June 23, 2023 Treating Pain & Addiction Pretraining Survey of Knowledge

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* 2. Please choose the organization in which you provide services from the choices below:

A health system (such as Affinia, Ascension, Spectrum, Trinity, United Health, etc..)

A Federally Qualified Health Center

A Rural Health Clinic

An independent practice (A practice not owned by a health system)

University student or residency program

Other (please specify)

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* 3. Please choose your organization from the choices below:

Trinity Health Alliance of Michigan (Formerly Affinia Health Network)

Answer Health

Borgess Health/Ascension

Bronson Healthcare

Blue Cross Blue Shield of Michigan or Blue Care Network Employees

Community Mental Health of Central Michigan (CMHCM)

CIPA

Corewell Health-Beaumont & Spectrum Health

Covenant Healthcare

Genesys PHO

Great Lakes PHO

Henry Ford Health System

Holland PHO

HVPA

IHA

Lakeland Care

McLaren Health

Munson Healthcare

Michigan Primary Care Association (MPCA)

Novello Physician Organization (NPO)

University of Michigan West (formerly MetroHealth)

University of Michigan

Other (please specify)

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* 4. Please choose your role:

Provider (MD, DO, PA-C, NP, etc.)

Nurse Care Manager/Care Coordinator

Social Worker Care Manager/Care Coordinator

Behavioral Health Specialist

Pharmacist

Other Clinical (CMA, RMA, etc.)

Non-Clinical (Practice Manager, Support Staff, etc.)

Leadership

Other (please specify)

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* 5. What specific topics are you hoping to learn about from this course?

Pretraining Confidence Assessment

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* 6. On a scale of 1-5 please rate your confidence in managing chronic pain.

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* 7. Please check the box that best explains your current approach to managing patients with chronic pain:

I prefer to manage/treat patients myself

I prefer to refer patients to a specialist

Pretraining Knowledge Assessment

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* 8. Fibromyalgia or centralized pain patients are more frequently diagnosed with:

A. Irritable bowel syndrome

B. Tension headache

C. Temporomandibular disorder

D. Chronic fatigue syndrome

E. All the above

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* 9. Regarding the interplay between fibromyalgia and depression, which statement is not true

A. The rate of depression in fibromyalgia patients is somewhat higher than other chronic pain syndromes, but not overly so

B. All antidepressants are effective in fibromyalgia

C. The analgesic response to the drug is independent of the antidepressant response (i.e. people without depression respond just as well as those with depression)

D. Depression and fibromyalgia share similar neurotransmitters leading to many people having both conditions

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* 10. Classes of drugs that have been shown to be efficacious in fibromyalgia and other central pain states include:

A. Opioids

B. Compounds that raise both serotonin and norepinephrine

C. NSAIDs

D. Alpha -2- delta ligands (e.g. gabapentin, pregabalin)

E. B and D

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* 11. Drugs that are generally effective in peripheral/nociceptive pain states include which of the following:

A. NSAIDs

B. Opioids

C. Acetaminophen

D. Tramadol

E. All of the above

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* 12. All antidepressants are effective analgesics

True

False

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* 13. Central nervous system neurotransmiter abnormalities that are present in fibromyalgia include all of the following except:

A. Low serotonin and norepinephrine

B. High Glutamate

C. Low GABA

D. High Nerve growth factor

E. Low endogenous opioids

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* 14. The clinical feaures of centralized pain include:

A. Multifocal pain

B. Fatigue

C. Sleep disturbances

D. Sensitivity to sensory stimuli

E. All of the above

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* 15. When individuals develop centralized pain, their pain is generally less responsive to:

A. Opioids

B. NSAIDs

C. Injections

D. Surgical procedures

E. All of the above

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* 16. Opioids are generally the most effective treatment for severe chronic pain

True

False

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* 17. Neuroimaging studies suggest that chronic pain…

A. is primarily a sensory event

B. contains more affect than sensory aspects

C. does not exist – brains of people with chronic pain look like healthy normal people

D. is the same as depression

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* 18. Which of the following symptoms use the same neurotransmitters and brain pathways as pain processing?

A. Affect

B. Sleep

C. Memory

D. Fatigue

E. All of the above

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* 19. Which statement(s) are true about Chronic Overlapping Pain Conditions (COPCs)?

A. Central sensitization is thought to be the mechanism behind COPCs

B. Osteoarthritis is a form of COPC

C. COPCs respond well to surgery and opioid therapy

D. A & C are correct

E. A,B, & C are correct

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* 20. Regarding general principals of opioid tapering, which statement is not true?

A. Patients should be included in the decision-making process, especially as it relates to the end goal of the taper.

B. The taper should proceed slowly enough to minimize the likelihood of withdrawal symptoms.

C. Support for management of withdrawal symptoms should be provided.

D. Patients who experience withdrawal symptoms should be encouraged to go back to their previous dose until symptoms resolve.

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* 21. Difficult conversations with patients related to an opioid therapy taper should focus primarily on...

A. Provider comfort with prescribing

B. Patient safety

C. Legal or payer requirements

D. The opioid epidemic

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* 22. SBIRT is…

A. A communication strategy for interprofessional care teams.

B. A single question screening tool for problematic opioid use.

C. A public health approach to the delivery of early intervention and treatment services for people with or at risk of developing substance use disorders.

D. A two-tiered screening approach for substance use disorder.

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* 1. Personal Information

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* 2. Please choose the organization in which you provide services from the choices below:

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* 3. Please choose your organization from the choices below:

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* 4. Please choose your role:

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* 5. What specific topics are you hoping to learn about from this course?

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* 6. On a scale of 1-5 please rate your confidence in managing chronic pain.

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* 7. Please check the box that best explains your current approach to managing patients with chronic pain:

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* 8. Fibromyalgia or centralized pain patients are more frequently diagnosed with:

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* 9. Regarding the interplay between fibromyalgia and depression, which statement is not true

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* 10. Classes of drugs that have been shown to be efficacious in fibromyalgia and other central pain states include:

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* 11. Drugs that are generally effective in peripheral/nociceptive pain states include which of the following:

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* 12. All antidepressants are effective analgesics

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* 13. Central nervous system neurotransmiter abnormalities that are present in fibromyalgia include all of the following except:

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* 14. The clinical feaures of centralized pain include:

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* 15. When individuals develop centralized pain, their pain is generally less responsive to:

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* 16. Opioids are generally the most effective treatment for severe chronic pain

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* 17. Neuroimaging studies suggest that chronic pain…

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* 18. Which of the following symptoms use the same neurotransmitters and brain pathways as pain processing?

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* 19. Which statement(s) are true about Chronic Overlapping Pain Conditions (COPCs)?

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* 20. Regarding general principals of opioid tapering, which statement is not true?

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* 21. Difficult conversations with patients related to an opioid therapy taper should focus primarily on...

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* 22. SBIRT is…