Counseling Points - September 2007 - (Page 19)

Fax form to (201) 612-8282 POSTTEST ANSWER AND PROGRAM EVALUATION FORM Counseling Points™: Office-based Medication-assisted Treatment of Opioid Dependence Using the scale provided, please complete the program evaluation so that we may continue to provide you with high-quality educational programming. Please fax to (201)612-8282. 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree To what extent were the following objectives satisfied? 1. Assess patients for opioid dependency and recognize those who may be at risk of developing a dependency 2. Explain the pharmacology and side effects of methadone and buprenorphine. 3. Educate the patient about how to prepare for and what to expect from induction therapy 4. Know the steps to conducting the required medical visits during induction. 5. Understand the role of counseling in medication-assisted treatment for opioid addiction To what extent was the content well-organized? 6. Assess patients for opioid dependency and recognize those who may be at risk of developing a dependency (Carolyn Baird) 7. Explain the pharmacology and side effects of methadone and buprenorphine (William Lorman) 8. Educate the patient about how to prepare for and what to expect from induction therapy (Kathleen Thompson-Gargano) 9. Know the steps to conducting the required medical visits during induction (Kathleen Thompson-Gargano) 10. Understand the role of counseling in medication-assisted treatment for opioid addiction (Carolyn Baird) To what extent was the content easily understandable? 11. Assess patients for opioid dependency and recognize those who may be at risk of developing a dependency (Carolyn Baird) 12. Explain the pharmacology and side effects of methadone and buprenorphine (William Lorman) 13. Educate the patient about how to prepare for and what to expect from induction therapy (Kathleen Thompson-Gargano) 14. Know the steps to conducting the required medical visits during induction (Kathleen Thompson-Gargano) 15. Understand the role of counseling in medication-assisted treatment for opioid addiction (Carolyn Baird) General Comments: 16. The topic was current and relevant to your area of professional interest 17. The program was free of commercial bias. 18. The program increased your awareness and understanding of the subject matter 19. As a result of this continuing education activity (check only one): K I will modify my practice. K I will wait for more information before modifying my practice. K I see no need to modify my practice. Suggestions for future topics: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 Additional comments: There is no fee for this educational activity. Posttest Answer Key Request for Credit K Check here if you would also like to apply for substance abuse credits Name Degree Organization Specialty Address City State ZIP Phone Fax E-mail Signature Date 1 2 3 4 5 6 7 8 9 10 11 12 Fax form to (201) 612-8282 SEPTEMBER 2007 19

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Welcome Office-Based Medication-Assisted Treatment of Opioid Dependence Summary Continuing Education Posttest Postest Answer and Program Evaluation Form

Counseling Points - September 2007

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