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Wednesday, July 25, 2007

Larry Tabak discussed recently introduced legislation regarding help for Americans suffering from pain. The legislation, titled "National Pain Care Policy Act of 2007," was introduced by Congresswoman Lois Capps and Congressman Mike Rogers. This legislation aims to improve the assessment, understanding, and treatment of pain. Discussion centered on the driving forces for this legislation; the role of NIH in supporting research that will lead to better pain control; following the legislation as it progresses through the Congress; and communication with Congressional staff, the American Pain Society, and the American Pain Foundation about pain research activities of the NIH Pain Consortium.

Linda Porter provided follow-up on the Second Annual Pain Consortium Symposium held May 1, 2007 in Masur Auditorium. About 375 people attended the symposium on site and another 250 watched the webcast. The consensus view was very favorable. Newsweek ran a feature on pain and Neurology Today ran an article mentioning several talks at the symposium, but erroneously reported about a presentation by Dr. Kathleen Foley.

Kathy Mann-Koepke reported on initial results from the Mechanisms, Models, Measurement & Management in Pain Research FOAs issued jointly by member Institutes of the Pain Consortium. So far, 170 applications have been received through 4 Council rounds; a little over half are R01 applications. The applications are broadly distributed among the sponsoring Institutes of the Pain Consortium and are reviewed in 33 scientific review groups (SRGs). Eleven applications have been funded in the January and May 2007 Council rounds.

Mike Iadarola reported on the activities of the NIH Pain Interest Group in 2006-2007. This past year the interest group sponsored a wide variety of seminars on pain ranging from molecular studies to behavioral research. Next year, the Pain Interest Group plans to invite several of the leading, senior pain researchers to present at the meetings in addition to regularly scheduled speakers.

Kenneth Hoffman gave an overview of the pain-related activities of Substance Abuse and Mental Health Services Administration, SAMHSA. This is a health services group administering block grants for mental health treatments, surveys of substance abuse including a drug abuse warning network, household diversion of drugs of abuse. There is current concern about increased of deaths associated with methadone use and abuse especially in rural areas of the US. SAMHSA is concerned with translational aspects of pain research, i.e. taking research findings and converting them into instruments or treatments that practicing physicians can use. Larry Tabak stressed the importance of keeping communication lines open with agencies like SAMHSA, who have interests related to the NIH and the Pain Consortium.

Christopher Mullins and Leroy Nyberg from NIDDK presented an initiative on A Multidisciplinary Approach to the Study of Urologic Chronic Pelvic Pain Syndromes. These disorders include interstitial cystitis/painful bladder syndrome and chronic prostatitis/chronic pelvic pain. The purpose of the initiative is to advance the understanding of the underlying pathology, the risk factors, and potential relationships of these disorders with other chronic pain syndromes, all aimed at better prevention and treatment efforts. They propose a novel organizational structure for this research. They also are seeking input from other NIH Institutes on this topic and possible participation in the initiative.

Linda Porter presented a proposal for a Pain Progress Review Group. The idea is to establish a collaborative group among NIH Institutes, academic researchers, industry representatives, health care providers, and patient advocates interested in research, prevention, and treatment of pain. The purpose is to identify priorities, develop a long term plan to advance pain research and management, and establish collaborative efforts among interested parties. This review group proposal is based on similar review groups on stroke at NINDS and on brain tumor research at NINDS/NCI. Discussion centered on ways to move forward with this proposal, expense of the initiative and opportunities for funding, and possibly extending an invitation to Dr. Krensky to attend the next Pain Consortium meeting.

There was discussion on further recruitment of NIH Institutes to the Pain Consortium including NIDDK and NHLBI. (See above item on pelvic pain syndromes by NIDDK.) Also, there was discussion on staff recruitment to assist with Pain Consortium business.

John Kusiak discussed his recent attendance at an organizational meeting of the Chronic Somatic Syndromes Consortium held at the University of Michigan. This involved initial discussions about creating an academic consortium to study chronic pain conditions such at CFS, FM, TMJD, IBS, etc. The purpose of the Consortium would be to develop guidelines for treatment and diagnosis of these disorders, facilitate interdisciplinary multi-center research, and educate physicians about pain treatments. There was substantial pharmaceutical industry involvement and enthusiasm for this effort. Discussion centered on presence of a consensus about common underlying mechanisms of these disorders; how these disorders are viewed by academic researchers, primary care and subspecialty physicians, pharmaceutical industry, and the NIH and CDC; and future steps including mechanisms for funding this consortium.

Dave Thomas provided information on IMED Communications and their interest in providing a publication on pain for medical education purposes. IMED receives outside funding to issue their publications. They form a faculty, sponsor a workshop, and then develop each publication. There is substantial input from the NIH Institutes on all aspects of the process. The final publication is distributed to ~ 150,000 physicians. IMED has done about 150 of these publications; six have been in collaboration with NIH Institutes. IMED will be invited to the next meeting to discuss a possible publication on pain.

Linda Porter provided information on a vulvodynia initiative from ORWH. Money has been set aside for this initiative and a link to the FOA will be placed on the Pain Consortium website.