Return to CME/CE Activities

Pain Management Interventions for Hip Fracture

• CME Information
• Faculty Biographies & Disclosures
• References
• Course Presentations
• CME Posttest

CME Information

Course Overview Educational Objectives Target Audience Method of Participation

Accreditation Statement Term of Approval Peer Review Program Director

Disclaimer Disclosure Acknowledgement of Support

Course Overview

Among elderly patients with hip fracture from low-impact injury, mortality rates in the first year after fracture are approximately 25 percent for women and 37 percent for men. Morbidity and poor functional recovery is substantial, with 25 percent of women and 50 percent of men unable to return home within 1 year. For these patients, adequate pain management from the preoperative period through rehabilitation contributes to avoiding complications (e.g., mental status changes, cardiopulmonary consequences), restoring ambulation, and transitioning to less-intensive care settings. For example, treatment of moderate to severe pain may require opioids, which present complications including habituation, alterations in mental status, nausea and vomiting, constipation, and respiratory depression, with individual variation in narcotic tolerance a clinical issue. Alternative or adjunctive methods that are safe and effective options in the older adult population are of interest.

This CME activity covers the systematic review and meta-analysis of the current clinical literature, conducted by the University of Alberta Evidence-based Practice Center, to evaluate the evidence about the effectiveness and safety of pain management interventions used for elderly patients with hip fracture.

Educational Objectives

At the conclusion of this activity, the participant should be able to:

• Describe the rationale for emphasizing pain management for elderly patients with hip fracture from low impact injury.
• Identify modes of pain management, both pharmcologic and non-pharmacologic, that are used for elderly patients with hip fractures.
• Estimate the likely success and benefits in practice of methods for relief from pain, to choose interventions appropriate for elderly patients with hip fracture.
• Identify potential harms associated with use of pain management interventions in patients with hip fractures.
• Describe the strengths, limitations and knowledge gaps of the current evidence about benefits and harms for each intervention.

Target Audience

This CME activity is designed to meet the educational needs of primary care physicians, emergency medicine physicians, gerontologists, orthopedic surgeons, anesthesiologists, nurses, physical therapists and other medical professionals who are involved in the care of elderly patients with hip fractures from low-impact injury.

Method of Participation

This activity is in PowerPoint file format and is accompanied by talking points and references linked to online sources.

To receive a maximum of 1.0 AMA PRA Category 1 Credit(s)™ you should:

• View the presentations in this enduring material.
• Complete the posttest (you must answer 8 out of 10 questions correctly).
• Complete and submit the CME registration and evaluation forms.

The estimated time to complete this activity, including review of the materials, is 1.0 hour(s).

Hardware/software requirements: Activities should be run with recent versions of common browsers, including Internet Explorer, Firefox, and Google Chrome.

If you have questions about the participation process, please e-mail the Office of Continuing Medical Education, cme@bcm.edu or phone 713.798.8237.

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Term of Approval

June 2011 through June 2014. Original release date: June 2011

Peer Review

In May 2011, this continuing medical education activity was reviewed by Melvyn A. Harrington M.D., an Associate Professor and the Director of the Residency Program, Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas. To ensure the continued scientific relevance of this enduring material, its content will be reviewed again in July 2014.

Disclosure: Nothing to disclose.

Program Director

Michael Fordis, MD
Sr. Associate Dean
Director, Center for Collaborative and Interactive Technologies
Director, John M. Eisenberg Center for Clinical Decisions and Communications Science
Baylor College of Medicine
Houston, Texas

Disclosures: Nothing to disclose.

Disclaimer

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support ^SM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Melvyn A. Harrington MD, Peer Reviewer: Consultant for Zimmer, Inc.; Board Member for J. Robert Gladden Orthopaedic Society and Arthritis Foundation

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Ahmed M. Abou-Setta, MD, PhD, Contributor: nothing to disclose 
Michael Fordis, MD, Activity Director: nothing to disclose
Michael Heggeness, MD, Contributor: nothing to disclose
Diane Markesich, PhD, Medical Writer: nothing to disclose

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

Acknowledgement of Support

This activity is supported by a contract, HHSA290200810015C, from the Agency for Healthcare Research and Quality.

Return to Top of Page