Interactive Exchange

Persistent and Breakthrough Pain

Balancing the Benefits and Risk of Opioid-Based Therapy

Meeting Slides

Linked Resources

Persistent Pain and BTP Semi-Structured Questionnaire

Brennan MJ, Bruckenthal P, Datta S, Gudin JA, Schottenstein DC. Preliminary development of a semistructured approach to persistent and breakthrough pain assessment. Paper presented at: PAINWeek; September 6-11, 2010; Las Vegas, NV.

4 A's Patient Reassessment Chart Note

Adapted from Passik SD, Kirsh KL, Whitcomb L, et al. A new tool to assess and document pain outcomes in chronic pain patients receiving opioid therapy. Clin Ther. 2004;26(4):552-561.

Patient-Prescriber Agreement Form from the TIRF REMS Access Program

For instructions on enrolling into the TIRF REMS Access program, please go to

TIRF REMS Access Education Program Materials and Knowledge Assessment

The TIRF REMS Access Education Program is designed to outline the key safety information critical for minimizing the risks of abuse, misuse, overdose, addiction, and serious complications associated with medication errors associated with TIRF medicines to ensure safe use.

TIRF REMS Access Program - Prescriber Enrollment Form

For real-time processing of this enrollment form electronically, please go to and ‘Log In’ (if you have previously enrolled in a REMS program for one of the TIRF medicines) or ‘Create an Account’ to get started.

Opioid Risk Tool

Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the opioid risk tool.  Pain Med. 2005;6:432-442.

The Numerical Opioid Side Effect (NOSE) Assessment Tool

Smith HS, Kirsh KL. Documentation and potential tools in long-term opioid therapy for pain. Med Clin North Am. 2007;91(2):213-228.

Checklist for Signs of Opioid Misuse, Abuse, or Diversion

Adapted from Utah Department of Health. Utah Clinical Guidelines on Prescribing Opioids for Treatment of Pain. Salt Lake City, UT: Utah Department of Health; 2009.

Daily Pain Chart

Adapted from Rhiner M. The American Pain Foundation TARGET Chronic Pain Initiative: better patient/clinician communication to improve pain management. J Pain Palliat Care Pharmacother. 2004;18(4):55-63.

Hospice Initial Pain Assessment

Adapted from Miller KE, Miller MM, Jolley MR. Challenges in pain management at the end of life. Am Fam Physician. 2001;64(7):1227-1234.

Interactive Presentation

Fundamentals of Breakthrough Pain: Assessment and Differential Diagnosis

Michael J. Brennan, MD

Persistent and Breakthrough Pain

Balancing the Benefits and Risks of Opioid-Based Therapy

Relevant Resources

Improving the Care of Patients With Chronic Pain

Individualized Assessment and Mechanism-Based Multimodal Treatment

Caring For Patients With Chronic Pain

Responsible Opioid Prescribing to Achieve Individualized Functional Goals

Acute Management of Migraine Attacks

Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes

Opioid-Induced Constipation

Proactive Diagnosis and Targeted Management

Intrathecal Drug Delivery for Chronic Pain

Selecting Patients and Optimizing Long-Term Outcomes

Opioid-Induced Constipation

Proactive Diagnosis and Targeted Management

Clinical Issues in Chronic Pain

Consensus and Controversies for Responsible Opioid Prescribing

Intrathecal Drug Delivery for Chronic Pain

The Role of Nurses in Optimizing Long-term Outcomes

Intrathecal Drug Therapy for Chronic Pain

Evolving Best-Practice Strategies to Maximize Efficacy and Safety

Comprehensive Chronic Pain Management

A Focus on Patients With Opioid-Induced Constipation

Best Practices in Intrathecal Therapy for Chronic Pain

Patient Selection, Treatment Initiation, and Ongoing Monitoring

Overcoming Challenges in Cancer Pain Management

Engaging With Patients About Opioid-Induced Constipation

Can You Spot Axial Spondyloarthritis?

The PCP’s Role in Timely Recognition and Referral

Clinical Issues in Chronic Pain

Debates and Discussions About Therapeutically Targeting Nerve Growth Factor Signaling

Comprehensive Relief from Cancer Pain

Expanding the Conversation on Opioid-Induced Constipation

Managing Opioid-Induced Constipation

Translating Guidelines Into Patient Care

Finding Relief in Osteoarthritis

New Paths to Chronic Pain Management

What’s New in Systemic Lupus Erythematosus?

Unlocking Novel Paths to Patient Care

Maybe It’s NOT Mechanical Back Pain

Getting on the Fast Track to Identify AxSpA