 in this robust and vi encourage th patients in th e highest leve gorous profes e world, in a sional ls of cl in dynamic inte ical practice membership llectual, tech for some of th online at w w n ic e most difficu al , social, and cu w.painmed.o lt ltural environ rg or by callin ment. Renew g 847.375.473 your 1 and update Thomas L . Y your account earwood, MD . PhD Co-Chair, M embership C F ommittee rancis P. Lag attuta, MD Co-Chair, M embership C ommittee Renew your membership online at www.painmed.org or by calling 847.375.4731 32 Preconference Sessions Wednesday, March 23вЂ“Thursday, March 24 Thursday, March 24 Essential Tools for Treating the Patient in Painв„ў 7:30вЂ“11:30 am, 1вЂ“5 pm Room: Annapolis Cadaver Workshop (Non-CME Activity) (CW11)* What Every Primary Care and Pain Specialist Needs to Know* Essential Tools for Treating the Patient in Painв„ў is designed for clinicians interested in obtaining an overview of some of the fundamentals of pain medicine in addition to practical approaches to the treatment of common pain disorders. The course offers clinically focused lectures and case presentations on the assessment, diagnosis, and treatment of patients with various acute, cancer, and chronic pain syndromes. Co-Chairs Zahid H. Bajwa, MD Salim M. Ghazi, MD Day 1, Wednesday, March 23 7:30вЂ“11:30 am, 1вЂ“5 pm Room: Woodrow Wilson CD Topics вЂў Assessment of Pain вЂў Pain in Older Adults вЂў Office-Based Pain Practice вЂў Mechanism-Based Treatment of Pain вЂў Assessment and Treatment of Headache вЂў Pharmacology of Opioids and NSAIDs вЂў Low Back Pain вЂў Advanced Interventional Pain Procedures вЂў Abdominal and Pelvic Pain Day 2, Thursday, March 24 7:30вЂ“11:30 am, 1вЂ“5 pm Room: Woodrow Wilson CD Topics вЂў Complex Regional Pain Syndrome вЂў Cancer Pain and Palliative Care (Medicine) вЂў Appropriate Management of Failed Back Syndrome вЂў Guide to Aberrant Behaviors Associated with Analgesic Use вЂў Opioid Agreements: The Good, the Bad, and the Ugly вЂў Pain and the Patient-Centered Medical Home вЂў Fibromyalgia and Myofascial Pain вЂў Pain Medicine and the Law The goals of interventional pain medicine physicians are to relieve, reduce, or manage pain and to improve a patientвЂ™s overall quality of life through minimally invasive techniques specifically designed to diagnose and treat painful conditions. AAPM presents an excellent hands-on opportunity to learn and perform basic and advanced interventional pain medicine procedures in a simulated setting. Participation in this workshop is essential to improving patient safety and patient outcomes in the interventional pain setting. Co-Chairs Lora L. Brown, MD Salim M. Hayek, MD PhD Faculty Ramsin Benyamin, MD David Caraway, MD Ken Chapman, MD Steven Cohen, MD Oscar De Leon-Cassasola, MD Michael Frey, MD Salim Ghazi, MD Michael Gofeld, MD Leonardo Kapural, MD PhD Philip Kim, MD Patrick McIntyre, MD Nilesh Patel, MD Dave Petersen, MD Joshua Prager, MD Binit Shah, MD Michael Stanton-Hicks, MD This workshop will be a highlight of AAPMвЂ™s preconference educational activities and will complement a robust curriculum of interventional, scientific, and practice management sessions that are slated for AAPMвЂ™s 27th Annual Meeting. Cadaver Workshop attendees will be able to select the type of proceduresВ that are most relevant to their pain practice by accessing the registration form on AAPMвЂ™s website at www.painmed.org/cadaver. This educational program is supported by Epimed, GE Healthcare, Kimberly Clark, Stryker International Spine, Boston Scientific, Globus Medical, Medtronic, NeuroTherm, St. Jude Medical, Vertos Medical, Cosman, Kyphon, and MinSurg, Corp. 7:30вЂ“11:30 am Room: Woodrow Wilson B Ultrasound Guidance for the Pain Physician (001)* *An additional fee is required to attend all preconference sessions. Preregistration is required. Responding to the accelerated advancement in the use of ultrasound guided blocks in the treatment of pain medicine, this program will provide an overview of the advantages and limitations of ultrasound guidance in the practice of pain medicine. This program will also provide hands-on application for the ultrasound novice to practice real-time techniques for common ultrasound procedures and review the available literature regarding feasibility, safety, and outcomes. Participation in this preconference session will enable learners to improve both cognitive and practical skills related to the use of ultrasound technology for regional anesthesia and interventional pain procedures. Dissemination of knowledge related to the difference between ultrasound and fluoroscopy will be discussed in accordance with the advantages and disadvantages of each of these interventional techniques. Preconference Sessions Educational Objectives 1. Apply the interventional techniques of ultrasound technology. 2. Perform musculoskeletal ultrasound examinations of the major joint areas, and apply real time ultrasound visualization to guide the needle to the target joint safely and efficiently. 3. Maximize proficiency in adjusting machine settings to optimize images, demonstrate basic ultrasound exams, and visualize needles through the use of ultrasound technology. This educational program is supported through in kind donations from Esaote North America, GE Healthcare, SonoSite, and Terason. Faculty Michael J. Derr, DO Mederic M. Hall, MD Bryan C. Hoelzer, MD Mark F. Hurdle, MD Susan M. Moeschler, MD Matthew J. Pingree, MD James C. Watson, MD Steven J. Wisniewski, MD 7:30вЂ“7:35 am Introduction Mark F. Hurdle, MD 7:35вЂ“7:55 am Ultrasound Guided Musculoskeletal Injections Steven J. Wisniewski, MD 7:55вЂ“8:15 am Ultrasound Guided Peripheral Nerve Blocks Susan M. Moeschler, MD 8:15вЂ“8:30 am Ultrasound Guided Axial Injections Mark F. Hurdle, MD 8:30вЂ“8:40 am Break 8:40вЂ“11:30 am Hands on Application Workshop Michael J. Derr, DO Mederic M. Hall, MD Bryan C. Hoelzer, MD Mark F. Hurdle, MD Susan M. Moeschler, MD Matthew J. Pingree, MD James C. Watson, MD Steven J. Wisniewski, MD Due to the вЂњhands-onвЂќ interactive format of the Ultrasound session, space will be limited to 56 registrants. This session may be subject to change. Please refer to AAPMвЂ™s website for the most current session information. 33 1вЂ“5 pm Room: Woodrow Wilson B Taking Control of Your Interventional Pain Practice: Accessing and Improving Practice Management Protocols (002)* This preconference session will provide interventional pain physicians the opportunity to ask questions about billing, coding, compliance, and other emerging practice management issues that affect the practice of interventional pain medicine. Seasoned professionals with proven track records in the pain management industry will provide attendees with what they need to stay current, compliant, and profitable in this ever-challenging healthcare arena. After completing this activity, attendees will improve their ability to review and reduce denials, identify OIG targets, pinpoint вЂњproblem areasвЂќ throughout the continuum of their practice, and implement monitoring techniques to increase profitability by decreasing loss in reimbursement. Educational Objectives 1. Understand what constitutes medical necessity in patient selection for utilizing ancillary services. 2. Strategically analyze the efficacy and profitability of an ancillary prior to implementing it in their practice. 3. Correctly code and document according to industry and federal guidelines for all ancillary services performed. Moderator Trish Bukauskas, CMM CPC CMSCS CMPA Faculty Trish Bukauskas, CMM CPC CMSCS CMPA Amy G. Mowles Linda M. VanHorn, MBA 1вЂ“1:05 pm Introduction Trish Bukauskas, CMM CPC CMSCS CMPA 1:05вЂ“2:05 pm Ready to Open a Pain Management Facility? Developing an OfficeBased or Ambulatory Surgery Facility Amy G. Mowles 2:05вЂ“3:05 pm Hidden Sources of Revenue: How to Incorporate Non-Physician Providers in Your Practice Linda M. VanHorn, MBA 3:05вЂ“3:20 pm Break 3:20вЂ“4:20 pm Optimize Revenue and Compliance in the Interventional Pain Practice by Accurately Coding and Documenting UDS and Diagnostic Ancillaries Trish Bukauskas, CMM CPC CMSCS CMPA 4:20вЂ“5 pm Question and Answer Panel *An additional fee is required to attend all preconference sessions. Preregistration is required. 34 Plenary Sessions Friday, March 25 Saturday, March 26 Room: Prince GeorgeвЂ™s D 8:30вЂ“8:45 am AAPM Welcome Address (101) Room: Prince GeorgeвЂ™s D 8:30вЂ“9:30 am Plenary Research Highlights (105) Perry G. Fine, MD 8:45вЂ“9:30 am Room: Prince GeorgeвЂ™s D Consumer-Driven Health Care: Implications for the Pain Physician (102) Regina E. Herzlinger, PhD, Nancy R. McPherson Professor of Business Administration, Harvard Business School, Boston, MA Regina E. Herzlinger, PhD, will give this yearвЂ™s Keynote Address. Named AmericaвЂ™s leading advocate for marketdriven, consumer-oriented health reform, Dr. Herzlinger is one the countryвЂ™s most respected healthcare analysts. She is widely recognized for the groundbreaking role she played in pointing the way toward a bold new healthcare plan. She has been dubbed by Money magazine as the вЂњgodmotherвЂќ of consumer-driven health care and has been listed annually by Modern Healthcare as one of the nationвЂ™s 100 most powerful people since 2003. 10:30вЂ“11 am Room: Prince GeorgeвЂ™s D American Medical Association Address (103) Amid the national initiative to reform the countryвЂ™s healthcare delivery system and in its continual effort to improve the framework in which physicians deliver care to patients, American Medical Association (AMA) President-Elect Peter W. Carmel, MD, and AMA Senior Vice President of Advocacy Richard Deem, MD, will address the challenges brought forth through the healthcare reform legislation and its short- and longterm effect on membership to both AMA and other related specialty societies. Healthcare Reform Peter W. Carmel, MD (Pictured left) Legislative Affairs Richard Deem, MD 11вЂ“11:45 am Room: Prince GeorgeвЂ™s D Medical Specialties Converge: Future Perspectives of Interventional Pain Physicians and Spine Surgeons (104) Various treatment options exist for treatment of complex spine disease in both the interventional pain practice and the spine surgery practices. This session examines the options, future perspectives, and cost effectiveness of treating the complex spine patient through the eyes of a prominent neurosurgeon and a prominent interventional pain medicine physician. Moderator Timothy R. Deer, MD (Pictured left) Correcting the Problem: The Invasive Approach to Spine Disease Robert M. Levy, MD PhD Reducing the Risks: The Minimally Invasive Approach to Spine Disease Timothy R. Deer, MD Increasing both the quality and quantity of scientific pain research remains a primary goal of the 27th Annual Meeting Planning Committee. The reputation of AAPM as a premier professional service and scientific organization continues to result in a significant increase in the quality of cutting-edge scientific-research abstracts. The Scientific Poster Review Committee has selected six of the highest ranking poster submissions for presentation in this plenary venue. Moderator Jeffrey M. Tiede, MD (Pictured) The Regional Analgesia Military Battlefield Pain Outcomes Study (RAMBPOS): A Preliminary Report Rosemary C. Polomano, PhD RN Role of the Rostral Ventromedial Medulla in a Rat Model of Stress-Induced Hypersensitivity to Pain Edward J. Bilsky, PhD Associations Between Spousal or Significant Other Solicitous Responses and Opioid Use in Patients with Chronic Pain Julie L. Cunningham, PharmD, AAMP, CPNP Analgesia of Axial Low Back Pain with Novel Spinal Neuromodulation Adnan Al-Kaisy, MB, ChB, FRCA Detecting Chronic Low Back Pain Based on Brain Gray Matter Hoameng Ung, BS MiDAS I (mildВ® Decompression Alternative to Open Surgery) Prospective, Open Label, Multi-Center Clinical Study: Comprehensive 1-Year Follow-Up Timothy R. Deer, MD 10:30вЂ“11:15 am Pain Care Reform (106) Room: Prince GeorgeвЂ™s D Invited Faculty Vice Admiral Regina Benjamin, MD MBA, U.S. Surgeon General As AAPM continues to work with President Barack ObamaвЂ™s administration and other national medical organizations to develop productive pain management solutions to vexing public health challenges, the Academy has extended a formal invitation to Surgeon General Regina Benjamin, MD MBA, to address the Academy and its extended learners to a series of public health issues that continue to threaten the safety of the American public. Dual problems of undertreatment of pain and prescription drug abuse will be discussed in a population-based forum. Concurrent Sessions 35 Friday, March 25 1:30вЂ“2:30 pm Room: Annapolis 3-4 Guidelines for the Treatment of Low Back Pain (203) Room: Woodrow Wilson CD 1:30вЂ“2:30 pm CRPS: Innovative Management Strategies (201) Based on the Cochrane methodology for systemic reviews and the United States Preventive Services Task Force (USPSTF) recommendations for guideline production, this scientific session will discern the various methodologies, criteria, and safeguards used in the production of quality, unbiased, valid evidence-based guidelines. A pro/con format will compare and contrast the APS and ASIPP guidelines relative to the treatment of low back pain. Audience participation will address additional questions and concerns related to the treatment of low back pain. Patients suffering from complex regional pain syndrome (CRPS) often present with severe, intractable pain that is not responsive to conventional treatment. Treatment of such patients is often daunting and many patients become debilitated with chronic pain. This scientific session addresses current concepts in the effective treatment and management of CRPS, including therapeutic and interventional modalities. This session discusses treatment strategies based upon current understanding of the underlying pathophysiological mechanisms in patients presenting with this chronic pain syndrome. The Importance of Producing Quality Guidelines: An Overview Ray M. Baker, MD American Pain Society (APS) Low Back Pain Guidelines: A Pro/ Con Debate Moderator Richard W. Rosenquist, MDвЂ”In Defense of the APS Low Back Pain Guidelines Laxmaiah Manchikanti, MDвЂ”The APS Low Back Pain Guidelines: An Alternate View May L. Chin, MD Current Treatment Concepts in CRPS John C. Rowlingson, MD Outpatient Ketamine Infusion for CRPS May L. Chin, MD Neuromodulation in CRPS: Indications and Efficacy Mehul J. Desai, MD MPH 1:30вЂ“2:30 pm Room: Annapolis 1-2 Improving Outcomes of Interventional Pain Procedures (202) The potential for some type of complications directly related to interventional pain procedures remains inevitable. Although most of the complications are of minimal clinical impact, some carry the risk of being life threatening. Patient complications can be greatly reduced through utilization of a scrupulous history and physical examination, best practice techniques, and recognition of pre-procedure pathophysiology. This scientific session demonstrates the importance and effectiveness of adhering to interventional pain guidelines as a method of improving patient and procedural outcomes, encouraging best practices while maintaining enough latitude to alter these techniques when specialists demonstrate it is in the best interest of the patient. 1:30вЂ“2:30 pm Room: Woodrow Wilson B Legal and Ethical Aspects of Pain Care (204) This scientific session provides critical information on the most pressing legal and ethical issues impacting the practice of pain medicine in America. Session faculty provide significant perspectives surrounding the new вЂњPill MillвЂќ law in Texas, along with an overview of Washington State landmark legislative developments regarding opioid prescribing, and the proposed threat to access quality pain care in the State of Florida. This scientific session concludes with an open dialogue surrounding each stateвЂ™s individual perspectives. Audience concerns and questions will be addressed. Moderator Michael L. Whitworth, MD Avoidable Complications of Advanced Interventional Pain Procedures Moderator Larry C. Driver, MD Texas Legislation Impact on Pain Practice Larry C. Driver, MD Overview of Developments in Washington State Guidelines Alex Cahana, MD FIPP In Pursuit of the Goal: Proposed Threats to Access and Quality Pain Care in the State of Florida Lora L. Brown, MD (invited faculty) Emerging Ethical Considerations in Responsible Opioid Prescribing Ben A. Rich, JD PhD Michael L. Whitworth, MD Avoidable Complications of Interventional Pain Injections and Neuroablation Charles N. Aprill, MD Patient-Centered Care Sessions The new patient-centered care sessions bridge together advanced medical management therapies and protocols of pain disease states with the latest advancements in interventional pain medicine. Practice Management Sessions Practice management sessions provide the latest information needed to successfully manage your thriving pain practice. Concurrent Sessions 36 3вЂ“4 pm Room: Woodrow Wilson B Army Pain Management: From Injury to Home (205) 3вЂ“4 pm Room: Annapolis 1-2 Physical Therapy for Non-Physiatrists (206) Historically, the militaryвЂ™s approach to pain has been centered on the use of opioid medications. While the success of opioids in pain management is well established, these medications have a significant side effect profile that can be lethal in the austere and chaotic military medical environment. Pain researchers continue to support an evolving appreciation that poorly managed pain can develop into a chronic disease of the nervous system. Physicians and patients often misconstrue that going to physical therapy will result in primary pain relief and in turn are disappointed to hear a report about (from the physician) or experience (as the patient) sore muscles and even increased pain. The primary end goal of exercise application is not the relief of pain but the improvement of flexibility, endurance, or strength. Sometimes when strength, endurance, or flexibility is improved, patients experience less pain due to improved mechanics, increased joint support, endorphin release, or other processes. Like all modalities used to treat pain, such as medication, injections, and stimulators, exercise does not help all patients and does not completely and permanently relieve many painful conditions. From 2009вЂ“2010, the U.S. Army Pain Management Task Force (PTF) performed a comprehensive review of pain medicine within the U.S. Army Medical Command (MEDCOM) and the Department of Defense (DoD). Its findings included 105 recommendations in regard to a pain medicine strategy that was holistic and multidisciplinary, utilized the most current pain care modalities and technologies, and focused on optimizing the quality of life of the suffering pain patient. All of the PTF recommendations were designed to support the task forceвЂ™s vision statement of вЂњproviding a standardized DoD and VHA vision and approach to pain management to optimize the care for warriors and their families.вЂќ This session provides an overview of the PTFвЂ™s Final Report and the corresponding comprehensive pain medicine strategy. Moderator Chester C. Buckenmaier, III, MD COL MC USA This educational session examines types of exercise and variations in intensity and frequency that result in different physiologic effects, along with multiple reviews regarding splinting for a variety of musculoskeletal conditions. This session also discusses prescription of physical therapy for specific conditions including complex regional pain syndrome (CRPS), low back pain, and shoulder and neck ailment. The focus is on writing the initial script, following up, and monitoring progress with the patient. Pearls for identifying optimal private physical therapy facilities will be offered. Battlefield Pain Management: From Point of Injury to Home Moderator Chester C. Buckenmaier, III, MD COL MC USA Donna M. Bloodworth, MD After the DoD: The Pain Care Continuum Types of Exercise and Splints Rollin M. Gallagher, MD MPH Donna M. Bloodworth, MD The Army Pain Task Force Exercise Prescription for CRPS Kevin T. Galloway, MHA BSN RN Gagan Mahajan, MD Exercise for Low Back, Neck, and Shoulder Conditions Steven P. Stanos, DO 3вЂ“4 pm Room: Woodrow Wilson CD Blurring the Line Between Surgeons and Pain Physicians (207) The line between what has traditionally been the role of surgeon and that of the pain medicine physician is becoming increasingly difficult to define. With new treatments options, including cutting-edge, minimally invasive techniques, the pain physician is now providing the patient with options that provide safe, quality interventional pain care options at a decreased delivery cost. This scientific session reviews these emerging interventional techniques and discusses their costs and overall impact on the healthcare delivery system. Moderator Timothy R. Deer, MD Minimally Invasive Surgical Interventions for Spinal Stenosis Timothy R. Deer, MD Bi-Annuloplasty and Endoscopic Laser Disc Surgery Leonardo Kapural, MD PhD Percutaneous Fusion: The Future of Stability Richard G. Bowman, II, MD Patient-Centered Care Sessions The new patient-centered care sessions bridge together advanced medical management therapies and protocols of pain disease states with the latest advancements in interventional pain medicine. Practice Management Sessions Practice management sessions provide the latest information needed to successfully manage your thriving pain practice. Concurrent Sessions 3вЂ“4 pm Room: Annapolis 3-4 Using Outcomes Data to Improve Patient Care (208) The practice of pain medicine is under increasing demand to provide evidence that care delivered to patients produces improved patient outcomes. Without significant outcomes data, pain physicians have limited information to guide patient care and face increasing risk of non-payment from payors for services rendered. While the gold standard for evidence is a well-controlled clinical trial, such trials are often not possible in select patient populations or for select interventions. Because of the difficulty, expense, and time needed to link quality outcomes data to improved patient pain care, few programs have successfully integrated outcomes data collection. This educational session reviews the potential that valid outcomes data offers pain physicians and demonstrates two ways that this data can be collected as part of ongoing pain care. It clearly demonstrates how outcomes data can be used to guide individual patient care, as well as how the data may be used to guide efforts to improve the process of patient care. Additional information about providing clinical outcomes of interdisciplinary pain care and ways in which pain physicians can make informed data-driven decisions regarding resource utilization will also be discussed. Moderator Michael A. Ashburn, MD MPH MBA Can Outcomes Data Improve Outcomes? Michael A. Ashburn, MD MPH MBA Outcomes Data Collection Within a Busy Pain Practice Gilbert J. Fanciullo, MD MS The Use of Outcomes Data to Improve Patient Care Martin D. Cheatle, PhD Using a Patient Management System to Guide Data-Driven Decision Making Fred N. Davis, MD 4:30вЂ“5:30 pm Room: Woodrow Wilson CD Pelvic Pain: A New Approach (209) Chronic pelvic pain syndrome is a chronic pain condition lasting longer than 6 months that often results in impaired function, signs of depression, and, more frequently, pain out of proportion to pathology. Pelvic afferent sensitization is caused by chronic irritation of visceral organs in the pelvis, their striated sphincters, muscular structures of the pelvic floor, or pudendal or other causes of neuralgias. This session will highlight the critical value of multidisciplinary team members for proper assessment, diagnosis, and treatment of chronic pelvic pain. Faculty will further discuss the significant roles of different specialists, including but not limited to psychologists, gynecologists, urologists, and pain medicine interventionalists, and examine new diagnostic and interventional techniques (i.e., surgery and neuromodulation) to be utilized in the treatment of chronic pelvic pain. Moderator Leonardo Kapural, MD PhD A GynecologistвЂ™s Approach: Novel Surgical Therapies for Chronic Pelvic Pain Tamer M. Yalcinkaya, MD Proposed Pain Medicine Algorithm for Treatment of Chronic Pelvic Pain Leonardo Kapural, MD PhD 37 4:30вЂ“5:30 pm Room: Annapolis 3-4 Regenerative Therapies: Clinical Applications and Evidence-Based Review (210) There have been considerable advances in understanding painful soft-tissue disorders, most notably chronic tendinopathies. The histopathology supports degeneration over an inflammatory model. It is unknown what interventions best stimulate the healing mechanisms necessary to induce tissue repair. This session delivers an understanding of the basic science of plateletrich plasma (PRP), which is rapidly gaining exposure and notoriety in the treatment of painful tendinopathies and related soft-tissue disorders, and is the foundation of the new frontier of what are being called regenerative therapies. It compares PRP to other regenerative therapies and their optimum clinical applications, and reviews the evidence for safety and efficacy. Moderator Joseph J. Ruane, DO PRP and Regenerative Therapies Ronald W. Hanson, MD PRP: State of the Evidence Joseph J. Ruane, DO 4:30вЂ“5:30 pm Room: Annapolis 1-2 Myofascial Pain: Bench to Bedside (211) Muscle pain in the context of myofascial pain syndrome (MPS) is a common condition in contemporary pain practice. Recently there have been tremendous breakthroughs in elucidating the pathophysiology of myofascial pain, including the quantification of biochemicals involved in this process. Furthermore, the role of sensitization in the development in MPS has increasingly been examined. This scientific session details the development of novel diagnostic techniques including microdialysis, magnetic resonance elastography, and ultrasound in the treatment of myo-fascial pain. Moderator Mehul J. Desai, MD MPH Neurobiology of Muscle Pain and Clinical Evaluation of Myofascial Pain Jay P. Shah, MD Treatment Options for Myofascial Pain Mehul J. Desai, MD MPH Concurrent Sessions 38 4:30вЂ“5:30 pm Room: Woodrow Wilson B Patient-Centered Pain Care: Who Is Driving the Bus? (212) Pain medicine has struggled to establish pain as far more than a mere symptom of disease and as itself a legitimate focus of health care. This effort has succeeded in establishing pain assessment and management as a focus of regulatory attention (i.e., The Joint Commission) and quality improvement efforts (e.g., VA pain management initiatives). However, despite such efforts, reducing pain intensity among outpatients has generally not improved the quality of the pain patientsвЂ™ lives. Cost expenditures on back pain care have greatly increased in the past decade without improvement in patient outcomes. The goals of outpatient pain care are usually disease centered or pain centered rather than patient centered. This can achieve symptom reduction over the short term but rarely achieves the long-term global improvement in patientsвЂ™ ability to live their lives and achieve their personal goals. In the case of chronic opioid therapy, this pain-centered focus has led to an increase in opioid abuse and overdose but little improvement in chronic pain patientsвЂ™ overall function. A narrow focus on eliminating pain may be no more patient centered than the focus on eliminating the pain-causing disease that it sought to replace. Incentives present within fee-for-service pain care have promoted use of disease-focused procedures but have not increased patient-centered outcomes. We postulate that the only sustainable path available to patient-centered pain care is the implementation of a case-managed measurement and value-based model that focuses on patient-centered pain care outcomes rather than pain reduction. Given that hydrocodone and acetaminophen are currently prescribed more than any other medicationвЂ”125 million times per yearвЂ”there is a great need to understand the necessary factors controlling the duration of prescription opioid use and pain surrounding surgery. This scientific session reviews the medical and societal problem of acute pain transitioning to chronic pain and the mechanisms and factors responsible for this transitionвЂ”using surgery and low back injury as models for study. Additional treatments used to reduce the development of chronic pain and persistent opioid use will also be presented. Moderator Sean Mackey, MD PhD What Do We Know and How Can We Prevent It? Sean Mackey, MD PhD Why Do Some Patients Have Persistent Opioid Use Following Surgery? Ian R. Carroll, MD MS 1:45вЂ“2:45 pm Room: Annapolis 1-3 Evidence-Based Therapies in Cancer Pain Management (302) With the advances in the treatment of cancer, a greater number of patients suffer from acute and chronic pain related to the disease itself or secondary to the cancer-related treatments. This scientific session provides an overview of effective medical pain therapies as well as innovative interventional pain techniques that improve cancer pain outcomes and are readily available in tertiary pain research centers. Moderator Vitaly Gordin, MD Medical Management of Cancer-Related Pain This scientific education session examines recent and upcoming changes in patient-centered pain care that will affect all pain practitioners. Vitaly Gordin, MD Current Trends in Cancer Pain Management Allen W. Burton, MD Moderator Interventional Therapies in Cancer Pain Mark D. Sullivan, MD PhD Patient-Centered Pain Care: ItвЂ™s Not About the Pain Mark D. Sullivan, MD PhD Aligning Clinical Outcomes, Public Policy, and Payer Incentives to Create Sustainable Pain Care Alex Cahana, MD Bernice R. Hecker, MD MHA FACC Saturday, March 26 1:45вЂ“2:45 pm Room: Woodrow Wilson CD When Acute Pain Becomes Chronic (301) Chronic pain remains an enormous challenge for the American population. With 10% of Americans developing chronic pain postsurgery, the development of postsurgical chronic pain is often thought to be secondary to sensitization of injured peripheral neurons. However, these mechanisms fail to explain: (a) why surgery does not lead to chronic pain in 90% of patients even though almost every surgery damages superficial and deep nerves and (b) why fear, anxiety, and depression (supraspinal pathology) best predict who will develop post-injury chronic pain. In addition to the problem of persistent pain after surgery, there is the societal problem of patients who continue to use opioids after surgery. Patient-Centered Care Sessions Allen W. Burton, MD 1:45вЂ“2:45 pm Room: Woodrow Wilson B The Value Proposition in Health Care: Do You Want to Get Paid for What You Do? (303) One of the defining goals of medicine is to add вЂњyears to lifeвЂќ and вЂњlife to years.вЂќ The economics of medicine indicate that there is a defined healthcare вЂњresource pieвЂќ that must be divided among all contemporary medical treatments. A logical, rational approach to this problem is to optimize the healthcare benefit per dollar expended. This scientific session examines and demonstrates how the methodology of the quality-adjusted life year (QALY) can be utilized by individual pain practitioners to calculate the value of any pain medical treatment or interventional pain procedures by simply determining the change in QALYs of the intervention. The new patient-centered care sessions bridge together advanced medical management therapies and protocols of pain disease states with the latest advancements in interventional pain medicine. Moderator and Faculty David W. Polly, MD Practice Management Sessions Practice management sessions provide the latest information needed to successfully manage your thriving pain practice. Concurrent Sessions 3вЂ“4 pm All About Opioids (304) Room: Woodrow Wilson CD Opioids are an important part of the multimodal painmanagement treatment plan and are often the drugs of choice in treating severe acute and chronic pain. Long-term opioid therapy provides much needed pain relief for many chronic pain conditions but carries the risks of several adverse outcomes, including but not limited to opioid-related hyperalgesia, an opioidinduced pain sensitivity. This scientific session will bring to the forefront the emerging science behind opioid-related hyperalgesia and the cumulative effect opioids have on the endocrine system. In addition, new opioid formulations and innovative opioid delivery systems will also be discussed. Moderator Lynn R. Webster, MD New Opioid Formulations and Delivery Systems Lynn R. Webster, MD Opioid-Induced Hyperalgesia Martin S. Angst, MD Opioid Endocrinopathy Annika Rhodin, MD PhD 3вЂ“5:15 pm Room: Annapolis 1-3 Pain Treatment Debate: Mock Trial (305) Using a mock-trial format, this scientific session examines common modalities of pain treatments and their efficacies, as well as the pros and cons of established pain treatments. This scientific session also explains the unresolved conflicts in treatment algorithms for the spine patient, and the proper patient evaluation and selection for whom spinal cord stimulation (SCS) may produce favorable outcomes. Several pain therapies and interventional treatments will be discussed, including whether or not spine surgery is advantageous to the chronic pain patient, whether oral opioids work effectively for noncancer pain, whether SCS and peripheral devices are effective, and whether minimally invasive surgeries are optimal alternatives to a larger, open surgery. Moderator Timothy R. Deer, MD 39 3вЂ“4 pm Room: Woodrow Wilson B Contracting with Payors (306) This scientific session provides an in-depth discussion of payor groups as well as the benefits of being вЂњin networkвЂќ with PPO/ HMO insurance companies versus вЂњout of networkвЂќ with insurance companies. This session will provide specific tools for interpreting payor contracts and working with carriers to make contracts more вЂњspecificвЂќ to the needs of pain medicine specialists. Scientific session attendees will learn how to successfully negotiate with the payors in order to achieve maximum reimbursement as well as explore what tools and data are necessary to develop successful contract negotiation with payors. Moderator and Faculty Trish Bukauskas, CMM CPC CMSCS CMPA 4:15вЂ“5:15 pm Room: Woodrow Wilson B Opioid Misuse in Cancer Patients: A Growing Problem (307) There is growing awareness about the misuse and abuse of prescription opioids. Additionally, the risk of addiction remains a valid concern when initiating long-term opioid therapy. The growing awareness of opioid misuse in the chronic pain population, along with increasing survivorship in cancer, has heightened awareness that the same risks, misuse, abuse, and addiction that exist in the chronic pain population may also effect the cancer pain population. This scientific session explores safe prescribing principles adapted from chronic pain literature, as well as effective avenues that mitigate the inherent risks and still allow clinicians to continue to treat pain successfully. Experts in the field of cancer pain will utilize a case discussion approach in their presentation of an algorithm of multidisciplinary care for the treatment of cancer pain in the at-risk population. Moderator Larry C. Driver, MD Overview of the Potential Scope of the Problem Diane M. Novy, PhD Challenging PatientsвЂ”Issues and Opportunities Spine Surgery for Back Pain Dhanalakshmi Koyyalagunta, MD Plaintiff: Robert M. Levy, MD PhD Defendant: Sunil J. Panchal, MD Steven D. Passik, PhD Oral Opioids for Noncancer Pain Plaintiff: Timothy R. Deer, MD Defendant: Sunil J. Panchal, MD Spinal Cord Stimulation and Peripheral Nerve Stimulation Devices for Pain Plaintiff: Robert M. Levy, MD PhD Defendant: Timothy R. Deer, MD Minimally Invasive Surgery Versus Larger Spine Surgery Plaintiff: Leonardo Kapural, MD PhD Defendant: Richard G. Bowman, II, MD Judge and Attorney for all trialsВ William M. Tiano, Esq. Multimodal Care Strategies for Multifaceted Problems 4:15вЂ“5:15 pm Room: Woodrow Wilson CD 2011: Coding Update and Beyond (308) 2011 has brought some changes to CPTВ® pain coding coupled with changes in relative value units (RVUs) for these and other codes. This session provides attendees with the latest coding changes along with an opportunity to discuss any challenging coding and reimbursement problems they may be facing in their practice. This session also addresses ICD-9-CM changes as well as relevant Medicare policy and reimbursement issues impacting pain medicine practices. Participants will have the opportunity to practice their coding skills using clinical case studies. Case studies will highlight common coding scenarios and include a discussion of modifier usage, multiple-procedure reporting, and the importance of ICD-9 coding on reimbursement. Moderator Fred N. Davis, MD Coding Update: 2011 Fred N. Davis, MD Coding Update and Beyond Emily H. Hill, PA Concurrent Sessions 40 Sunday, March 27 8:30вЂ“9:30 am Room: Annapolis 1-3 REMS UpdateвЂ”E-Prescribing (401) The Academy recognizes that prescription drug abuse, misuse, and diversion are a serious public health crisis that requires mindful solutions to ensure maximum safety for the American public. AAPM national leadership is shaping populationbased solutions to help the growing number of Americans whose quality of life and productivity is adversely affected by chronic pain conditions and diseases, while at the same time addressing concerns about the prescription drug abuse public health crisis. This plenary session provides a unique opportunity to discuss standards for disease management of chronic pain conditions and diseases, while assuring its pivotal role in developing professional and educational opportunities for all other physicians. Moderator 8:30вЂ“9:30 am Room: Woodrow Wilson CD Spine Imaging: The Significance of Structure and Morphology (403) All spine imaging has a вЂњspecificity challengeвЂќ because of a large background of asymptomatic degenerative disease, which increases with age. With radicular pain syndromes, concordance is essential. There is also a major sensitivity fault in typical spine imaging because pain syndromes may be dynamic (i.e., only seen with weight-bearing or specific postures). In axial pain syndromes, there is extensive evidence that only physiologic imaging parameters correlate with joint pain. This scientific session provides an extensive summary of published literature examining the relationship between structural imaging abnormalities and pain syndromes. Faculty will further examine the case-based evidence to provide a valuable prediction of discogenic pain from imaging findings. Scott M. Fishman, MD Moderator and Faculty REMS Update Timothy P. Maus, MD Scott M. Fishman, MD E-Prescribing Policy Aaron Gilson, PhD MS MSSW 8:30вЂ“9:30 am Room: Woodrow Wilson B Medical Marijuana for the Treatment of Chronic Pain (402) Controversy exists regarding the use of marijuana in the treatment of both acute and chronic pain. This controversy is further amplified by the current legal environment in which the use of marijuana for medical purposes, including the treatment of pain, is legal in some but not all states. Despite the legalization of marijuana for the treatment of pain in some regions of the United States, clinical efficacy has not been firmly established. This is of particular significance as the abuse potential of marijuana is recognized worldwide. Furthermore, the medical-legal liabilities and risks posed by medical marijuana have not been well defined for the specialty of pain medicine. This scientific session will further explore the following question: Should patients be placed at risk of developing iatrogenic medical conditions when the efficacy of the prescribed pharmacologic agent has not been firmly established? This scientific session also provides information about the pharmacology and efficacy of marijuana use for the treatment of acute and chronic pain. Additionally, clinical implications of marijuana abuse and dependence, as well as medical-legal risks and liabilities that medical marijuana poses for the pain medicine physicians will be further defined. Moderator Mike W. Hooten, MD Evidence-Based Outcomes of Smoked Marijuana for Chronic Pain Mike W. Hooten, MD Pharmacology of Smoked Marijuana Ajay D. Wasan, MD MSc Smoked Marijuana for Chronic Pain: A Medical-Legal Perspective Joshua B. Murphy, JD 9:45вЂ“10:45 am Room: Woodrow Wilson B National Institutes of Health (NIH) Pain Research: Optimizing Funding Through Grant Writing (404) A successful application for research funding requires careful planning, along with a keen understanding of grant writing within the appropriate funding system. This scientific session outlines the grant writing, peer review, and funding processes of grant application at the National Institutes of Health (NIH). Faculty will provide critical information on NIH funding opportunities in pain research as well as defined funding mechanisms, peer review processes, and referral processes with the NIH. This scientific session provides an excellent opportunity to investigate NIH grant writing from a principal investigatorвЂ™s perspective. Moderator Yu (Woody) Lin, MD PhD Funding Opportunities and Mechanisms at NIH Yu (Woody) Lin, MD PhD NIH Grant Writing from a Principal InvestigatorвЂ™s Perspective Sean Mackey, MD PhD NIH Peer Review and Referral Processes Weijia Ni, PhD 9:45вЂ“10:45 am Room: Annapolis 1-3 Social Media Revolution: Marketing in the Decade Ahead (405) Twitter, Facebook, YouTube, LinkedInвЂ”social media is fundamentally changing the way the world communicates. More than 50% of the worldвЂ™s population is younger than 30 years old and 96% of them belong to a social media site. Current research reports that the fastest growing segment on Facebook is 55вЂ“65-year-old females. This practice management session addresses how you can harness the power of social media to differentiate your pain practice from your peers, improve patient satisfaction, and continue to improve market share. Smoked Marijuana and Addiction Terry D. Schneekloth, MD Patient-Centered Care Sessions The new patient-centered care sessions bridge together advanced medical management therapies and protocols of pain disease states with the latest advancements in interventional pain medicine. Moderator and Faculty Linda M. VanHorn, MBA Practice Management Sessions Practice management sessions provide the latest information needed to successfully manage your thriving pain practice. Concurrent Sessions 41 9:45вЂ“10:45 am Room: Woodrow Wilson CD Chronic Daily Headache (406) 11 amвЂ“Noon Room: Woodrow Wilson CD Psychological Therapies for Chronic Pain (409) Intractable migraine and cervicogenic headaches are among the most challenging conditions in headache and pain medicine, and understanding their pathophysiology is crucial to the application of appropriate diagnostic and therapeutic modalities. In the course of treating chronic pain patients, several psychological modalities may be used to modify a variety of unhelpful neurological patterns, associations, or behaviors. These psychological modalities include eye movement desensitization and reprocessing (EMDR) and hypnosis. EMDR encompasses a comprehensive, integrative psychotherapy approach. EMDR is an information-processing therapy using structured protocols of psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies. Hypnosis uses a wakeful state of focused attention and heightened suggestibility, with diminished peripheral awareness. It is a mental state (state theory) or set of attitudes and beliefs (non-state theory) usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary instructions and suggestions. This symposium emphasizes the importance of the multidisciplinary approach to treating headache disorders. It will review the pathophysiology, comorbidity, and advances in pharmacological therapies. Topics covered in this session include the emerging role of various interventional diagnostic and therapeutic techniques, the role of radiofrequency ablation, and neuromodulation. Moderator and Faculty Zahid H. Bajwa, MD Diagnosis and Treatment of Chronic Daily Headache Zahid H. Bajwa, MD 11 amвЂ“Noon Room: Woodrow Wilson B Optimizing Clinical Research Opportunities and Publishing in Pain Medicine (407) Several pain physicians have great interest in conducting clinical research but need tips as to the вЂњhow toвЂќ in getting started in the arena of beginning clinical investigation. This scientific session promises to be of great interest to both the pain medicine specialists in academia as well as the pain practitioner in private practice. Renowned research faculty will deliver hands-on clinician-scientist information regarding the process of beginning clinical research. In addition, the editor of Pain Medicine will discuss hands-on deliverables on how to get published in pain medicine. This session will allow ample time for a panel discussion in which attendees are able to bring up specific issues and questions to the expert faculty. Moderator Ajay D. Wasan, MD MSc How to Collaborate Across Institutional Boundaries Ajay D. Wasan, MD MSc How to Publish in Pain Medicine Rollin M. Gallagher, MD MPH 11 amвЂ“Noon Room: Annapolis 1-3 Cost Effectiveness of Spinal Cord Stimulation and Intrathecal Polyanalgesia in the Management of Chronic Non-Malignant Pain (408) This scientific session provides a clear analysis of the cost impact in regards to spinal cord stimulation and intrathecal drug therapy in the management of chronic non-malignant pain. Expert faculty will provide evidence of the cost savings and superior pain control associated with these modalities when compared to other conventional medical management treatment options. This session also provides an update on the use of polyanalgesia, its appropriate indications, and its important role in the restoration of lost pain control. Moderator Krishna Kumar, MD MBBA Cost Effectiveness of SCS Krishna Kumar, MD MBBA Cost Impact and Clinical Benefits of Intrathecal Polyanalgesia in the Management of Chronic Non-Malignant Pain Sharon Bishop, MHlthSci BNurs Targeted for the non-psychiatric pain practitioner, this scientific session will explore each application in relationship to patient selection and patient exclusion through multiple case scenarios. Moderator Albert L. Ray, MD Hypnosis and Behavioral Cognitive Therapy in the Treatment of Pain Albert L. Ray, MD Eye Movement Desensitization and Reprocessing Mary Elena Collazo, PsyD 42 AA P M F a c u l t y L i s t a n d D i s c l o s u r e s Adnan Al-Kaisy, MB ChB FRCA Consultant, Pain Medicine and Anaesthesia GuyвЂ™s and St. ThomasвЂ™ Hospital London, United Kingdom Nothing to disclose Martin S. Angst, MD Associate Professor Stanford University Stanford, CA Nothing to disclose Charles N. Aprill, MD Interventional Spine Specialists Kenner, LA Disclosure info Michael A. Ashburn, MD MBA MPH Director, Pain Medicine and Palliative Care Penn Pain Medicine Center University of Pennsylvania Philadelphia, PA ZARS Pharma, Inc. (stockholder) Zahid H. Bajwa, MD Director, Education and Clinical Pain Research Beth Israel Deaconess Medical Center Boston, MA Allergan (research grantвЂ”co-principal investigator); Endo (research grantвЂ”co-principal investigator); King (speakerвЂ™s bureauвЂ”speakerвЂ™s training), Merck (research grantвЂ”co-principal investigator), Pfizer (consultant); Xanodyne (consultantвЂ”speaker training) Ray M. Baker, MD Director, Spine Program Swedish Medical Center Seattle, WA Nothing to disclose Edward J. Bilsky, PhD Director, Center for Excellence in the Neurosciences University of New England College of Osteopathic Medicine Biddeford, ME Aiko Pharmaceuticals (Ownership StakeвЂ”Co-Founder); Biousian Biosystems, Inc. (Ownership StakeвЂ”Co-Founder; Epix Pharmaceuticals (Payment, Consultant) Sharon Bishop, MHlthSci BNurs Clinical Research Coordinator Regina General Hospital Regina, SK, Canada Nothing to disclose Donna M. Bloodworth, MD Outpatient Medical Director Harris County Hospital District Houston, TX Nothing to disclose Richard G. Bowman, II, MD Pain Rehabilitation Director The Center For Pain Relief, Inc. Charleston, WV Nothing to disclose Lora L. Brown, MD Coastal Pain Management and Rehabilitation Bradenton, FL Vertos Medical (honorariumвЂ”consultant); St. Jude (honorariumвЂ”speaker) Chester C. Buckenmaier, III, MD COL MC USA Associate Professor, Uniformed Science University of the Health Sciences Defense and Veterans Pain Management Initiative Annapolis, MD Nothing to disclose Trish Bukauskas, CMM CMPA CMSCS CPC Chief Executive Officer Total Business Consulting Clearwater, FL AVEE Laboratories, Inc. (salary, marketing consultant) Allen W. Burton, MD Professor and Chair University of Texas MD Anderson Cancer Center Houston, TX Al Mann Foundation for Biomedical Research (consulting feesвЂ”consultant); Azur, Inc. (honorariumвЂ”speaker); Boston Scientific, Inc. (consulting feesвЂ”consultant); Medtronic, Inc. (research grant to departmentвЂ” investigator); Neurogesx, Inc. (honorariumвЂ”speaker) Alex Cahana, MD FIPP Chief, Pain Medicine University of Washington Medical Center Seattle, WA Nothing to disclose Peter W. Carmel, MD President-Elect American Medical Association Chicago, IL Nothing to disclose Ian R. Carroll, MD MS Assistant Professor Stanford University Palo Alto, CA Nothing to disclose Martin D. Cheatle, PhD Director, Pain and Chemical Dependency Research Center for Studies of Addiction University of Pennsylvania Philadelphia, PA Ameritox, Inc (honorariumвЂ”advisory board) May L. Chin, MD Co-Director, Anesthesiology and Critical Care Medicine Pain Center at George Washington University Washington, DC Nothing to disclose Mary Elena Collazo, PsyD The Lite Center Miami, FL Nothing to disclose Julie L. Cunningham, PharmD AAMP CPNP Pharmacotherapy Coordinator Mayo Clinic Rochester, MN Nothing to disclose Fred N. Davis, MD Co-Founder Michigan Pain Consultants, PC Grand Rapids, MI ProCare Research, LLC (no paymentвЂ”speaker) Richard Deem Senior Vice President, Advocacy American Medical Association Washington, DC Nothing to disclose Timothy R. Deer, MD President and CEO The Center for Pain Relief, Inc. Charleston, WV Bioness, Inc. (consultant/research); Inset Technologies (consultant); Medasys, Incorporated (consultant/ research); Spinal Modulation, Inc. (consultant); Stryker Instruments (consultant); St. Jude Medical, Inc. (consultant); Vertos Medical Inc. (consultant) Michael J. Derr, DO Associate ConsultantвЂ”Clinical Mayo Clinic Rochester, MN Nothing to disclose Mehul J. Desai, MD MPH Director, Pain Medicine Services George Washington University Hospital Washington, DC Kimberly-Clark (HonorariumвЂ”Speaker/Faculty); Medtronic Inc. (HonorariumвЂ”Speaker/Faculty) Larry C. Driver, MD Professor and Vice-Chair University of Texas M.D. Anderson Cancer Center Houston, TX Nothing to disclose Gilbert J. Fanciullo, MD MS Director, Section of Pain Medicine Dartmouth Hitchcock Medical Center Lebanon, NH PriCara (honorariumвЂ”speaker, advisory committee) Scott M. Fishman, MD Chief, Pain Medicine University of CaliforniaвЂ“Davis School of Medicine Lawrence J. Ellison Ambulatory Care Center Sacramento, CA American Pain Foundation (President/Chairman of Board) AA P M F a c u l t y L i s t a n d D i s c l o s u r e s Rollin M. Gallagher, MD MPH Clinical Professor, Psychiatry and Anesthesiology Director, Pain Policy Research and Primary Care Penn Pain Medicine Deputy National Program Director for Pain Management VeteranвЂ™s Affairs Health System Philadelphia VA Medical Center Philadelphia, PA Nothing to disclose Kevin T. Galloway, MHA BSN RN Office of the Army Surgeon General Alexandria, VA Nothing to disclose Aaron M. Gilson, PhD MS MSSW Director, U.S. Program at the Pain and Policy Studies Group University of Wisconsin School of Medicine and Public Health Paul P. Carbone Comprehensive Cancer Center Madison, WI Regina E. Herzlinger, PhD (Invited Faculty) Nancy R. McPherson Professor of Business Administration Harvard Business School Boston, MA Novartis (faculty) Emily H. Hill, PA President Hill & Associates Wilmington, NC Nothing to disclose Bryan C. Hoelzer, MD Assistant Professor and Physician Mayo Clinic Rochester, MN Nothing to disclose Mike W. Hooten, MD Assistant Professor Mayo Clinic Rochester, MN Nothing to disclose Covidien (honorariumвЂ”advisory board member, speaker training), King Pharmaceuticals (research grantвЂ” researcher), Meda Pharmaceuticals (honorariumвЂ” advisory board member), Purdue Pharma (unrestricted educational grantвЂ”Board of Regents of the University of Wisconsin was the grantee) Mark F. Hurdle, MD Assistant Professor Mayo Clinic Rochester, MN Vitaly Gordin, MD Director, Pain Division Penn State University College of Medicine Hershey, PA Leonardo Kapural, MD PhD Medical Director, Chronic Pain Center Wake Forest University Health Sciences Winston-Salem, NC Nothing to disclose Boston Scientific (honorariumвЂ”workshop faculty); Elan Pharma (honorariumвЂ”speaker); Kimberley Clark (honorariumвЂ”speaker/workshop); Pfiedler Enterprises (honorariumвЂ”workshop faculty); St. Jude Medical (honorariumвЂ”workshop faculty) Mederic M. Hall, MD Sports Medicine Fellow Mayo Clinic Rochester, MN Nothing to disclose Ronald W. Hanson, MD Physician Centeno-Schultz Clinic Broomfield, CO American Medical Society for Sports Medicine (honorariumвЂ”speaker); Sonosite (honorariumвЂ”speaker) Salim M. Hayek, MD PhD Chief, Division of Pain Medicine University Hospitals Case Medical Center Cleveland, OH Boston Scientific (consultant), Endo Pharmaceuticals (consultant), Johnson & Johnson (consultant), Pfizer (consultant) Bernice R. Hecker, MD MHA FACC Contractor Medical Director Medicare Noridian Administrative Services Mountlake Terrace, WA Nothing to disclose Nothing to disclose Dhanalakshmi Koyyalagunta, MD Associate Professor University of Texas MD Anderson Cancer Center Houston, TX Nothing to disclose Krishna Kumar, MD MBBS MS FRCS Clinical Professor Regina General Hospital Regina, SK, Canada Nothing to disclose Robert M. Levy, MD PhD Professor Northwestern University Feinberg School of Medicine Chicago, IL Bioness, Inc. (speaker, education, consulting); Codman Shurtleff, Inc. (speaker, education, consulting); Medtronic Neurological (speaker, education, consulting); Spinal Modulation (speaker, education, consulting); St. Jude Medical, Inc. (speaker, education, consulting); Stryker Instruments (speaker, education, consulting); Vertos Medical, Inc. (speaker, education, consulting) 43 Yu (Woody) Lin, MD PhD Program Director National Institutes of Health Bethesda, MD Nothing to disclose Sean Mackey, MD PhD Chief, Division of Pain Management Stanford University Stanford, CA Nothing to disclose Gagan Mahajan, MD Associate Professor University of CaliforniaвЂ“Davis Sacramento, CA Nothing to disclose Laxmaiah Manchikanti, MD Medical Director Pain Management Center of Paducah Paducah, KY Nothing to disclose Timothy P. Maus, MD Assistant Professor of Radiology Mayo Clinic Rochester, MN Nothing to disclose Bill H. McCarberg, MD DABPM Kaiser Permanente Escondido, CA Abbott (honorariumвЂ”speaker), Cephalon (honorariumвЂ”speaker), Endo (honorariumвЂ”speaker), Forest (honorariumвЂ”speaker), King (honorariumвЂ” speaker), Ligand (honorariumвЂ”speaker), Lilly (honorariumвЂ”speaker), Merck (honorariumвЂ” speaker), Mylan (honorariumвЂ”speaker), Neurogesx (honorariumвЂ”speaker), Pfizer (honorariumвЂ”speaker), Pricara (honorariumвЂ”speaker), Purdue (honorariumвЂ” speaker) Susan M. Moeschler, MD Anesthesiologist Mayo Clinic Rochester, MN Nothing to disclose Amy G. Mowles President and CEO Mowles Medical Practice Management, LLC Edgewater, MD Nothing to disclose Joshua B. Murphy, JD Associate Chief Legal Officer and Chair of Litigation and Risk Management Mayo Clinic Rochester, MN Nothing to disclose Weijia Ni, PhD Scientific Review Officer/Referral Officer National Institutes of Health Bethesda, MD Nothing to disclose 44 AA P M F a c u l t y L i s t a n d D i s c l o s u r e s Diane M. Novy, PhD University of TexasвЂ”MD Anderson Cancer Center Houston, TX John C. Rowlingson, MD Cosmo A. DiFazio Professor of Anesthesiology University of Virginia School of Medicine Charlottesville, VA James C. Watson, MD Consultant Mayo Clinic Rochester, MN Nothing to disclose Nothing to disclose Nothing to disclose Sunil J. Panchal, MD President National Institute of Pain/COPE Foundation Lutz, FL Joseph J. Ruane, DO Medical Director McConnell Spine, Sport & Joint Center Columbus, OH Lynn R. Webster, MD Medical Director Lifetree Clinical Research and Pain Clinic Salt Lake City, UT King Pharmaceuticals (consultant); Purdue Pharma, LP (consultant); Endo Pharmaceuticals (speaker) Genzyme Biosurgery (honorariumвЂ”speaker, consultant); Pfizer, Inc. (honorariumвЂ”speaker) Steven Passik, PhD Clinical Psychologist Memorial Sloan-Kettering Cancer Center New York, NY Terry D. Schneekloth, MD Psychiatrist Mayo Clinic Rochester, MN Cephalon (honorariumвЂ”consultant and speaker); King (honorariumвЂ”consultant and speaker); Pricara (honorariumвЂ”consultant and speaker); Purdue (honorariumвЂ”consultant and speaker) Nothing to disclose Adolor Corporation (research); Alkermes, Inc. (research); Alko (research); Ameritox (advisory board); AstraZeneca (consultant); Bayer (research); Boston Scientific (consultant, research); Cephalon, Inc. (consultant, research); Collegium Pharmaceutical (research); Elan Corporation, plc (consultant); Endo Pharmaceuticals (research); Forest Pharmaceuticals, Inc. (research); Hisamitsu Pharmaceutical Co., Inc. (research); HoffmanLaRoche LTP (research); King Pharmaceuticals, Inc. (research, advisory board); Medtronic Inc. (consultant, research, advisory board); Myriad Genetics, Inc. (research); Nektar (advisory board); NeurAxon (research); NeurogesXВ® (advisory board); Neuromed (advisory board); Nevro Corp. (consultant); Pfizer Inc. (research); Purdue Pharma LP (consultant, advisory board); QRxPharma Limited (research); Reckitt Benckiser Group plc (research); Recro Pharma, Inc. (research); Regeneron Pharmaceuticals, Inc. (research); Theravance (research); Wyeth (research, advisory board) Matthew J. Pingree, MD Mayo Clinic Rochester, MN Nothing to disclose David W. Polly, MD Professor University of Minnesota Minneapolis, MN Medtronic (consultant) Rosemary C. Polomano, PhD RN Associate Professor of Pain Medicine University of Pennsylvania School of Nursing Philadelphia, PA Nothing to disclose Albert L. Ray, MD Medical Director The Lite Center Miami, FL Eli Lilly and Co. (honorariumвЂ”speaker, medical advisory board); King Pharmaceuticals (honorariumвЂ”speaker); Xanodyne (honorariumвЂ”speaker, medical advisory board) Annika Rhodin, MD PhD Department of Surgical Sciences, Anaesthesiology, and Intensive Care Uppsala University Uppsala, Sweden Grunenthal Sweden AB (salary, medical advisor) Ben A. Rich, JD PhD Professor and Chair, Bioethics University of CaliforniaвЂ“Davis School of Medicine Sacramento, CA Nothing to disclose Richard W. Rosenquist, MD Director, Center for Pain Medicine and Regional Anesthesia University of Iowa Iowa City, IA Nothing to disclose Jay P. Shah, MD Senior Staff Physician National Institutes of Health Bethesda, MD Nothing to disclose Steven P. Stanos, DO Medical Director, Center for Pain Management Rehabilitation Institute of Chicago Chicago, IL Nothing to disclose Mark D. Sullivan, MD PhD Professor University of Washington Seattle, WA ABT Biopharma (research consultation stipendвЂ”research consultation) William M. Tiano, Esq Principal Berthold, Tiano, and OвЂ™Dell Charleston, WV Nothing to disclose Hoameng Ung, BS Research Assistant Stanford Systems Neuroscience and Pain Lab Stanford, CA Michael L. Whitworth, MD Interventional Pain Physician Advanced Pain Management Columbus, IN Nothing to disclose Steven J. Wisniewski, MD Assistant Professor Mayo Clinic Rochester, MN Nothing to disclose Tamer M. Yalcinkaya, MD Section Head, Reproductive Endocrinology Wake Forest School of Medicine Winston-Salem, NC Nothing to disclose Nothing to disclose Linda M. VanHorn, MBA President/CEO 21st Century Edge, Inc. Kansas City, MO 21st Century Edge, Inc. (owner), Boston Scientific (consultant), St. Jude Medical (consultant) Ajay D. Wasan, MD MSc Director, Clinical Pain Research Brigham and WomenвЂ™s Hospital Chestnut Hill, MA Eli Lilly and Company (consultant); Medtronic, Inc. (consultant) All confirmed AAPM faculty disclosures are available at www.painmed.org/disclosures. S a t e l l i t e S y mp o s i a 45 Satellite symposia will be held in conjunction with the annual meeting. These independently sponsored, commercially supported symposia are open to meeting registrants. The AAPM Program Planning Committee has reviewed and approved the symposia after determining the topics are relevant to the audience and complementary to the official AAPM program. There is no additional fee to attend these symposia, but preregistration is required. Seating will be available on a first-come, first-served basis. Program details and speakers are subject to change. All satellite symposia will be designated for a maximum of 1.25 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. Please preregister at www.symposiareg.org/aapm or with Cathy Rickert at 847.375.4798 or [email protected]. *A complete list of satellite symposia is available at the Annual Meeting section of the AAPM website at www.painmed.org or at www.symposia.org/aapm. Wednesday, March 23 Thursday, March 24 11:45 amвЂ“1 pm Satellite Luncheon Symposium 11:45 amвЂ“1 pm Satellite Luncheon Symposium Rational Selection of Adjuvant Analgesics in Chronic Pain Management: Moving from Symptom Control Toward a Mechanism-Based Approach Chronic pain is widespread and often poorly managed. As our understanding of chronic pain neurobiology continues to expand and novel neuromodulatory approaches emerge specifically targeting the pathophysiological underpinnings of chronic pain, clinicians who manage patients with chronic pain must be aware of these advances in science and medicine in order to provide the best possible care for their patients. Thus, this activity will begin with an overview of the prevalence and morbidity associated with chronic pain conditions and barriers that exist in effectively treating patients suffering from pain. Next, the faculty will review the current understanding and latest findings in the pathophysiology of chronic pain and highlight potential neuromodulatory targets for treatment. They will then go on to discuss a paradigm shift in the chronic pain management approach from an empirical methodology of trying-and-rejecting and symptom control towards mechanism-specific intervention and rational selection of analgesics in individual patients. Furthermore, they will discuss recent clinical trial data demonstrating efficacy and safety data of adjuvant analgesics in managing chronic pain effectively. The activity will conclude with an interactive question and answer session. Chairperson Scott M. Fishman, MD Faculty Ajay D. Wasan, MD MSc This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and ACCELMED. PIM is accredited by the ACCME to provide continuing medical education for physicians. Postgraduate Institute for Medicine (PIM) 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 they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. PIM designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)в„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. For accreditation information, contact Jennifer Engelhardt at 720.895.5333 or [email protected]. This activity is supported by an educational grant from Lilly USA, LLC. Risk Reduction in Breakthrough Pain Treatment: Applications for Pain Management in Cancer In this program, the pathophysiology and characteristics of breakthrough pain will be reviewed as well as ways to assess and identify breakthrough pain when present. The prevalence of breakthrough pain and the negative impact in cancer patients will be explored. In addition, the pharmacokinetics of opioids, benefits, and limitations of approved treatments for breakthrough pain and investigational agents will be examined. The concepts of opioid misuse, abuse, and addiction; ways to minimize risk in patients taking opioids; and strategies to address issues, including the implementation of Risk Evaluation and Mitigation Strategy (REMS) programs, will be discussed. Finally, case studies will be examined to apply breakthrough pain management strategies. Course Director Perry G. Fine, MD Faculty Steven D. Passik, PhD Thomas Strouse, MD This symposium is jointly sponsored by USF Health and MedXcel, LLC. This session will offer continuing education for physicians, psychologists, nurses, and pharmacists. Participants with any questions regarding continuing education earned through participation in this independent satellite symposium should contact John Robinson at [email protected] or call 813.830.9311, ext. 120. USF Health CME designates this educational activity for a maximum 1.25 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. For accreditation information contact Kandi Smith, CME Coordinator II, 813.974.6237 or [email protected]. This symposium is supported by an educational grant from MEDA Pharmaceuticals, Inc. 6:30вЂ“7:45 pm Satellite Dinner Symposium The Nuances and Complexities of Opioid Rotation: A PointCounterpoint Debate The goal when utilizing opioid therapy is to provide adequate pain relief balanced with tolerable adverse events (AEs). Individual patientsвЂ™ responses to different opioids can vary significantly. If gradual dose titration yields treatment-limiting AEs or poor analgesia, there is a change in the patientвЂ™s clinical status, drug-drug interactions suggest the need for an opioid with different pharmacokinetic properties, or there is a preference or need for a different administration route or formulation, opioid rotationвЂ”switching from one opioid to anotherвЂ”can be a therapeutic option. There are now many opioids and formulations to choose from when utilizing opioid rotation. Physicians can reduce the 46 S a t e l l i t e S y mp o s i a risk of overdosing or underdosing as one opioid is discontinued and another is administered by selecting a safe and reasonably effective starting dose for the new opioid, followed by dose adjustment. This requires knowledge of an вЂњequianalgesic dose table,вЂќ which provides broad estimates of the potency relationships between opioids and guidelines for dose adjustments to individualize therapy for each patient. The purpose of this educational activity is to provide physicians with rationale, strategies, and best practices when considering opioid rotation to improve clinical outcomes for patients with chronic pain. Faculty Moderator Gavril W. Pasternak, MD PhD Faculty Speaker Ricardo A. Cruciani, MD PhD The University of Nebraska Medical Center, Center for Continuing Education (UNMC/CCE) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The UNMC/CCE designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the ACCME through the joint sponsorship of the UNMC/CCE and PharmaCom Group, Inc. Participants with any questions regarding continuing education earned through participating in this independent satellite symposium should contact Diane Frost at [email protected] or call (402) 559-5145. This activity is funded through an educational grant from Mallinckrodt Inc., a Covidien company. Friday, March 25 7вЂ“8:15 am Satellite Breakfast Symposium PractitionerвЂ™s EdgeвЂ”Strategies to Ensure the Safe Use of Opioid Therapy for Patients with Chronic Pain The purpose of this educational program will be to discuss effective strategies for the management of chronic pain that reduce the risk for opioid misuse, abuse, and diversion. Attendees will be provided with the latest published data regarding risk management strategies and benefits of abuse-deterrent opioid formulations for chronic pain, the consequences of inadequate pain relief, potential barriers to provision of adequate pain relief, and strategies to overcome these barriers. One key barrier to be addressed is the fear of opioid abuse, misuse, diversion, and addiction. In this program, video vignette case studies will be utilized to illustrate clinically relevant examples of patients with varying levels of risk for opioid misuse, abuse, diversion, and addiction. Faculty panel members will work with audience members to identify optimal treatment strategies while discussing the latest scientific information with regard to pain management. A multimedia presentation will be interspersed with audience response questions to further engage the audience and provide data for rigorous panel discussion. PractitionerвЂ™s Edge is an innovative symposium format that provides attendees with cutting-edge medical education in a peer-to-peer discussion setting. The goal is to provide practical tools and education that may be utilized immediately in daily practice. Faculty Bill H. McCarberg, MD Lynn R. Webster, MD This independent commercially supported symposium is cosponsored by Postgraduate Institute for Medicine (PIM) and Integrity Continuing Education, Inc. CME credits will be awarded by PIM. PIM is accredited by the ACCME to provide CME for physicians. For accreditation information, please visit www.pimed.com or contact Allison Hughes at 720.895.5315. PIM designates this educational activity for a maximum 1.25 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. For accreditation information contact:Allison Hughes, 720.895.5315 or [email protected]. This activity is funded by an educational grant from King Pharmaceuticals, Inc. NoonвЂ“1:15 pm Satellite Luncheon Symposium Osteoarthritis: From Biomarkers to New Strategies for Pain Management Osteoarthritis (OA), a chronic and painful degenerative joint disorder, affects nearly 27 million U.S. adults. It is currently the leading source of physical disability with severely impaired quality of life due to pain and loss of joint function. Scientific advances in the field of OA include increased understanding of the complex etiology of the disease, as well as the concerted efforts to establish and validate systemic (serum or urine) biomarkers to measure and predict the full spectrum of disease progression. This symposium will include an update on the most recent advances in the establishment of systemic biomarkers for OA. The management of OA pain is addressed by several recent guidelines, but there is considerable variation in some of the recommendations, particularly regarding the appropriate use of opioids. In this symposium the most recent evidence, as well as the various recommendations for the use of different drug classes, including topical agents, will be discussed. Faculty Introduction and Overview F. Michael Gloth, II, MD FACP AGSF, Chair Biomarkers in Osteoarthritis: Needs and Outcomes Virginia Byers Kraus, MD PhD The Use of Non-Opioid Analgesics in Osteoarthritis Pain Marc C. Hochberg, MD MPH The Use of Opioids in Osteoarthritis Pain F. Michael Goth, II, MD FACP AGSF This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Miller Medical Communications, LLC. CME credits will be awarded by PIM. PIM is accredited by the ACCME to provide continuing medical education for physicians. PIM designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. For accreditation information contact Jennifer Engelhardt at [email protected]. This activity is supported by an educational grant from Endo Pharmaceuticals Inc. Saturday, March 26 7вЂ“8:15 am Satellite Breakfast Symposium Comprehensive Chronic Pain Management: Improving Physical and Psychological Function Using a unique, highly interactive, video patient case teaching format, this symposium is intended to provide clinicians who manage patients with chronic pain with new insights and expand their understanding to achieve the goals of effective pain managementвЂ”reduction of pain, improvement in function, and restoration of psychological healthвЂ” utilizing a multidisciplinary (pharmacological and nonpharmacological) approach. Attendees will have multiple вЂњinteractiveвЂќ opportunities to S a t e l l i t e S y mp o s i a reinforce their own best practices or recognize potential gaps in their clinical practice and will receive information to help them accurately assess the severity of pain, evaluate biopsychosocial factors that impact treatment, and develop strategies to meet the goals of therapy and improve patient outcomes. Faculty Course Director Ricardo A. Cruciani, MD PhD IntroductionвЂ”The Ongoing Unmet Need for Functional Improvement in Chronic Pain Patients Steven Stanos, DO Chronic Pain Mechanisms: How Can Understanding the Pathophysiology Improve Outcomes? David A. Williams, PhD Applying the Evidence: Patient Assessment, Selection, and Monitoring of Pain Therapy Bill H. McCarberg, MD Multidisciplinary Care for Functional Improvement: Turning Theory Into Practice Steven Stanos, DO This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Beth Israel Medical Center & St. LukeвЂ™s and Roosevelt 47 Hospitals and Health Education Alliance, Inc. Beth Israel Medical Center & St. LukeвЂ™s and Roosevelt Hospitals are accredited by the ACCME to provide continuing medical education for physicians. Participants with any questions regarding continuing education earned through participation in this independent satellite symposium should contact Lissa Charles at [email protected]. Beth Israel Medical Center designates this live educational activity for a maximum of 1.25 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. For accreditation information contact: Lois Grossman, 212.420.2341 or [email protected]. This activity is supported by an educational grant from PriCara, Division of Ortho-McNeilJanssen Pharmaceuticals, Inc., administered by Ortho-McNeil-Janssen Scientific Affairs, LLC. 11:30 amвЂ“12:45 pm Satellite Luncheon Symposium An Interactive Exploration of Integrated Opioid Therapy in Chronic Pain (Consultation with Experts) Effective pain control in individuals with acute or chronic pain provides a number of benefits, including an increased ability to work and improved function, ability to perform activities of daily living, and quality of life. The overall goal of therapy with analgesics is to find the minimum dose that adequately manages pain and enhances patient function while minimizing any unwanted adverse effects. Considerable evidence indicates that opioids have a major role in the treatment of chronic noncancer pain. Further, the American Academy of Pain Non-CME Corporate SYMPOSIA AAPM has opened its door to the following not-for-credit sessions. The focus of these sessions is uniquely different from others at the meeting. Those presenting at this session either represent or will be discussing the views of a commercial interest. The session does not meet continuing education requirements and offers no continuing medical education credit. The material discussed at the session does not represent the views or opinions of AAPM. This satellite event is not considered an official educational offering of the AAPM Annual Meeting. There is no fee to attend; however, preregistration is encouraged. Seating will be available on a first-come, first-served basis. Friday, March 25 7вЂ“8:15 pm Non-CME Corporate Dinner Symposium New Perspectives on Acute Pain: Focusing on Efficacy and Tolerability Greater awareness of the role of ascending and descending pathways in pain signaling, coupled with pharmacologic innovations, has reshaped the approach used to manage acute pain. Based on findings that support the management of pain through multiple mechanisms of action and the importance of targeting ascending and descending pathways, the speakers will discuss how acute pain can be effectively managed with multimodal analgesia, while maintaining tolerability. Faculty Perry G. Fine, MD Sunil J. Panchal, MD This non-CME corporate activity is funded through a grant from PriCaraВ®, a Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. Saturday, March 26 5:30вЂ“6:45 pm Non-CME Corporate Dinner Symposium The Evolving Landscape of Chronic Opioid Therapy and Risk Management This corporate dinner session is designed to update the audience on significant recent changes in the treatment landscape of chronic opioid therapy. Presentations and discussion will focus on recent major changes in regulations regarding prescribing opioids, reimbursement for office-based drug testing, and strategies to evaluate adherence to chronic opioid therapy. New data on how adherence to chronic opioid therapy relates to reduced healthcare costs will also be presented. Moderator Steve Passik, PhD Updates on Regulations and Treatment Guidelines Related to Chronic Opioid Therapy Changing Compensation for Office-Based Urine Drug Testing Heide Bajnrauh Patton Boggs LLP, Public Policy Advisor Optimizing Patient Outcomes While Minimizing Risk Michael Larson, PhD Healthcare Costs Among Chronic Opioid Users: Impact of Adherence Elizabeth Davis Ami Sklar, MPH This non-CME corporate session is funded through a grant from Ameritox. 48 C ORPOR A TE S HO W C A S E S C HE D ULE Medicine (AAPM) and American Pain Society (APS) systematic review of the evidence on chronic opioid therapy for chronic noncancer pain not only advocates the benefit of chronic opioid therapy but also recommends the application of risk-minimization techniques as preventive measures against potential exploitation, misappropriation, or abuse of these legally prescribed analgesics. This interactive and innovative symposium will utilize a blended educational approach, including challenging case presentations, thought leader consultations, and audience participation through discussion and ARS. The goal will be to enable learners to develop strategies for individualized management of chronic pain in their patients. Participants will receive a tool kit containing valuable and relevant clinical tools. Faculty Perry Fine, MD, Chair Case Study Presentation on Patient Selection Lynn Webster, MD Case Study Presentation on Opioid Optimization Perry Fine, MD Case Study Presentation on Risk Stratification Kenneth Kirsh, PhD MediCom Worldwide, Inc., is the accredited provider for this activity and is approved to sponsor continuing education for physicians, psychologists, nurses, and pharmacists. Join AAPM in thanking the following companies for supporting a satellite symposium: Ameritox Ltd. Endo Pharmaceuticals Inc. King Pharmaceuticals, Inc. Lilly USA, LLC Mallinckrodt Inc., A Covidien Company MEDA Pharmaceuticals, Inc. PriCaraВ®, a Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. Purdue Pharma L.P. MediCom Worldwide, Inc. designates this educational activity for a maximum 1.25 AMA PRA Category 1 Creditsв„ў. Physicians should only claim credit commensurate with the extent of their participation in the activity. Participants with any questions regarding continuing education earned through participation in this independent satellite symposium should contact Joan Meyer at 215.337.9991 ext. 129 or [email protected]. This symposium is supported by an educational grant from Purdue Pharma LP. Corporate Showcase ScheduleвЂ”Non-CME Events We invite you to attend one of the Corporate Showcases that are being offered this year. These are industry-supported events. Come and learn about the new products, services, and programs that are being offered. Showcase descriptions and times are listed below; please refer to the onsite listing for the most current schedule. The events will be taking place in the Prince George Exhibit Hall C on the lower level the convention center. Thursday, March 24 5вЂ“5:30 pm Mild Clinical Research Compendium A comprehensive review of mild clinical study patient outcomes from the MIDAS Study Series. Session will cover clinical and statistical relevance of mild procedure safety and efficacy. Supported by Vertos Medical 5:30вЂ“6:30 pm SCS Finally Comes Around: Clinical Results in Axial Low Back Pain Treatment To date, conventional SCS systems have not reliably demonstrated a significant effect on low back pain. Please join us as Dr. Lora Brown shares early data regarding the Nevro SystemвЂ™s (currently awaiting pivotal trial) sustained and significant effect on axial low back and leg pain in FBSS patients. The Nevro System is also designed to not induce or require paresthesia to exert its effect. Supported by Nevro Corp. 5:45вЂ“6:15 pm Custom-Compounded Prescription Drugs Masterpharm is a state-of-the-art compounding facility. We provide superior customer service plus quality custom-compounded prescription drugs at competitive pricing. MasterPharm has an international reputation as an authority in pain management. We invite you to call our healthcare professionals for assistance with placing an order or to answer any questions. Supported by MasterPharm Compounding Pharmacy Friday, March 25 9:30вЂ“10:30 am Announcing the First Buprenorphine Analgesic Transdermal System Joseph V. Pergolizzi, Jr, MD Join your colleagues for this informative corporate showcase sponsored by Purdue Pharma L.P. YouвЂ™ll gain valuable product insight about the first buprenorphine transdermal system. This is a promotional event. CME will not be available. Full prescribing information, included boxed warning, will be distributed and discussed at this event. Supported by Purdue Pharma L.P. 5:45вЂ“6:15 pm Mild Procedure Overview and Safety Session will provide an introduction to the mild procedure, which will include patient selection, treatment techniques, and overall safety profile. Supported by Vertos Medical 6вЂ“6:45 pm Advances in the Management of Postherpetic Neuralgia (PHN): Understanding Localized Treatment and Its Role in Clinical Practice Dr. Standiford Helm, MD, medical director of Pacific Coast Pain Management Center in Laguna Hills, CA, will outline advances in the treatment of PHN, review the most recent clinical data for prescriptionstrength localized treatment, and discuss the practical management of patients with PHN. Supported by NeurogesX, Inc. Saturday, March 26 9:30вЂ“10 am Millennium Laboratories Corporate Showcase Meet Robert SaenzвЂ”expert in answering the tough questions on safeguarding your pain practice. Learn how to combat drug diversion and recognize drug diverters. Supported by Millennium Laboratories 9:30вЂ“10:30 am Pain Pathophysiology III This session will provide educational content on Pathophysiology of Pain III. Supported by Lilly USA, LLC EEXHIBIT x h i b i t oHALL r s FLOOR P LA N 49 Posters Corporate Showcase RoomRoom A B 50 List of Exhibitors The AAPM exhibit program features more than 120 booths from companies showcasing their products and services specifically designed for leaders in the study and treatment of pain. By visiting these vendors, you will learn more about advancements that can keep you and your organizations at the forefront of your field. AAPM exhibitors feature products and information in pharmaceuticals, medical supplies and equipment, medical publications, and alternate delivery systems, among others. Exhibitors by Company Booth Company Booth Advanced Device Access Management, LLC . . . . . . . . . . . . . . . . . . . . . . . . . 124 Advanced Infusion Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242 Advanced Toxicology Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 Aegis Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 AFTS Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 436 AllMeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 American Academy of Pain Medicine . . . . . . . . . . . . . . . . . Near Registration American Chronic Pain Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Ameritox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Anazao Health Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Automated HealthCare Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409 Bay Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 Biosound Esaote Ultrasound, Esaote North America . . . . . . . . . . . . . . . . 423 Boston Scientific . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 Calloway Labs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401 Caron Treatment Centers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Cephalon, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200 Competitive Technologies, Inc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Cosman Medical, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419 Covidien . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428 CPAIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 Custom Compounding Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Company Booth Masterpharm Compounding Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339 MD Logic EMR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Medical Positioning, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441 Medtox Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Medtronic, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Millennium Laboratories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335 NeurogesX, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 NeuroTherm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Nevro Corp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427 North American Neuromodulation Society . . . . . . . . . . . . . . . . . . . . . . . . . . 149 North American Spine Society . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429 PainEDU.org/Inflexxion, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425 PainFromCancer.org . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 Pain Medicine News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Pearson, Clinical Assessment Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421 Phamatech Laboratories and Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Physicians Business Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413 Physician Partner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 PPM Information Solutions, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Practical Pain Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443 Practice Partners in Healthcare, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Prescribe Responsibly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Dominion Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 PriCaraВ®, Div. of Ortho-McNeil-Janssen Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Elsevier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 ProStrakan, Inc.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Emerging Solutions in Pain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Purdue Pharma L.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 Endo Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322 Redwood Laboratory Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240 Epimed International, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433 RJ Laser USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237 GE Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Roxane Laboratories, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438 Global Analyticals Development, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446 Select Laboratory Partners, Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445 gloStream . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238 SonoSite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329 Harvest Technologies Corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347 St. Jude Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Journal of Opioid Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 StreamlineMD, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Kimberly Clark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Stryker Interventional Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405 King Pharmaceuticals, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321, 343 Terason . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342 LabCorp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346 Theralase, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234 Lilly USA, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315 Valley Forge Medical Center & Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435 Linear Medical Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431 Vertos Medical, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334 LiteCure, LLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Wiley-Blackwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434 Mallinckrodt (A Covidien Company) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Xanodyne Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229 as of February 15, 2011 Exhibitors by Product Category Exhibit Schedule Opening Reception with Exhibits and Posters* Thursday, March 24, 5вЂ“6:30 pm Exhibits Open Friday, March 25, 9:30 amвЂ“Noon; 2:30вЂ“7 pm (Reception with exhibits and posters*, 5:30вЂ“7 pm) Exhibits Open Saturday, March 26, 9:30вЂ“11:30 am *See page 30 for more details. ASC Developer/Manager Practice Partners in Healthcare, Inc. Assessments Pearson, Clinical Assessment Group Billing Services PPM Information Solutions, Inc. Chronic Pain & Addiction Treatment Valley Forge Medical Center & Hospital Clinical Trial Management CPAIN Drug Testing MEDTOX Laboratories Drug Addiction Testing Caron Treatment Centers Education American Chronic Pain Assoc. Emerging Solutions in Pain Mallinckrodt (A Covidien Company) North American Neuromodulation Society North American Spine Society PainEDU.org/Inflexxion, Inc. PainFromCancer.org Electronic Health Records Allmeds gloStream MD Logic EMR Imaging Equipment GE Healthcare Implantable Medical Devices St. Jude Medical In-Office Dispensing Physician Partner Laboratory Testing Advanced Toxicology Network Aegis Labs AFTS Labs Ameritox Calloway Labs Dominion Diagnostics 51 LabCorp Millenium Laboratories Phamatech Laboratories and Diagnostics Redwood Laboratory Management Laboratory Equipment & Testing Select Laboratory Partners, Inc. Global Analytical Development, LLC Medical Devices Millennium Laboratories Medical Equipment/Supplies Advanced Device Access Management, LLC Biosound Esaote Ultrasound, Esaote North America Boston Scientific Competitive Technologies, Inc. Cosman Medical, Inc. Global Analytical Development, LLC Harvest Technologies Corporation Kimberly-Clark Medical Positioning Inc. Medtronic, Inc. NeuroTherm Nevro Corp RJ Laser USA Select Laboratory Partners, Inc. SonoSite, Inc. Stryker Interventional Spine Terason Theralase Inc. Pain Management Bay Recovery Vertos Medical, Inc. Pharmaceuticals Anazao Health Corporation Epimed International, Inc. Cephalon, Inc. Covidien Custom Compounding Centers Endo Pharmaceuticals, Inc. King Pharmaceuticals, Inc. MasterPharm Compounding Pharmacy NeurogesX PriCaraВ®, A Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. ProStrakan, Inc. Purdue Pharma L.P. Roxane Laboratories, Inc. Xanodyne Pharmaceuticals Publishing Elsevier, Inc. Journal of Opioid Management Pain Medicine News Practical Pain Management Wiley-Blackwell Therapeutic Lasers LiteCure, LLC 52 Exhibitors BOOTH 124 BOOTH 147 Advanced Device Access Management, LLC 1630 Genesse Street Utica, NY 13502 315.507.3838 fax 315.507.3294 www.adamimplants.com American Chronic Pain Association PO Box 850 Rocklin, CA 95677 916.632.0922 fax 916.632.3208 www.theacpa.org BOOTH 242 BOOTH 211 Advanced Infusion Solutions 132 Fairmont Street, Suite B Clinton, MS 39056 601.988.1700 fax 601.988.1701 www.advancedinfusionsolutions.com AIS is the fastest growing pharmacy in the U.S. specializing in intrathecal pump medications. Our program is unique. Physician practices are never billed for intrathecal medications. We bill patientвЂ™s insurance/Medicare. AIS is Joint Commission accredited, provides complimentary concentration calculations, dosage conversions, and optional online ordering for convenience. Ameritox 300 E. Lombard Street, Suite 1610 Baltimore, MD 21202 443.220.0115 fax 443.220.0122 www.ameritox.com BOOTH 417 Advanced Toxicology Network 3560 Air Center CV, #101 Memphis, TN 38118 901.794.5770 x241 fax 901.363.7979 www.atnlabs.com BOOTH 135 Aegis Labs 515 Great Circle Road Nashville, TN 37228 850.322.1129 fax 850.561.1129 www.aegislabs.com For over 20+ years, AegisВ® has remained one of the most trusted drug testing laboratories for pain management, forensics and sports organizations throughout the U.S. With Aegis you have access to testing in oral fluid, urine and/or blood; consultation with 9 PhD/2 PharmD experts; and the highest quality client service in the industry. BOOTH 436 AFTS Labs 586 New York Avenue, Unit 2 Huntington, NY 11743 631.923.0166 fax 631.923.0171 www.aftslabs.com BOOTH 247 AllMeds 151 Lafayette Drive, Suite 401 Oak Ridge, TN 37830 865.482.1999 fax 865.481.0921 www.allmeds.com BOOTHвЂ”In the Registration Area American Academy of Pain Medicine 4700 West Lake Avenue Glenview, IL 60025 847.375.4731 fax 877.734.8750 www.painmed.org Corporate Relations Council Silver Level Support BOOTH 138 Anazao Health Corporation 5710 Hoover Boulevard Tampa, FL 33634 800.995.4363 fax 800.985.4363 www.anazaohealth.com At Anazao Health, compounding high-risk sterile preparations is our specialty. We offer a wide variety of patient-specific preparations (local anesthetics, intrathecal pump refills, specialized injectables, and epidural preparations) utilized by pain management physicians, physiatrists, neurologists, and anesthesiologists. We are PCAB Accredited and meet or exceed USP Chapter 797 requirements. Our online ordering increases order accuracy, reduces order entry, and provides report capabilities. BOOTH 409 Automated HealthCare Solutions 2901 SW. 149th Avenue, Suite 400 Miramar, FL 33027 954.789.7853 fax 786.594.4659 www.ahcs.com Automated HealthCare Solutions offers an automated Workers Compensation Medication dispensing program utilizing state-of-theart technology. AHCS also offers on site drug testing. We assist you in establishing and maintaining a CLIA waived laboratory. AHCS provides programs and services to assist practices in improving patient care while creating an ancillary revenue stream. BOOTH 341 Bay Recovery 4241 Jutland Drive, Suite 103 San Diego, CA 92117 619.804.5324 fax 858.490.3424 www.bayrecovey.com BOOTH 423 Biosound Esaote Ultrasound ULTRASOUND COURSE SUPPORTER Esaote North America 8000 Castleway Drive Indianapolis, IN 46250 317.813.6000 fax 317.813.6600 www.biosound.com Biosound Esaote is a leading manufacturer and distributor of medical ultrasound and MRI equipment in the United States. The MyLab ultrasound line offers unique MSK features which provide premium performance for diagnostic ultrasound studies and high-level Exhibitors 53 functionality at an excellent value. Biosound EsaoteвЂ™s highly recognized MyLab series provides an easy transition to becoming a Diagnostic and Interventional MSK Specialist. BOOTH 307 Corporate Relations Council Boston Scientific 25155 Rye Canyon Loop CADAVER COURSE SUPPORTER Valencia, CA 91355 661.949.4339 fax 661.949.4359 www.controlyourpain.com Boston ScientificвЂ™s Precision Plusв„ў SCS System powered by SmoothWaveв„ў Technology blends sophistication and simplicity to deliver life-changing therapy for chronic pain patients. Investing in innovative products, clinical initiatives, and world-class service, Boston Scientific is committed to Making life smootherв„ў for physicians, patients, and the neuromodulation community. BOOTH 401 Calloway Labs 34 Commerce Way Woburn, MA 01801 781.224.9899 fax 781.224.2423 www.callowaylabs.com BOOTH 419 CADAVER COURSE SUPPORTER Cosman Medical, Inc. 76 Cambridge Street Burlington, MA 01803 781.272.6561 fax 781.272.6563 www.cosmanmedical.com Cosman Medical is a leading manufacturer of radiofrequency generators and electrodes for pain management and neurosurgery. The new Cosman G4 generator Version 2 is fully automatic, programmable with touch-screen controls, and has 4 RF outputs. The G4вЂ™s features include physician settings presets, procedure data storage, hand-held wireless remote control, and automatic staggered lesion start feature. Also important, the Cosman Medical products are economically priced! BOOTH 428 BOOTH 239 Caron Treatment Centers PO Box 150 Wernersville, PA 19565 610.743.6402 fax 610.670.0962 www.caron.com Caron Treatment Centers is a nationally recognized nonprofit provider of alcohol and drug addiction treatment. Caron has more clinical programs to meet specific needs of each patient, regardless of their age, gender or severity of their addiction than any other treatment center in the U.S. With extensive experience in the treatment of co-occurring psychological/psychiatric disorders, Caron offers the most comprehensive treatment programs for adolescents, young adults, adults and their families. BOOTH 200 conducted in Rome, based on вЂњScrambler TherapyвЂќ using Information Theory and Complex Systems. Calmare is a patented technology that creates a series of complex artificial neuronal messages of вЂњnon-painвЂќ that are transmitted to the brain via the bodyвЂ™s dermatome pathway. Corporate Relations Council Cephalon, Inc. ESSENTIALS COURSE SUPPORTER 41 Moores Road Frazer, PA 19355 bronze Level 610.883.5878 fax 610.738.6311 Support www.cephalon.com Cephalon is a global biopharmaceutical company dedicated to developing and bringing to market medications to improve the quality of life of individuals around the world. Cephalon has first-in-class and best-in-class medicines in several therapeutic areas and currently offers more than 150 products in nearly 100 countries. For more information about Cephalon, visit www.cephalon.com. BOOTH 137 Competitive Technologies, Inc. 1375 Kings Highway East, Suite 400 Fairfield, CT 06824 203.368.6044 fax 203.368.5399 www.calmarett.com Competitive Technologies, Inc., is introducing a new noninvasive treatment for drug resistant chronic neuropathic and cancer related pain. Our Calmare Pain Therapy treatment is the result of 22 years of research Covidien Corporate Relations Council 675 McDonnell Boulevard Hazelwood, MO 63042 314.654.3348 fax 314.654.7129 www.covidien.com Covidien is committed to providing quality medication along with professional and consumer education in the therapeutic area of pain management. Covidien intends to display EXALGOВ® (hydromorphone HCI) Extended-Release Tablets and PENNSAIDВ® (diclofenac sodium topical solution) 1.5% w/w. BOOTH 204 CPAIN 2343 Alexandria Drive, Suite 400 Lexington, KY 40504 859.223.4334 fax 859.514.4350 www.cpain.org The Chronic Pain Impact Network (CPAIN) provides comprehensive patient assessments in the form of Patient Profile reports that guide pain management and monitor treatment effectiveness. CPAIN captures data on pain treatments, associated patient-reported outcomes and clinician assessments. CPAIN also provides data for comparative effectiveness research (CER), enhanced post marketing safety surveillance, cost-effective research, and assessment of risk evaluation and mitigation strategies. BOOTH 114 Custom Compounding Centers 3911 5th Avenue, Suite 202 San Diego, CA 92103 858.481.7060 fax 858.481.7063 BOOTH 110 Corporate Relations Council Dominion Diagnostics 211 Circuit Drive North Kingstown, RI 02852 877.734.9600 fax 401.667.0330 www.dominiondiagnostics.com Dominion Diagnostics is a fully certified national medical laboratory specializing in clinical quantitative urine drug testing, scientifically 54 Exhibitors accurate medication monitoring, and fully integrated clinical support services. Dominion provides information regarding patient prescription adherence, illicit drug usage, addiction, and substance misuse for a diversity of medical specialties, including pain and addiction medicine. BOOTH 118 Elsevier 8701 Ivyberry Way Gaithersburg, MD 20886 240.277.3001 fax 301.527.9248 BOOTH 146 Emerging Solutions in Pain 101 Washington Street Morrisville, PA 19067 215.337.9991 fax 215.337.0956 www.emergingsolutionsinpain.com BOOTH 238 gloStream 1050 Wilshire Drive, Suite 200 Troy, MI 48084 877.456.3671 fax 248.659.1577 www.glostream.com gloStream provides physicians and healthcare facilities with certified electronic medical records and practice management solutions delivered through a nationwide network of local technology partners. gloStream products are secure, easy-to-use applications and the only integrated EMR/PM solutions on the market embedded with Microsoft Office. For more information, visit www.glostream.com. BOOTH 347 BOOTH 322 Corporate Relations Council Endo Pharmaceuticals, Inc. 100 Endo Boulevard Chadds Ford, PA 19317 610.459.7273 www.Endo.com process including chemistry, hematology and toxicology specialities. ESSENTIALS COURSE SUPPORTER BOOTH 433 CADAVER COURSE SUPPORTER Epimed International, Inc. 141 Sal Landrio Drive Johnstown, NY 12095 518.725.0209 fax 518.725.0207 www.epimedpain.com Epimed International, Inc. will be featuring products designed for chronic and acute pain management techniques. We will display the Expanded Line of RaczВ® Spring Guide Epidural Catheters; RXв„ў, R.K.в„ў, and FIC Epidural Introducer Needles; R-Fв„ў Line of Radiofrequency Products; Coudeв„ў & Straight Blunt Nerve Block Needles; and Mini Trays. Also being shown are radiation safety products, TENS units, and anatomical models. BOOTH 108 CADAVER COURSE SUPPORTER GE Healthcare 384 Wright Brothers Drive ULTRASOUND COURSE SUPPORTER Salt Lake City, UT 84116 801.201.6164 fax 435.884.6733 www.gehealthcare.com GE is making a new commitment to health. Healthymagination will change the way we approach healthcare, with more than 100 innovations all focused on addressing three critical needs: lowering costs, touching more lives, and improving quality. For more inforamtion, visit www.gehealthcare.com. BOOTH 446 Global Analytical Development LLC 5990 142nd Avenue North Clearwater, FL 33760 727.530.9996 fax 727.530.9991 Global Analytical provides clinical analyzers and technical consulting services for practices intersted in performing routine lab and urine drug screening for moderate and high complex testing. Emphasis is placed on training and regulatory compliance for the lab set-up Harvest Technologies Corporation 40 Grissom Road, Suite 100 Plymouth, MA 02360 508.732.7500 fax 508.732.0400 www.harvesttch.com BOOTH 243 Journal of Opioid Management 470 Boston Post Road, Suite 301 Weston, MA 02493 781.899.2702 fax 781.899.4900 www.opioidmanagement.com BOOTH 116 Kimberly-Clark 1400 Holcomb Bridge Road Roswell, GA 30076 770.587.8274 fax 920.721.1961 www.kchealthcare.com BOOTH 321, 343 King Pharmaceuticals, Inc. 400 Crossing Boulevard Bridgewater, NJ 08807 908.429.6000 fax 908.927.8423 www.kingpharm.com CADAVER COURSE SUPPORTER Corporate Relations Council PLATINUM Level Support BOOTH 346 LabCorp 500 Perimeter Park Drive, #C Morrisville, NC 27560 919.481.5276 fax 919.481.5404 www.labcorp.com LabCorp offers pain management drug testing profiles that provide physicians with information relevant to the treatment of patients who are prescribed pain medications. LabCorp pain management drug tests can assist in monitoring patients and help detect prescription drug diversion. To implement pain management drug testing in your practice, contact LabCorp at 888.883.5017 or painmanagement@ labcorp.com. Exhibitors BOOTH 315 55 Corporate Relations Council Lilly USA, LLC Lilly Corporate Center ESSENTIALS COURSE SUPPORTER Indianapolis, IN 46285 317.277.1986 www.lilly.com Lilly, a leading innovation-driven corporation, is developing a growing portfolio of first-in-class and best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answersвЂ”through medicines and informationвЂ”for some of the worldвЂ™s most urgent medical needs. BOOTH 431 Linear Medical Solutions 3333 Hendricks Avenue Jacksonville, FL 32207 904.739.1309 fax 904.739.1310 www.linearsolutions.com Linear Medical Solutions is a multifunctional medical services company offering a diverse, niche based group of business services and products targeted at physician practices throughout the United States. The goal of Linear Medical Solutions is to provide business solutions that product increased revenue, assist with cost containment and total patient satisfaction thereby producing a tangible, quantifiable increase in net profit for our clients. Our future depends on the success of your practice. BOOTH 142 LiteCure, LLC 250 Corporate Boulevard, Suite B Newark, DE 19702 302.709.0408 fax 302.709.0409 www.lifecure.com BOOTH 437 Mallinckrodt (A Covidien Company) 675 McDonnell Boulevard Hazelwood, MO 63042 314.654.3348 fax 314.654.7129 www.covidien.com C.A.R.E.S. Alliance, Collaborating and Acting Responsibly to Ensure Safety, is committed to providing education and enabling tools to healthcare professionals and patients, focusing on the safe prescribing, dispensing, storage, use, and disposal of opioid analgesics. C.A.R.E.S. Alliance focuses on collaboration, education and innovation to improve outcomes for patients with pain. BOOTH 339 Masterpharm Compounding Pharmacy 115-06 Liberty Avenue Richmond Hill, NY 11419 866.630.5600 fax 866.630.5700 www.masterpharm.com Masterpharm is a state-of-the-art ccompounding facility. We provide superior customer service plus quality custom-compounded prescription drugs at competitive pricing. MasterPharm has an international reputation as an authority in pain management. We invite you to call our healthcare professionals for assistance with placing an order or to answer any questions. BOOTH 107 MD Logic EMR 2170 Satellite Boulevard, Suite 435 Duluth, GA 30097 770.497.1560 fax 770.497.1469 www.mdlogic.com BOOTH 441 Medical Positioning Inc. 1717 Washington Kansas City, MO 64108 816.474.1555 fax 816.474.7755 www.medicalpositioning.com BOOTH 122 Medtox Laboratories 402 W. County Road D St. Paul, MN 55112 651.628.6175 www.medtox.com The MEDTOX Prescription Management Sales Department sells our laboratory testing services to pain and prescription management clinics, offices, and departments throughout the United States. BOOTH 117 Premier Executive Medtronic, Inc. 710 Medtronic Parkway Gold Level Minneapolis, MN 55432 Support 800.328.2518 fax 763.505.0450 CADAVER COURSE SUPPORTER www.medtronic.com At Medtronic, weвЂ™re committed to Innovating for Life by pushing the boundaries of medical technology and actually changing the way the world treats chronic disease. Medtronic Neuromodulation provides innovative implantable neurostimulation and drug delivery devices to therapeutically treat intractable pain as well as other chronic diseases and neurological disorders. 56 Exhibitors BOOTH 335 BOOTH 429 Millennium Laboratories 16981 Via Tazon San Diego, CA 92127 877.451.3534 www.becausepainmatters.com Millennium is the urine drug testing resource of choice for clinicians focused on the treatment of chronic pain.В MillenniumвЂ™s turn-key medication monitoring services include qualitative presumptive urine testing at the point of care, quantitative confirmations and 12-hour/ day results interpretation assistance, and the fastest reliableВ urine drug testing confirmation in the nation. North American Spine Society 7075 Veterans Boulevard Burr Ridge, IL 60527 630.230.3649 fax 630.230.3749 www.spine.org BOOTH 217 Corporate Relations Council NeurogesX, Inc. 2215 Bridgepointe Parkway, Suite 200 San Mateo, CA 94404 650.393.7419 fax 650.649.1798 www.neurogesx.com BOOTH 126 BOOTH 425 PainEDU.org/Inflexxion, Inc. 320 Needham Street, Suite 100 Newton, MA 02464 617.332.6028 fax 617.332.1820 www.painedu.org PainEDU.org and painACTION.com offer a synergistic and collaborative approach to safe and effective chronic pain management through clinician education and patient pain management. PainEDU.org offers clinicians a better understanding of pain management through interviews, articles, educational courses, and case studies. Registered users have access to opioid risk management screening tools and teaching resources. CADAVER COURSE SUPPORTER NeuroTherm 30 Upton Drive, Suite 2 Wilmington, MA 01887 978.406.4320 www.neurotherm.com NeuroTherm is a leading manufacturer of products used in the field of interventional pain, including RF generators, intradiscal therapies, epidural catheters, discography, and a wide range of consumable products used in the treatment of chronic pain. We are focused on developing safe, effective and innovative products while offering a remarkable level of service to ensure physicians are able to perform procedures more safely, quickly, and effectively. BOOTH 136 BOOTH 427 BOOTH 130 Nevro Corp 4040 Campbell Avenue, Suite 210 Menlo Park, CA 94025 650.283.4254 fax 650.251.9415 www.nevrocorp.com The Nevro Neuromodulation System is designed to reliably treat axial low back pain associated with FBSS and to overcome some of the shortcomings of conventional SCS systems. NevroвЂ™s neuromodulation system is intended to provide significant relief of axial back and leg pain without requiring paresthesia or inducing movement-related shocking. Learn more about our clinical data and planned pivotal trial at our corporate showcase March 24 at 6 pm, or at the plenary session March 26 at 8:30 am. Pain Medicine News 545 W. 45th Street New York, NY 10036 212.957.5300 fax 212.957.7230 www.painmedicinenews.com Pain Medicine News (PMN), an independent monthly newspaper, is the best-read pain publication in the United States. Boasting an editorial board of renowned clinicians and researchers across 12 specialties, PMN provides comprehensive meeting coverage; clinical, legal and policy issues; practice management information; educational review articles; continuing medical education credit; and educational materials such as special reports, wall charts, and pocket guides. BOOTH 149 North American Neuromodulation Society 4700 W. Lake Avenue Glenview, IL 60025 847.375.4398 www.neuromodulation.org The North American Neuromodulation Society (NANS) is dedicated to being the premier organization representing neuromodulation. NANS promotes multidisciplinary collaboration among clinicians, scientists, engineers, and others to advance neuromodulation through education, research, innovation, and advocacy. Through these efforts NANS seeks to promote and advance the highest quality patient care. PainFromCancer.org 6 Erie Street Montclair, NJ 07042 973.233.5572 fax 973.453.8245 www.painfromcancer.org PainfromCancer.org has been created to provide your patients with tools and information to educate themselves about the types, causes, and available treatment options for cancer pain. From communicating their pain to understanding its causes, PainfromCancer.org is a valuable educational resource for your cancer patients, their families, and practitioners. BOOTH 421 Pearson, Clinical Assessment Group 19500 Bulverde Road San Antonio, TX 78259 800.627.7271 fax 800.232.1223 http://psychcorp.com BOOTH 235 Phamatech Laboratories and Diagnostics 10157 Barnes Canyon Road San Diego, CA 92121 888.635.5840 fax 858.635.5843 www.phamatech.com Exhibitors BOOTH 413 Physicians Business Network 10950 Grandview, Suite 200 Overland Park, KS 66210 800.288.4901 fax 913.381.3454 www.pbnmed.com BOOTH 134 Physician Partner 3607 Old Conejo Road Thousand Oaks, CA 91320 800.333.9800 fax 800.333.9916 www.physicianpartner.com BOOTH 128 PPM Information Solutions, Inc. 9000 W. 67th Street Mission, KS 66202 913.262.2332 fax 913.262.3633 www.ppmconnect.com PPM Information Solutions, Inc. offers todayвЂ™s anesthesia and pain practice everything it needs to control its revenue cycle. Our products and services take the everyday complications out of medical billing by providing accelerated claims processing, streamlined collections management, and unparalleled reporting capabilities. BOOTH 443 Practical Pain Management 7 North Willow Street Montclair, NJ 07042 973.783.7009 www.ppmjournal.com Pain is complex and can be challenging to treat safely and effectively. Practical Pain Management and Practical Pain Management.com help patients and clinicians navigate the latest research in pain to improve patient care and ultimately the quality of life of pain sufferers. Practical Pain Management is operated by Vertical Health, a leading company focused on pain management, musculoskeletal disease, and endocrine disease. BOOTH 112 Practice Partners in Healthcare, Inc. 1 Chase Corporate Drive, Suite 200 Birmingham, AL 35244 205.824.6250 fax 205.824.6251 www.practicepartners.org Practice Partners in Healthcare is a developer, manager, and minority equity partner of single and multi-specialty ASCs. We deliver successproven expertise to new and existing surgery centers, in physician owned or physician/hospital joint ventures in both CON and non-CON states. For more information visit us at www.practicepartners.org. BOOTH 106 Prescribe Responsibly 2000 L. Street NW, Suite 300 Washington, DC 20036 202.835.8876 fax 202.835.9438 www.PrescribeResponsibly.com Prescribe Responsibly is an online resource for healthcare professionals about the appropriate and responsible prescribing of opioid analgesics for patients with acute and chronic pain. PrescribeResponsibly.com 57 brings together five leaders with expertise in pain management, psychology and addiction medicine to address concerns physicians might have when prescribing opioid analgesics. Prescribe Responsibly is sponsored by PriCaraВ®, a Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. BOOTH 109 PriCaraВ®, Division of Corporate Relations Council Ortho-McNeil-Janssen Pharmaceuticals, Inc. 1000 Route 202 Raritan, NJ 08869 908.218.6000 www.pricara.com PriCaraВ®, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. is dedicated to serving primary care physicians. We currently market products to treat pain, acid reflux disease and infectious diseases. BOOTH 123 ProStrakan, Inc. 1430 US Highway 206 Bedminster, NJ 07921 908.234.1096 fax 908.234.2835 www.abstral.com BOOTH 301 Corporate Relations Council Purdue Pharma L.P. One Stamford Forum Stamford, CT 06901 203.588.7311 fax 203.588.6262 www.Purduepharma.com Silver Level Support BOOTH 240 Redwood Laboratory Management 15 Vernal Spring Irvine, CA 92603 714.496.6164 fax 858.461.6851 BOOTH 237 RJ Laser USA 4140 Jade Street, Suite 102 Capitola, CA 95010 855.995.2737 fax 831.464.7744 www.rjlaserusa.com RJ Laser USA provides the most versatile and powerful therapeutic lasers in the US. The innovative RJ laser system is based on more than 28 years of experience in development and production of laser devices. BOOTH 438 Roxane Laboratories, Inc. PO Box 16532 Columbus, OH 43216 800.848.0120 fax 614.308.3576 www.roxane.com 58 Exhibitors BOOTH 445 The Terason t3200в„ў Ultrasound SystemвЂ“MSK Series with Flexible Imaging Technology (FIT) simplifies musculoskeletal ultrasound, with enhanced image quality, custom exam presets, and state-of-the-art transducers. The versatile, cost-effective Terason System is easy to use, and its image quality is trusted by thousands of clinicians throughout the world. Select Laboratory Partners, Inc. 1100 Revolution Mill Drive Greensboro, NC 27405 336.510.1120 BOOTH 329 ULTRASOUND COURSE SUPPORTER BOOTH 129 CADAVER COURSE SUPPORTER St. Jude Medical 6901 Preston Road Plano, TX 75024 972.309.8000 fax 972.309.8150 www.sjmneuro.com St. Jude Medical Neuromodulation Division develops technologies that put more control into the hands of those who treat chronic pain patients worldwide. Our products include the innovative Pentaв„ў lead, the first five-column paddle lead for lateral coverage and precise field control; the radiopaque, mechanical locking Swift-Lockв„ў anchor; and MultiSteering technology for real-time assessment and coverage of multifocal pain. To learn more, visit sjmneuro.com. BOOTH 223 bronze Level Support StreamlineMD, LLC 3333 S. Arlington Road Akron, OH 44312 330.564.2664 fax 330.706.6346 www.streamlinemd.com StreamlineMD is a certified provider of Electronic Health Record (EHR), Practice Management (PM), and outsourced billing solutions. The company offers its services principally to independent physician practices focused on Pain Management and related specialties. The Streamline EHR contains fully developed clinical content for interventional pain management including more than 40 procedures. BOOTH 405 CADAVER COURSE SUPPORTER Stryker Interventional Spine 4100 E. Milham Avenue Kalamazoo, MI 49001 800.253.3210 www.stryker.com/ivs Relieving pain. Improving lives. Stryker Interventional Spine services this motto by focusing on minimally invasive spinal procedures that quickly return patients to their active lifestyles. We deliver your вЂњsingle source solutionвЂќ for treating vertebral compression fractures (Vertebroplasty & Kyphoplasty), radiofrequency ablation and providing effective methods for disc decompression and discography. Visit www.strykerivs.com or by downloading our вЂњappвЂќ at the App Store under Stryker IVS. BOOTH 342 Terason 77 Terrace Hall Avenue Burlington, MA 01803 781.270.4143 fax 781.270.4145 www.terason.com BOOTH 234 Theralase, Inc. 29 Gervais Drive Toronto, ON, Canada M3C 1Y9 866.843.5273 fax 416.447.3020 www.theralase.com SonoSite 21919 30th Drive SE Bothell, WA 98021 425.951.1200 fax 425.951.1201 www.sonosite.com ULTRASOUND COURSE SUPPORTER BOOTH 435 Valley Forge Medial Center & Hospital 1033 W. Germantown Pike Norristown, PA 19403 610.539.8500 Ext. 292 fax 610.539.6065 www.vfmc.net Since 1973, Valley Forge Medical Center and Hospital has provided comprehensive treatment to adults with substance abuse. We specialize in chronic pain and are the only recognized Center of Excellence for Addiction-Free Pain ManagementВ® in the country. Our professional staff provides high-quality treatment services and support to individuals and their families seeking freedom from addiction and relief of suffering with chronic pain. VFMC is a licensed hospital in PA and is accredited by JCAHO. BOOTH 334 Vertos Medical 11 Columbia, Suite B Aliso Viejo, CA 92656 949.349.0008 fax 949.349.0218 www.vertosmed.com Elite Associate PLATINUM Level Support CADAVER COURSE SUPPORTER BOOTH 434 Wiley-Blackwell 350 Main Street Malden, MA 02148 781.388.8200 www.wiley.com Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the worldвЂ™s leading societies. Wiley-Blackwell publishes more than 1,400 peer-reviewed journals and more than 1,500 new books annually in print and online, as well as databases, major reference works, and laboratory protocols. For more information, please visit www.wileyblackwell.com or http://onlinelibrary.wiley.com/. BOOTH 229 Corporate Relations Council Xanodyne Pharmaceuticals One Riverfront Place Newport, KY 41071 859.371.6383 fax 859.371.6391 www.xanodyne.com Xanodyne Pharmaceuticals, Inc., is an integrated specialty pharmaceutical company with both development and commercial capabilities focused on pain management. Xanodyne promotes ZipsorВ® (diclofenac potassium) liquid-filled Capsules, an analgesic for relief of mild to moderate acute pain in adults. AAPM Gratefully Acknowledges members of Its Corporate relations council PREMIER EXECUTIVE ELITE ASSOCIATE ASSOCIATE SM 59 60 Notes Thank You We appreciate your generous contribution to the success of this annual meeting. the American Academy of Pain Medicine Thank You We appreciate your generous contribution to the success of this annual meeting. the American Academy of Pain Medicine YouвЂ™re invited to come learn about... A B T S P P V U пњЎ # B 301 F A Purdue Pharma L.P. Corporate Showcase A A P M 27 A M F ,M 25, 2011 9:30 вЂ“ 10:30 P G вЂ™ E H C G N H &C W , DC C WARNING: IMPORTANCE OF PROPER PATIENT SELECTION, POTENTIAL FOR ABUSE, AND LIMITATIONS OF USE Proper Patient Selection Butrans is a transdermal formulation of buprenorphine indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time. (1) Potential for Abuse Butrans contains buprenorphine which is a mu opioid partial agonist and a Schedule III controlled substance. Butrans can be abused in a manner similar to other opioid agonists, legal or illicit. Consider the abuse potential when prescribing or dispensing Butrans in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. (9) Joseph V. Pergolizzi Jr, MD Adjunct Faculty Department of Anesthesiology Georgetown University School of Medicine Washington, DC Persons at increased risk for opioid abuse include those with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (eg, major depression). Assess patients for their clinical risks for opioid abuse or addiction prior to being prescribed opioids. Routinely monitor all patients receiving opioids for signs of misuse, abuse and addiction. (2.2) Limitations of Use Do not exceed a dose of one 20 mcg/hour Butrans system due to the risk of QTc interval prolongation. (2.3) Avoid exposing the Butrans application site and surrounding area to direct external heat sources. Temperature-dependent increases in buprenorphine release from the system may result in overdose and death. (5.11) Parentheses refer to sections in the Full Prescribing Information. Please read Brief Summary of Full Prescribing Information on the following pages. This is a promotional event. CME will not be available for this session. В©2011 Purdue Pharma L.P., Stamford, CT 06901-3431 B7895-PA 3/11 for transdermal administration BRIEF SUMMARY OF PRESCRIBING INFORMATION (For complete details please see the full prescribing information and Medication Guide.) WARNING: IMPORTANCE OF PROPER PATIENT SELECTION, POTENTIAL FOR ABUSE, AND LIMITATIONS OF USE Proper Patient Selection Butrans is a transdermal formulation of buprenorphine indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time. (1) Potential for Abuse Butrans contains buprenorphine which is a mu opioid partial agonist and a Schedule III controlled substance. Butrans can be abused in a manner similar to other opioid agonists, legal or illicit. Consider the abuse potential when prescribing or dispensing Butrans in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. (9) Persons at increased risk for opioid abuse include those with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (e.g., major depression). Assess patients for their clinical risks for opioid abuse or addiction prior to being prescribed opioids. Routinely monitor all patients receiving opioids for signs of misuse, abuse and addiction. (2.2) Limitations of Use Do not exceed a dose of one 20 mcg/hour Butrans system due to the risk of QTc interval prolongation. (2.3) Avoid exposing the Butrans application site and surrounding area to direct external heat sources. Temperature-dependent increases in buprenorphine release from the system may result in overdose and death. (5.11) 1 INDICATIONS AND USAGE Butrans is indicated for the management of moderate to severe chronic pain in patients requiring a continuous, around-the-clock opioid analgesic for an extended period of time. 4 CONTRAINDICATIONS Butrans is contraindicated in: вЂў patients who have significant respiratory depression вЂў patients who have severe bronchial asthma вЂў patients who have or are suspected of having paralytic ileus вЂў patients who have known hypersensitivity to any of its components or the active ingredient, buprenorphine вЂў the management of acute pain or in patients who require opioid analgesia for a short period of time вЂў the management of post-operative pain, including use after out-patient or day surgeries вЂў the management of mild pain вЂў the management of intermittent pain (e.g., use on an as needed basis [prn]) 5 WARNINGS AND PRECAUTIONS 5.1 Respiratory Depression Respiratory depression is the chief hazard of Butrans. Respiratory depression occurs more frequently in elderly or debilitated patients as well as those suffering from conditions accompanied by hypoxia or hypercapnia when even moderate therapeutic doses may dangerously decrease pulmonary ventilation, and when opioids, including Butrans, are given in conjunction with other agents that depress respiration. Profound sedation, unresponsiveness, infrequent deep (вЂњsighingвЂќ) breaths or atypical snoring frequently accompany opioid-induced respiratory depression. Use Butrans with extreme caution in patients with any of the following: вЂў significant chronic obstructive pulmonary disease or cor pulmonale вЂў other risk of substantially decreased respiratory reserve such as asthma, severe obesity, sleep apnea, myxedema, clinically significant kyphoscoliosis, and central nervous system (CNS) depression вЂў hypoxia вЂў hypercapnia вЂў pre-existing respiratory depression 5.2 CNS Depression Butrans may cause somnolence, dizziness, alterations in judgment and alterations in levels of consciousness, including coma. 5.3 Interactions with Alcohol, Central Nervous System Depressants, and Illicit Drugs Hypotension, profound sedation, coma or respiratory depression may result if Butrans is added to a regimen that includes other CNS depressants (e.g., sedatives, anxiolytics, hypnotics, neuroleptics, muscle relaxants, other opioids). Therefore, use caution when deciding to initiate therapy with Butrans in patients who are taking other CNS depressants. Take into account the types of other medications being taken, the duration of therapy with them, and the patientвЂ™s response to those medicines, including the degree of tolerance that has developed to CNS depression. Consider the patientвЂ™s use, if any, of alcohol and/or illicit drugs that cause CNS depression. If the decision to begin Butrans is made, start with a lower Butrans dose than usual. Consider using a lower initial dose of a CNS depressant when given to a patient currently taking Butrans due to the potential of additive CNS depressant effects. 5.4 QTc Prolongation A positive-controlled study of the effects of Butrans on the QTc interval in healthy subjects demonstrated no clinically meaningful effect at a Butrans dose of 10 mcg/hour; however, a Butrans dose of 40 mcg/hour (given as two Butrans 20 mcg/hour Transdermal Systems) was observed to prolong the QTc interval [see Clinical Pharmacology (12.2)]. Consider these observations in clinical decisions when prescribing Butrans to patients with hypokalemia or clinically unstable cardiac disease, including: unstable atrial fibrillation, symptomatic bradycardia, unstable congestive heart failure, or active myocardial ischemia. Avoid the use of Butrans in patients with a history of Long QT Syndrome or an immediate family member with this condition, or those taking Class IA antiarrhythmic medications (e.g., quinidine, procainamide, disopyramide) or Class III antiarrhythmic medications (e.g., sotalol, amiodarone, dofetilide). 5.5 Head Injury The respiratory depressant effects of opioids, including Butrans, include carbon dioxide retention, which can lead to an elevation of cerebrospinal fluid pressure. This effect may be exaggerated in the presence of head injury, intracranial lesions, or other sources of pre-existing increased intracranial pressure. Butrans may produce miosis that is independent of ambient light, and altered consciousness, either of which may obscure neurologic signs associated with increased intracranial pressure in persons with head injuries. 5.6 Hypotensive Effects Butrans may cause severe hypotension. There is an added risk to individuals whose ability to maintain blood pressure has been compromised by a depleted blood volume, or after concurrent administration with drugs such as phenothiazines or other agents which compromise vasomotor tone. Buprenorphine may produce orthostatic hypotension in ambulatory patients. Administer Butrans with caution to patients in circulatory shock, since vasodilation produced by the drug may further reduce cardiac output and blood pressure. 5.7 Misuse, Abuse, and Diversion of Opioids Butrans contains buprenorphine, a partial agonist at the mu opioid receptor and a Schedule III controlled substance. Opioid agonists have potential for being abused, are sought by drug abusers and people with addiction disorders, and are subject to criminal diversion. Butrans can be abused in a manner similar to other opioid agonists, legal or illicit. Consider this potential for abuse when prescribing or dispensing Butrans in situations where the prescriber or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. Monitor all patients receiving opioids for signs of abuse, misuse, and addiction. Furthermore, assess patients for their potential for opioid abuse prior to being prescribed opioid therapy. Persons at increased risk for opioid abuse include those with a personal or family history of substance abuse (including drug or alcohol abuse) or mental illness (e.g., depression). Opioids may still be appropriate for use in these patients; however, they will require intensive monitoring for signs of abuse. Notwithstanding concerns about abuse, addiction, and diversion, provide proper management of pain. However, all patients treated with opioid agonists require careful monitoring for signs of abuse and addiction, since use of opioid agonist analgesic products carries the risk of addiction even under appropriate medical use [see Drug Abuse and Dependence (9.2)]. Data are not available to establish the true incidence of addiction in patients with chronic pain treated with opioids. Abuse of Butrans poses a significant risk to the abuser that could potentially result in overdose or death [see Drug Abuse and Dependence (9)]. Contact your state professional licensing board or state controlled substances authority for information on how to prevent and detect abuse or diversion of this product. 5.8 Hepatotoxicity Although not observed in Butrans chronic pain clinical trials, cases of cytolytic hepatitis and hepatitis with jaundice have been observed in individuals receiving sublingual buprenorphine for the treatment of opioid dependence, both in clinical trials and through post-marketing adverse event reports. The spectrum of abnormalities ranges from transient asymptomatic elevations in hepatic transaminases to case reports of hepatic failure, hepatic necrosis, hepatorenal syndrome, and hepatic encephalopathy. In many cases, the presence of pre-existing liver enzyme abnormalities, infection with hepatitis B or hepatitis C virus, concomitant usage of other potentially hepatotoxic drugs, and ongoing injection drug abuse may have played a causative or contributory role. In other cases, insufficient data were available to determine the etiology of the abnormality. The possibility exists that buprenorphine had a causative or contributory role in the development of the hepatic abnormality in some cases. For patients at increased risk of hepatotoxicity (e.g., patients with a history of excessive alcohol intake, intravenous drug abuse or liver disease), baseline and periodic monitoring of liver function during treatment with Butrans is recommended. A biological and etiological evaluation is recommended when a hepatic event is suspected. 5.9 Application Site Skin Reactions In rare cases, severe application site skin reactions with signs of marked inflammation including вЂњburn,вЂќ вЂњdischarge,вЂќ and вЂњvesiclesвЂќ have occurred. Time of onset varies, ranging from days to months following the initiation of Butrans treatment. Instruct patients to promptly report the development of severe application site reactions and discontinue therapy. 5.10 Anaphylactic/Allergic Reactions Cases of acute and chronic hypersensitivity to buprenorphine have been reported both in clinical trials and in the post-marketing experience. The most common signs and symptoms include rashes, hives, and pruritus. Cases of bronchospasm, angioneurotic edema, and anaphylactic shock have been reported. A history of hypersensitivity to buprenorphine is a contraindication to the use of Butrans. 5.11 Application of External Heat Advise patients and their caregivers to avoid exposing the Butrans application site and surrounding area to direct external heat sources, such as heating pads or electric blankets, heat or tanning lamps, saunas, hot tubs, and heated water beds, etc., while wearing the system because an increase in absorption of buprenorphine may occur [see Clinical Pharmacology (12.3)]. Advise patients against exposure of the Butrans application site and surrounding area to hot water or prolonged exposure to direct sunlight. There is a potential for temperature-dependent increases in buprenorphine released from the system resulting in possible overdose and death. 5.12 Patients with Fever Patients wearing Butrans systems who develop fever or increased core body temperature due to strenuous exertion should be monitored for opioid side effects and the Butrans dose should be adjusted if necessary [see Dosage and Administration (2.4)]. 5.13 Driving and Operating Machinery Butrans may impair the mental and physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery. Caution patients accordingly. 5.14 Seizures Butrans, as with other opioids, may aggravate seizure disorders, may lower seizure threshold, and therefore, may induce seizures in some clinical settings. Use Butrans with caution in patients with a history of seizure disorders. 5.15 Special Risk Groups Use Butrans with caution in the following conditions, due to increased risk of adverse reactions: alcoholism; delirium tremens; adrenocortical insufficiency; CNS depression; debilitation; kyphoscoliosis associated with respiratory compromise; myxedema or hypothyroidism; prostatic hypertrophy or urethral stricture; severe impairment of hepatic, pulmonary or renal function; and toxic psychosis. 5.16 Use in Pancreatic/Biliary Tract Disease and Other Gastrointestinal Conditions Butrans may cause spasm of the sphincter of Oddi. Use with caution in patients with biliary tract disease, including acute pancreatitis. Opioids, including Butrans, may cause increased serum amylase. The administration of Butrans may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Use Butrans with caution in patients who are at risk of developing ileus. 5.17 Use in Addiction Treatment Butrans has not been studied and is not approved for use in the management of addictive disorders. 5.18 MAO Inhibitors Butrans is not recommended for use in patients who have received MAO inhibitors within 14 days, because severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics. 6 ADVERSE REACTIONS The following adverse reactions described elsewhere in the labeling include: вЂў Respiratory Depression [see Warnings and Precautions (5.1)] вЂў CNS Depression [see Warnings and Precautions (5.2)] вЂў QTc Prolongation [see Warnings and Precautions (5.4)] вЂў Hypotensive Effects [see Warnings and Precautions (5.6)] вЂў Application Site Skin Reactions [see Warnings and Precautions (5.9)] вЂў Anaphylactic/Allergic Reactions [see Warnings and Precautions (5.10)] вЂў Seizures [see Warnings and Precautions (5.14)] 6.1 Clinical Trial Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. A total of 5415 patients were treated with Butrans in controlled and open-label chronic pain clinical trials. Nine hundred twenty-four subjects were treated for approximately six months and 183 subjects were treated for approximately one year. The clinical trial population consisted of patients with persistent moderate to severe pain. The most common adverse reactions (в‰Ґ5%) reported by patients in clinical trials comparing Butrans 10 or 20 mcg/hour to placebo are shown in Tables 2, and comparing Butrans 20 mcg/hour to Butrans 5 mcg/hour are shown in Table 3 below: Table 2: Adverse Events Reported in в‰Ґ 5% of Patients during the Open-Label Titration Period and DoubleBlind Treatment Period: Opioid-NaГЇve Patients Open-Label Double-Blind Titration Period Treatment Period Butrans Butrans Placebo MedDRA (N = 1024) (N = 256) (N = 283) Preferred Term Nausea 23% 13% 11% Table 3: Adverse Events Reported in в‰Ґ 5% of Patients during the Open-Label Titration Period and DoubleBlind Treatment Period: Opioid-Experienced Patients Open-Label Titration Period Butrans Double-Blind Treatment Period Butrans 20 Butrans 5 MedDRA (N = 1160) (N = 219) Preferred Term (N = 221) Nausea 15% 12% 8% Headache 11% 11% 5% Application site pruritus 9% 13% 5% Somnolence 6% 5% 2% Vomiting 5% 5% 2% Dizziness 5% 5% 2% Constipation 4% 6% 3% Application site erythema 3% 10% 5% Application site rash 3% 9% 6% Application site irritation 2% 5% 3% The following table lists adverse events that were reported in at least 2.0% of patients in four placebo/active-controlled titration-to-effect trials. Table 4: Adverse Events Reported in Titration-toEffect Placebo/Active-Controlled Clinical Trials with Incidence в‰Ґ2% MedDRA Preferred Term Butrans (N = 392) Placebo (N = 261) Nausea 23% 8% Dizziness 16% 8% Headache 16% 11% Application site pruritus 15% 12% Constipation 14% 5% Somnolence 14% 5% Vomiting 11% 2% Peripheral edema 7% 3% Dry mouth 7% 2% Application site erythema 7% 2% Application site rash 6% 6% Fatigue 5% 1% Hyperhidrosis 4% 1% Pruritus 4% 1% Fall 4% 2% Diarrhea 3% 2% Pain in extremity 3% 2% Insomnia 3% 2% Dyspnea 3% 1% Dyspepsia 3% 3% Urinary tract infection 3% 2% Back pain 3% 2% Joint swelling 3% 1% Hypoesthesia 2% 1% Dizziness 10% 4% 1% Arthralgia 2% 2% Headache 10% 5% 5% Stomach discomfort 2% 1% Application site pruritus 8% 4% 7% Somnolence 8% 2% 2% Paraesthesia 2% 1% Vomiting 8% 4% 2% Tremor 2% <1% Constipation 7% 4% 1% Confusional State 2% 3% Rash 2% 1% Anorexia 2% 1% The adverse events seen in controlled and open-label studies are presented below in the following manner: most common (в‰Ґ5%), common (в‰Ґ1% - <5%), and less common (<1%). The most common adverse events (в‰Ґ5%) reported by patients treated with Butrans in the clinical trials were nausea, headache, application site pruritus, dizziness, constipation, somnolence, vomiting, application site erythema, dry mouth, and application site rash. The common (в‰Ґ1% to <5%) adverse events reported by patients treated with Butrans in the clinical trials organized by MedDRA (Medical Dictionary for Regulatory Activities) System Organ Class were: Gastrointestinal disorders: diarrhea, dyspepsia, and upper abdominal pain General disorders and administration site conditions: fatigue, peripheral edema, application site irritation, pain, pyrexia, chest pain, and asthenia Infections and infestations: urinary tract infection, upper respiratory tract infection, nasopharyngitis, influenza, sinusitis, and bronchitis Injury, poisoning and procedural complications: fall Metabolism and nutrition disorders: anorexia Musculoskeletal and connective tissue disorders: back pain, arthralgia, pain in extremity, muscle spasms, musculoskeletal pain, joint swelling, neck pain, and myalgia Nervous system disorders: hypoesthesia, tremor, migraine, and paresthesia Psychiatric disorders: insomnia, anxiety, and depression Respiratory, thoracic and mediastinal disorders: dyspnea, pharyngolaryngeal pain, and cough Skin and subcutaneous tissue disorders: pruritus, hyperhidrosis, rash, and generalized pruritus Vascular disorders: hypertension Other less common adverse events, including those known to occur with opioid treatment, that were seen in <1% of the patients in the Butrans trials include the following in alphabetical order: Abdominal distention, abdominal pain, accidental injury, affect lability, agitation, alanine aminotransferase increased, angina pectoris, angioedema, apathy, application site dermatitis, asthma aggravated, bradycardia, chills, confusional state, contact dermatitis, coordination abnormal, dehydration, depressed level of consciousness, depressed mood, depersonalization, disorientation, disturbance in attention, diverticulitis, drug hypersensitivity, drug withdrawal syndrome, dry eye, dry skin, dysarthria, dysgeusia, dysmenorrhea, dysphagia, euphoric mood, face edema, flatulence, flushing, gait disturbance, hallucination, hiccups, hot flush, hyperventilation, hypotension, hypoventilation, ileus, insomnia, libido decreased, loss of consciousness, malaise, memory impairment, mental impairment, mental status changes, miosis, muscle weakness, nervousness, nightmare, orthostatic hypotension, palpitations, psychotic disorder, respiration abnormal, respiratory depression, respiratory distress, respiratory failure, restlessness, rhinitis, sedation, sexual dysfunction, syncope, tachycardia, tinnitus, urinary hesitation, urinary incontinence, urinary retention, urticaria, vasodilatation, vertigo, vision blurred, visual disturbance, weight decreased, and wheezing. 7 DRUG INTERACTIONS 7.1 Metabolic Drug Interactions CYP3A4 Inhibitors Co-administration of ketoconazole, a strong CYP3A4 inhibitor, with Butrans, did not have any effect on Cmax and AUC of buprenorphine. Based on this observation, pharmacokinetics of Butrans is not expected to be affected by co-administration of CYP3A4 inhibitors. However, certain protease inhibitors (PIs) with CYP3A4 inhibitory activity such as atazanavir and atazanavir/ritonavir resulted in elevated levels of buprenorphine and norbuprenorphine following sublingual administration of buprenorphine and naloxone. Patients in this study reported increased sedation, and symptoms of opiate excess have been found in post-marketing reports of patients receiving sublingual buprenorphine and atazanavir with and without ritonavir concomitantly. It should be noted that atazanavir is both a CYP3A4 and UGT1A1 inhibitor. As such, the drug-drug interaction potential for buprenorphine with CYP3A4 inhibitors is likely to be dependent on the route of administration as well as the specificity of enzyme inhibition [see Clinical Pharmacology (12.3)]. CYP3A4 Inducers The interaction between buprenorphine and CYP3A4 enzyme inducers has not been studied; therefore it is recommended that patients receiving Butrans be closely monitored for reduced efficacy if inducers of CYP3A4 (e.g. phenobarbital, carbamazepine, phenytoin, rifampin) are co-administered [see Clinical Pharmacology (12.3)]. 7.2 Non-Metabolic Drug Interactions Benzodiazepines There have been a number of reports regarding coma and death associated with the misuse and abuse of the combination of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection of crushed buprenorphine tablets. Preclinical studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. Prescribe Butrans with caution to patients taking benzodiazepines or other drugs that act on the central nervous system regardless of whether these drugs are taken on the advice of a physician or are being abused/ misused. Warn patients that it is extremely dangerous to self-administer benzodiazepines while taking Butrans, and caution patients to use benzodiazepines concurrently with Butrans only as directed by their physician. Skeletal Muscle Relaxants Butrans, like other opioids, may interact with skeletal muscle relaxants to enhance neuromuscular blocking action and increase respiratory depression. 8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Pregnancy Category C There are no adequate and well-controlled studies with Butrans in pregnant women. Butrans should be used during pregnancy only if the potential benefit justifies the potential risk to the mother and the fetus. In animal studies, buprenorphine caused an increase in the number of stillborn offspring, reduced litter size, and reduced offspring growth in rats at maternal exposure levels that were approximately 10 times that of human subjects who received one Butrans 20 mcg/ hour, the maximum recommended human dose (MRHD). Teratogenic Effects Studies in rats and rabbits demonstrated no evidence of teratogenicity following Butrans or subcutaneous (SC) administration of buprenorphine during the period of major organogenesis. Rats were administered up to one Butrans 20 mcg/hour every 3 days (gestation days 6, 9, 12, & 15) or received daily SC buprenorphine up to 5 mg/kg (gestation days 6-17). Rabbits were administered four Butrans 20 mcg/ hour every 3 days (gestation days 6, 9, 12, 15, 18, & 19) or received daily SC buprenorphine up to 5 mg/kg (gestation days 6-19). No teratogenicity was observed at any dose. Area under the curve (AUC) values for buprenorphine with Butrans application and SC injection were approximately 140 and 110 times that of human subjects who received the MRHD of one Butrans 20 mcg/hour. Non-Teratogenic Effects In a peri- and post-natal study conducted in pregnant and lactating rats, administration of buprenorphine either as Butrans or SC buprenorphine was associated with toxicity to offspring. Buprenorphine was present in maternal milk. Pregnant rats were administered 1/4 of one Butrans 5 mcg/ hour every 3 days or received daily SC buprenorphine at doses of 0.05, 0.5, or 5 mg/kg from gestation day 6 to lactation day 21 (weaning). Administration of Butrans or SC buprenorphine at 0.5 or 5 mg/kg caused maternal toxicity and an increase in the number of stillborns, reduced litter size, and reduced offspring growth at maternal exposure levels that were approximately 10 times that of human subjects who received the MRHD of one Butrans 20 mcg/hour. Maternal toxicity was also observed at the no observed adverse effect level (NOAEL) for offspring. 8.2 Labor and Delivery The safety of Butrans given during labor and delivery has not been established. Opioids cross the placenta and may produce respiratory depression and psychophysiologic effects in neonates. Butrans is not recommended for use in women immediately prior to and during labor, when use of shorter-acting analgesics or other analgesic techniques are more appropriate. Occasionally, opioid analgesics may prolong labor through actions which temporarily reduce the strength, duration and frequency of uterine contractions. However this effect is not consistent and may be offset by an increased rate of cervical dilatation, which tends to shorten labor. Closely observe neonates whose mothers received opioid analgesics during labor for signs of respiratory depression. Have a specific opioid antagonist, such as naloxone or nalmefene, available for reversal of opioid-induced respiratory depression in the neonate. Neonates whose mothers have been taking opioids chronically may also exhibit withdrawal signs, either at birth and/ or in the nursery, because they have developed physical dependence. This is not, however, synonymous with addiction. Neonatal opioid withdrawal syndrome, unlike opioid withdrawal syndrome in adults, may be life-threatening and should be treated according to protocols developed by neonatology experts. 8.3 Nursing Mothers Buprenorphine has been detected in low concentrations in human milk. Breast-feeding is not advised in mothers treated with Butrans. 8.4 Pediatric Use The safety and efficacy of Butrans in patients under 18 years of age has not been established. Butrans is not recommended for use in pediatric patients. 8.5 Geriatric Use Of the total number of subjects in the clinical trials (5,415), Butrans was administered to 1,377 patients aged 65 years and older. Of those, 457 patients were 75 years of age and older. In the clinical program, the incidences of selected Butrans-related AEs were higher in older subjects. The incidences of application site AEs were slightly higher among subjects <65 years of age than those в‰Ґ 65 years of age for both Butrans and placebo treatment groups. In a single-dose study of healthy elderly and healthy young subjects treated with Butrans 10 mcg/hour, the pharmacokinetics and safety outcomes were similar. In a separate dose-escalation safety study, the pharmacokinetics in the healthy elderly and hypertensive elderly subjects taking thiazide diuretics were similar to those in the healthy young adults. In the elderly groups evaluated, adverse event rates were similar to or lower than rates in healthy young adult subjects, except for constipation and urinary retention, which were more common in the elderly. Although specific dose adjustments on the basis of advanced age are not required for pharmacokinetic reasons, use caution in the elderly population to ensure safe use [see Dosage and Administration (2.4) and Clinical Pharmacology (12.3)]. 8.6 Hepatic Impairment In a study utilizing intravenous buprenorphine, peak plasma levels (Cmax) and exposure (AUC) of buprenorphine in patients with mild and moderate hepatic impairment did not increase as compared to those observed in subjects with normal hepatic function. Butrans has not been evaluated in patients with severe hepatic impairment and should be administered with caution [see Dosage and Administration (2.4), and Clinical Pharmacology (12.3]). 8.7 Renal Impairment The pharmacokinetics of buprenorphine is not altered during the course of renal failure [see Clinical Pharmacology (12.3]). 8.8 Gender Differences There was no significant gender effect observed for Butrans with respect to either the incidence of adverse events or pharmacokinetics [see Clinical Pharmacology (12.3)]. 9 DRUG ABUSE AND DEPENDENCE 9.1 Controlled Substance Butrans contains buprenorphine, a mu opioid partial agonist and Schedule III controlled substance. Butrans can be abused and is subject to misuse, abuse, addiction and criminal diversion. 9.2 Abuse Abuse of Butrans poses a hazard of overdose and death. This risk is increased with compromise of the Butrans Transdermal System and with concurrent abuse of alcohol or other substances. Butrans has been diverted for non-medical use. All patients treated with opioids, including Butrans, require careful monitoring for signs of abuse and addiction, because use of opioid analgesic products carries the risk of addiction even under appropriate medical use. Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. Opioid drugs are sought by people with substance use disorders (abuse or addiction, the latter of which is also called вЂњsubstance dependenceвЂќ) and criminals who supply them by diverting medicines out of legitimate distribution channels. Butrans is a target for theft and diversion. вЂњDrug-seekingвЂќ behavior is very common in persons with substance use disorders. Drug-seeking tactics include, but are not limited to, emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated вЂњlossвЂќ of prescriptions, altering or forging of prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). вЂњDoctor shoppingвЂќ to obtain additional prescriptions is common among people with untreated substance use disorders, and criminals who divert controlled substances. Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction and is characterized by misuse for nonmedical purposes, often in combination with other psychoactive substances. Since Butrans may be diverted for non-medical use, careful record-keeping of prescribing information, including quantity, frequency, and renewal requests is strongly advised. The risks of misuse and abuse should be considered when prescribing or dispensing Butrans. Concerns about abuse and addiction, should not prevent the proper management of pain, however. Treatment of pain should be individualized, balancing the potential benefits and risks for each patient. Butrans is intended for transdermal use only. Compromising the transdermal delivery system will result in the uncontrolled delivery of buprenorphine and pose a significant risk to the abuser that could result in overdose and death [see Warnings and Precautions (5.1)]. The risk of fatal overdose is further increased when buprenorphine is abused concurrently with alcohol or other CNS depressants, including other opioids and benzodiazepines [see Warnings and Precautions (5.3)]. Abuse may occur by applying the transdermal system in the absence of legitimate purpose, or by swallowing, snorting or injecting buprenorphine extracted from the transdermal system. Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, proper dispensing and correct storage and handling are appropriate measures that help to limit misuse and abuse of opioid drugs. Careful record-keeping of prescribing information, including quantity, frequency, and renewal requests is strongly advised. Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product. 9.3 Physical Dependence and Tolerance Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drugвЂ™s effects over time. Tolerance could occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects. Physical dependence to an opioid is manifested by characteristic withdrawal signs and symptoms after abrupt discontinuation of a drug, significant dose reduction, or upon administration of an antagonist. Physical dependence and tolerance are not unusual during chronic opioid analgesic therapy. The opioid abstinence or withdrawal syndrome in adults is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, piloerection, myalgia, mydriasis, irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate [see Use In Specific Populations (8.2)] Infants born to mothers physically dependent on opioids will also be physically dependent and may exhibit respiratory difficulties and withdrawal symptoms. In general, opioids should not be abruptly discontinued [see Dosage and Administration (2.5)]. 10 OVERDOSAGE 10.1 Symptoms Acute overdosage with Butrans can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, bradycardia, hypotension, partial or complete airway obstruction, atypical snoring and death. Deaths due to overdose have been reported with abuse and misuse of buprenorphine. Review of case reports has indicated that the risk of fatal overdose is further increased when Butrans is abused concurrently with alcohol or other CNS depressants, including other opioids. 10.2 Treatment In cases of overdose, remove Butrans immediately. It is important to take the pharmacokinetic profile of Butrans into account when treating overdose. Even in the face of improvement, continued medical monitoring is required because of the possibility of extended effects as opioid continues to be absorbed from the skin. After removal of Butrans, the mean buprenorphine concentrations decrease approximately 50% in 12 hours (range 10-24 hours) with an apparent terminal half-life of approximately 26 hours. Due to this long apparent terminal half-life, patients may require monitoring and treatment for at least 24 hours. In the treatment of Butrans overdosage, primary attention should be given to the maintenance of a patent airway, and of effective ventilation (clearance of CO2) and oxygenation, whether by spontaneous, assisted or controlled respiration. Supportive measures (including oxygen and vasopressors) should be employed in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. Cardiac arrest or arrhythmias may require cardiac massage or defibrillation. Naloxone may not be effective in reversing any respiratory depression produced by buprenorphine. High doses of naloxone, 10-35 mg/70 kg, may be of limited value in the management of buprenorphine overdose. The onset of naloxone effect may be delayed by 30 minutes or more. Doxapram hydrochloride (a respiratory stimulant) has also been used. Since the duration of action of Butrans may exceed that of the antagonist, keep the patient under continued surveillance and administer repeated doses of the antagonist according to the antagonist labeling as needed to maintain adequate respiration. Maintenance of adequate ventilation is essential when managing Butrans overdose and more important than specific antidote treatment with an opioid antagonist such as naloxone. Do not administer opioid antagonists in the absence of clinically significant respiratory or circulatory depression secondary to buprenorphine overdose. In patients who are physically dependent on any opioid agonist including Butrans, an abrupt partial or complete reversal of opioid effects may precipitate an acute abstinence or withdrawal syndrome. The severity of the withdrawal syndrome produced will depend on the degree of physical dependence and the dose of the antagonist administered. See the prescribing information for the specific opioid antagonist for details of its proper use. 17 PATIENT COUNSELING INFORMATION See MEDICATION GUIDE (including Instructions for Use) as appended at the end of the full prescribing information. 17.1 Information for Patients and Caregivers Provide the following information to patients receiving Butrans or their caregivers: 1. Advise patients to carefully follow instructions for the application, removal, and disposal of Butrans. Each week, apply Butrans to a different site based on the 8 described skin sites, with a minimum of 3 weeks between applications to a previously used site. 2. Advise patients to apply Butrans to a hairless or nearly hairless skin site. If none are available, instruct patients to clip the hair at the site and not to shave the area. Instruct patients not to apply to irritated skin. If the application site must be cleaned, use clear water only. Soaps, alcohol, oils, lotions, or abrasive devices should not be used. Allow the skin to dry before applying Butrans. 3. Advise the patient to wear Butrans continuously for 7 days. 4. Advise patients to talk to their doctor if they have any pain or bothersome side effects while they are using Butrans. The dose may have to be changed. 5. Advise patients not to increase or decrease the Butrans dose they are using without first speaking to their doctor. 6. Advise patients that Butrans may impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating heavy machinery). 7. Advise patients who are taking Butrans not to drink alcohol. They should also avoid taking sleep aids and CNS depressants, unless a doctor prescribes them. 8. Advise patients that while wearing Butrans, they should avoid exposing the Butrans site to external heat sources, such as heating pads, electric blankets, heat lamps, saunas, hot tubs, heated water beds, etc, because an increase in absorption of buprenorphine may occur that could lead to an overdose or death. 9. Advise women who become pregnant, or who plan to become pregnant, to ask their doctor about the effects that Butrans may have on themselves and their pregnancy. 10. Advise patients that buprenorphine is a drug that some people may abuse. They should use Butrans only as directed, and not give it to anyone other than the individual for whom it was prescribed. Protect it from theft. Be especially careful to keep this medication away from children and pets. 11. Advise patients to tell their doctor if they have a history of serious skin reactions to adhesives, as they may not be able to use Butrans. 12. Advise patients who must stop using Butrans that they should speak with their doctor to manage the transition to other pain medications. Healthcare professionals can telephone Purdue PharmaвЂ™s Medical Services Department (1-888-726-7535) for information on this product. CAUTION DEA Order Form Required. Distributed by: Purdue Pharma L.P. Stamford, CT 06901-3431 Manufactured by: LTS Lohmann Therapie-Systeme AG Andernach, Germany U.S. Patent Numbers: 5,681,413; 5,804,215; 6,264,980; 6,315,854; 6,344,211; RE41408; RE41489; RE41571. Issued: August 2010 В©2010, Purdue Pharma L.P. 302578-0A the American Academy of Pain Medicine february 23вЂ“26, 2012 вЂў palm springs, ca PLAN NOW TO ATTEND AAPMвЂ™S 28TH ANNUAL MEETING The Premier Meeting for Physicians and Their Treatment Teams in the Field of Pain Medicine вЂў Hear Presentations by Nationally Recognized Leaders from the Specialty of Pain Medicine вЂўGet the Latest in the Science, Clinical Practice, and Social Policy Issues in Pain Medicine вЂўNetwork with Colleagues, Mentors, and Partners вЂўPast conferences have qualified for 30+ hours of AMA PRA Category 1 Credits of CME* in pain medicine and end-of-life care * AAPM is accredited by the Accreditation Council of Continuing Medical Education (ACCME) to offer continuing medical education for physicians. For more information, visit www.painmed.org or call 847.375.4731 вЂў [email protected] An official independent LUNCHEON SATELLITE SYMPOSIUM held in conjunction with the American Academy of Pain MedicineвЂ™s 27th Annual Meeting An Interactive Exploration of Integrated Opioid Therapy in Chronic Pain CONSULTATION WITH EXPERTS Saturday, March 26, 2011 11:30 am вЂ“ 12:45 pm Gaylord National Hotel & Convention Center Woodrow Wilson Ballroom A National Harbor, Maryland PROGRAM Welcome and Introductions Case Study Presentation on Integration of Opioid Therapy in Chronic Pain Management Presented by individual faculty followed by moderator led discussion in a clinical consultation format with ARS questions Patient Selection Lynn R. Webster, MD, FACPM, FASAM Co-founder and Medical Director Lifetree Clinical Research Salt Lake City, Utah Opioid Optimization Perry G. Fine, MD вЂ“ Moderator Professor of Anesthesiology Pain Research Center School of Medicine University of Utah Salt Lake City, Utah Risk Stratification Kenneth L. Kirsh, PhD Director of Behavioral Medicine The Pain Treatment Center of the Bluegrass Lexington, Kentucky Questions and Answers Summary and Conclusions Receive a flash drive with valuable tools and resources discussed throughout this symposium. (Limited quantity) Earn up to 1.25 CE credit hours! If you have not preregistered for this activity please register onsite, space permitting. For questions regarding the content of this activity, please call 1-800-408-4242, ext. 128 There are no fees for participating in this activity. Provided by MediCom Worldwide, Inc. Supported by an educational grant from Purdue Pharma L.P. В©2011 MediCom Worldwide, Inc., 101 Washington St., Morrisville, PA 19067, 800-408-4242.