Wednesday, July 6, 2011
The meeting was attended by 4 co-chairs of the Pain Consortium and program staff from across the participating ICs.
Dr. Amy Adams (NIDCR) presented an update on the report released on June 29th, 2011 by the Institute of Medicine (IOM) Committee on Advancing Pain Research, Care, and Education titled "Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research". Under the 2010 Patient Protection and Affordable Care Act, the committee was charged by the Department of Health and Human Services (DHHS) to assess the state of the science, care, and education regarding pain and make recommendations for advancing the field. In preparing the report, the committee conducted a literature review, commissioned a paper on the economic burden of pain, conducted a series of workshops, and used an online forum to gather public input. Two main underlying principles of the report are that chronic pain is a disease in itself and that pain management is a moral imperative, and it makes short term and long term recommendations covering four key areas – public health challenges, pain care, education of providers, and pain research. The short term recommendations include a call to the HHS Secretary to create a comprehensive population-level strategy for pain prevention, treatment, management, and research as well as designate a lead institute for pain at NIH. Dr. Adams explained that NIH staff will study other models of IOM report implementation as a next step towards implementing the recommendations of this report.
Dr. Adams also provided an update on the Interagency Pain Research Coordinating Committee (IPRCC) which will consist of 7 voting federal members and 12 voting non-federal members, including 6 scientists and 6 public members and is anticipated to hold its first meeting in Spring 2012.
Dr. Partap Khalsa (NCCAM) presented the report and recommendations from the Steering Committee for advancing the research agenda for chronic low back pain (cLBP) which was formed in late 2010/early 2011 and has held five meetings to date. The current effort was motivated by the two multi-Institute workshops on back pain organized by NCCAM in 2009 and 2010. The committee’s report recognizes cLBP as a serious health and societal problem with increases in treatment cost and utilization, but modest clinical benefits. The Committee recommended that NIH convene a process with the sponsorship of the Pain Consortium for establishing research diagnostic criteria (RDC) for cLBP within the context of a larger strategic vision for research, treatment, education, and policy on cLBP.
Dr. Dave Thomas (NIDA) presented an update on the NIH Pain Consortium Centers of Excellence for Pain Education (CoEPEs) initiative. The need for greater pain education has been highlighted in recent reports such as the President’s 2011 action plan to address the national prescription drug abuse epidemic titled ‘Epidemic: Responding to America’s Prescription Drug Abuse Crisis’ and the recent IOM Pain Report ‘Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research’. The current NIH Pain Consortium Centers of Excellence (CoE) for Pain Education proposal calls for 9 CoEs at medical, dental, and nursing schools across the country. NIDA is currently identifying contractors to oversee the CoEs and develop content. The next steps will involve soliciting, reviewing, and selecting CoEs with the initiative launch by November 2011.
Dr. Nora Volkow (Director, NIDA) mentioned that NIDA will be hosting actress Debra Winger for a performance of The Addiction Performance Project at the NIH Campus on August 5th, 2011. The performance will be part of a new NIDA project designed to address the stigma associated with addiction and promote a healthy dialogue.
Dr. Linda Porter (NINDS) provided an update on the Analgesic Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) initiative, a public-private partnership program sponsored by the Food and Drug Administration (FDA). This initiative’s goal is to streamline the discovery and development of analgesics, especially through efforts to optimize analgesic clinical trials. The initiative’s Scientific and Professional Advisory and Recommendations Committee (SPARC) includes NIH Pain Consortium members as well as academic, advocacy, and industry representatives. The inaugural scientific workshop was held on June 15th, 2011 at the FDA campus and based on recommendations from the workshop two additional working groups were established under ACTTION – the Community Patient Awareness about Clinical Trials (COMPAACT) group to educate patients about the importance of analgesic clinical trials and the Safety and Benefit-Risk Evaluation (SABRE) group to improve safety reporting and benefit-risk assessments of analgesic clinical trials. ACTTION has also published a number of retroactive literature surveys to date.
The long standing Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) is now affiliated with ACTTION. The initiative aims to develop recommendations for improved design and execution of pain clinical trials and focuses on one problem area in clinical trials every year. This year IMMPACT addressed two topics - risk/benefit analysis of clinical trials and what practicing physicians need to know to evaluate published clinical trial outcome data.
NIH and the FDA are planning a workshop on a state of the science related to opioid efficacy. There was discussion as to whether this meeting might be held in conjunction with the NIH Pain Consortium Symposium in 2012 and opportunities to enhance the symposium based on recommendations from past year participants. There was also general discussion about improving communication of Pain Consortium activities to the community.