American Pain Society and Pfizer Independent Grants for Learning and Change Pain Research Grant Fund
APS and Pfizer Independent Grants for Learning and Change (IGLC) are excited to collaborate on a $1.5 Million funding opportunity focused on improving care for individuals with chronic pain.
It is the first project of its kind to fund implementation projects for the National Pain Strategy. See press release.
Congratulations to the APS and Pfizer IGLC Pain Research Grant Recipients!
Web-based Self-management of Adolescent Chronic Pain: National Implementation Project
Approximately 5-8% of children report severe chronic pain and disability. Although evidence supports pain-self management as effective for reducing pain and disability, data show that most youth do not have access to this intervention. Our own prior studies demonstrate that technology-delivered pain self-management (WebMAP program) can reduce barriers to care, is feasible, acceptable, and effective in reducing pain-related disability and improving anxiety and depression in youth with chronic pain. We propose an implementation project to address critical challenges in nationwide dissemination of our WebMAP pain self-management program. In Phase 1, semi-structured interviews (n=24) will generate data to understand perspectives of multiple stakeholders (adolescents, parents, providers, and clinic managers) regarding barriers and facilitators of adoption and implementation of WebMAP. This information will be used to inform final adaptation of WebMAP and implementation approaches. In Phase 2, using a hybrid effectiveness-implementation trial design, 8 clinics from across the U.S. will participate in a pragmatic randomized controlled trial with a stepped wedge design to sequentially implement WebMAP in the clinics following randomized usual care periods. Data will be collected from clinic records, web and app administrative tracking, and provider surveys to gather information on adoption and implementation following the RE-AIM public health impact framework. Individual patient-level pain outcomes will be collected from a minimum of 120 patients to evaluate intervention effectiveness. The expected outcome of the project is to yield a strategic approach for a nationwide internet-delivered pain self-management intervention for youth with chronic pain that can be readily sustained in clinical settings.
Development of an Electronic Prescription Bundle of Non-Pharmacological Strategies for Chronic Musculoskeletal Pain
BEsT - Bundle for Exercises and TENS
The University of Iowa
Centers for Disease Control (CDC) Guidelines for prescribing opioids for chronic pain suggest non-pharmacological strategies are preferred treatment choices, and if opioids are used they should be combined with non-pharmacological therapy. At the University of Iowa Hospitals and Clinics (UIHC), over 14,700 outpatients with chronic musculoskeletal pain were seen in the last year. Of these outpatients, 30% were seen by primary care providers. Our overall goal is to develop, implement, evaluate and disseminate the integration of two non-pharmacological pain treatments to facilitate multimodal, interdisciplinary care for adults with chronic musculoskeletal pain at UIHC, addressing the strategy of service and delivery and reimbursement from the National Pain Strategy. We propose to leverage the strengths of the Electronic Health Record (EHR) (e.g., templated orders, decision cues, algorithms, patient education and alerts), combined with specific adoption strategies informed by Roger’s Diffusion of Innovations model, to help providers quickly and accurately prescribe exercise and/or TENS for patients with chronic musculoskeletal pain as part of an individualized plan of care in an integrated health care delivery system. This project is innovative because it moves the prescription of non-pharmacological pain strategies to the same level as pharmacological strategies using the existing EHR. The project is also innovative in the development of algorithms for exercise and TENS prescription for electronic clinical decision support to promote effective prescribing of these non-pharmacologic pain treatments. Outcomes will be measured for provider adoption/behavior, including opioid prescriptions, provider perceptions, and patient adherence before and after implementation.
A Personalized Self-Management Program for Older Adults with Chronic Pain and Negative Emotions
Weill Cornell Medicine
Our overarching goal is to improve the care and outcomes of older adults with chronic pain in primary care, where the vast majority of U.S. older adults receive pain care. We focus on older adults with chronic pain, negative emotions, and a wide range of cognitive functioning, from cognitively intact patients to those with moderate cognitive impairment. To achieve our goal, we will test the efficacy of a promising self-management program, Problem Adaptation Therapy for Pain (PATH‐Pain), developed by our multidisciplinary team to reduce pain intensity and pain‐related disability. Project objectives are closely aligned with those of the National Pain Strategy (NPS) and Pfizer/American Pain Society RFP and with the applicant institution (Weill Cornell Medicine). A major resource for this grant is Cornell’s NIH‐funded Roybal Center, The Translational Research Institute on Pain in Later Life (TRIPLL), whose mission is to develop novel interventions for older adults with pain. We will randomize 120 older adults (≥60 years) with chronic pain (pain on most days for ≥ 3 months) and negative emotions (PANAS‐X ≥ 20) to PATH‐Pain vs. Usual Care with Education (UCE). Participants will be recruited from the Wright Center for Aging Research and Clinical Care (WCARCC), a freestanding outpatient practice that provides primary care to over 5,000 older adults in New York City. For our primary objectives, we will examine the effects of PATH‐Pain vs. UEC on pain intensity and pain‐related disability. Our secondary objective will focus on the mediating effect of emotion regulation on pain intensity and pain‐related disability.