Perioperative Continuation of Chronic Opioids and Buprenorphine

This monthly learning session addresses the complexities of managing patients on chronic opioid or buprenorphine therapy in the perioperative setting. Participants will explore the rationale behind continuing or adjusting these therapies during surgery, weighing the risks of withdrawal, inadequate pain relief, and drug interactions. The program will outline evidence-based protocols and strategies for managing these patients, encompassing pre-operative assessment, intraoperative adjustments, and tailored post-operative pain management plans. A key focus will be on the importance of interprofessional collaboration and communication, highlighting the need for seamless coordination between anesthesia providers, surgeons, pain specialists, and addiction specialists to ensure optimal patient outcomes.

Target Audience

Iowa Surgical providers
Clinical teams

Learning Objectives

Explain the rationale for continuing or adjusting chronic opioid and buprenorphine therapy in patients undergoing surgical procedures, considering the risks of opioid withdrawal, inadequate analgesia, and potential drug interactions.
Describe evidence-based protocols and strategies for managing patients on chronic opioid or buprenorphine therapy in the perioperative period, including pre-operative assessment, intraoperative adjustments, and post-operative pain management plans.
Discuss the importance of interprofessional collaboration and communication in caring for patients on chronic opioid or buprenorphine therapy undergoing surgery, including coordination between anesthesia providers, surgeons, pain specialists, and addiction specialists.

Rachael Duncan

Rachael Duncan, PharmD, BCPS, BCCP, is a Colorado-based clinical pharmacist board-certified in pharmacotherapy and critical care pharmacy. She has spent the past decade focused on policy, advocacy, and educational work surrounding opioid stewardship and addiction treatment at both the state and national level. Rachael is the Chief Clinical Officer of Epifluence, where she is Program Director of the Maternal Overdose Matters (MOMs+) Initiative and Associate Director of The Naloxone Project (TNP). She leads several educational and quality improvement initiatives focused on helping hospitals and health systems build addiction treatment infrastructure, with a special focus on rural and frontier communities. She is the author and editor of multiple state- and nation-wide guidelines around opioid stewardship, alternatives to opioids (ALTO) for pain management, and MOUD for addiction treatment, championed ALTO and MOUD across Colorado EDs with the Colorado Hospital Association, and published the first peer-reviewed paper on ALTOs in the ED. Rachael’s clinical experience is in ED and hospital pharmacy.

Continuing Medical Education (CME)

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Iowa Medical Society (IMS). Compass Healthcare Collaborative is accredited by the IMS to provide continuing medical education for physicians.

Designation: Compass designates this live activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support: This activity was developed without support from any ineligible company. *The ACCME defines ineligible companies as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Note: The ACCME does not consider providers of clinical service directly to patients to be commercial interests unless the provider of clinical services is owned, or controlled by, and ACCME defined ineligible company.

Disclosure: Compass adheres to the Standards for Integrity and Independence in Accredited Continuing Education. The content of this activity is not related to products or the business lines of an ACCME-defined ineligible company. None of the planners or moderators for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing products used by or on patients.

Note: AMA PRA Category 1 Credits™ are accepted for nursing and other healthcare discipline license renewal purposes, provided the topic is relevant to the applicant’s field or discipline. After participating, you will receive a Certificate of Attendance detailing the number of AMA PRA Category 1 Credits™ you can claim. This certificate is provided for self-reporting requirements and must be submitted to your state board for license renewal.

Merit-based Incentive Payment System (MIPS) Credit Designation: Improvement Activity (IA): This activity qualifies for MIPS credit as an Improvement Activity. Participants who successfully completed the activity are eligible for full credit for the Improvement Activities category of the MIPS program. Note: Each provider must attest to your participation and practice changes on the CMS QPP website, but you can reference the MIPS verbiage noted below.

Activity Type: Patient Safety and Practice Assessment (IA_PSPA_CME):

Activity ID: IA_PSPA_28: Completion of an Accredited Safety or Quality Improvement Program.

Documentation includes:
- Meaningful clinician participation in a project focused on improving pain management.
- Documentation of data collection and analysis regarding prescribing patterns.
- Implementation of interventions to improve quality or safety.
- Measurement of the impact of the interventions.