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Friday, October 26, 2018

NIH Pain Consortium Quarterly Meeting Minutes

Summary:

The NIH Pain Consortium Quarterly meeting included an overview of the in-progress and published pain-related HEAL projects across the different institutes. There was a discussion about communication of HEAL and associated funding opportunity announcements. An update on the National Pain Strategy population research group was given.

Welcome and Roll Call – Dr. Walter Koroshetz, NINDS

Dr. Koroshetz welcomed the group and introduced the incoming NCCIH Director, Dr. Helene Langevin.

Overview of Helping to End Addiction Long-Term (HEAL) Pain Projects and FOA (Funding Opportunity Announcement) status – ALL

Program directors leading various pain-related HEAL initiatives presented high-level overviews of their upcoming funding opportunity announcements and gave a status update.  Multiple notices of intent to publish and funding opportunity announcements have been published on the NIH HEAL website.  Notices of intent and in-progress initiatives that are not on the NIH HEAL website are not officially approved as HEAL projects.

Dr. Amir Tamiz presented NINDS-led HEAL initiatives currently in progress including an early phase pain investigation clinical trials network, an exploratory/developmental grant on novel pain target validation and assay development, initiatives on translational and clinical devices to treat pain, and initiatives to optimize non-addictive therapies including small molecules and biologics to treat pain. NINDS-led HEAL initiative FOAs that have been published include: Discovery and Validation of Novel Targets for Safe and Effective Pain Treatment; Discovery, Analytical and Clinical Validation of Biomarkers, Biomarker Signatures and Endpoints for pain.  Over 15 ICs have signed on to the various NINDS-led initiatives. Administrative supplements for validation of novel non-addictive pain targets have been published.

NCATS and NINDS are leading an initiative on human-based screening platforms and novel drugs to treat pain and opioid use disorder. This initiative is currently in progress.

Dr. Wendy Weber presented an overview of the NCCIH-led HEAL initiative on pragmatic and implementation studies for the management of pain to reduce opioid prescribing (PRISM).  Another NCCIH-led HEAL initiative for a pragmatic randomized controlled trial of acupuncture for management of chronic low back pain in older adults was presented. These initiatives are currently in progress and notices of intent to publish have been released. 

Dr. Jenna Norton presented a NIDDK-led initiative on an integrated approach to pain and opioid use in hemodialysis patients. This initiative is currently in progress.

Dr. Michael Wilson presented 5 upcoming initiatives focused on translating BRAIN, SPARC and HEAL discoveries into effective stimulation devices for pain treatment. These initiatives are currently in progress.

Dr. Linda Porter informed the group that the Acute to Chronic Pain Transition Common Fund program is also a part of the NIH HEAL initiative, however funds are separate.  Multiple RFAs for the Common Fund program were released in September 2018, and submitted applications are being prepared for review. 

Dr. Rebecca Baker gave a brief overview on the process for FOA review, project approval and funding.  She thanked the group for finalizing FOAs under a tight timeline. Given the urgency of the opioid crisis, review of HEAL-related projects are being prioritized by the NIH Office of Extramural Research and HHS.  Special attention is given to initiatives that span across HHS agencies. The current timeline is for all HEAL-related FOAs to be published by early December 2018. 

Discussion of Communications for HEAL and the FOAs – Dr. Amy Adams, NINDS

The Society for Neuroscience (SfN) meeting will occur in early November 2018.  A handout that includes current HEAL initiatives and notices has been generated for distribution at this meeting.  It was determined that initiatives that had gone through concept clearance could be included as ‘in-progress’. There will be a press briefing at SfN for Dr. Walter Koroshetz and others focused on pain and the opioid epidemic. 

Dr. Adams mentioned that there is a need for consistency of content across the various ICs working on HEAL initiatives. Archiving the webinars in a central place would be helpful.  Dr. Baker stated that under events on the NIH HEAL website are a list of webinars, workshops and meetings to help plan HEAL projects.  Once approved, an updated research plan will be available on the website and will include a public facing description of the various research areas.

NCCIH population level research project – Dr. Richard Nahin, NCCIH

Dr. Nahin presented an update on behalf of the National Pain Strategy Population Research Implementation team.  Objectives of this working group are to: 1) Estimate the prevalence of chronic pain and high-impact chronic pain; 2) Refine and employ standardized electronic health care data methods to determine use and costs of care; and 3) Develop a system of metrics to track changes in prevalence, impact, treatment and costs.  To meet these objectives, the group has sought ways to harmonize pain measures especially in chronic disabling pain and better understand the ‘who, what, where, when, and why’ of pain and pain management.  Additionally, the group has sought to assess use of evidence-based research practice guidelines such as the CDC guideline on opioid prescribing for chronic pain.  The working group has reached out to the National Center for Health Statistics to begin a pilot survey that would be included in the national survey for physicians.  Dr. Nahin invited members of the NIH Pain Consortium to participate in the project which will involve creating a pilot survey of approximately 15-20 questions in 2019/2020 with a full survey expected in 2021.  The survey would potentially reach 3,000 physicians through the American Medical Association with oversampling of physicians who often manage pain and/or prescribe opioids.