The Role of Nonpharmacological Approaches to Pain Management Proceedings of a Workshop (2019) / Chapter Skim
Currently Skimming:
5 Major Current Research Initiatives and Priorities
5 Major Current Research Initiatives and Priorities
Pages 41-50
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. • The National Center for Medical Rehabilitation Research funds research focused on how people adapt to disability, including the use of technologies to enhance function and manage chronic pain (Cernich)
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In response to a mandate of the 2010 Patient Protection and Affordable Care Act, the National Institutes of Health (NIH) asked the Institute of Medicine (IOM)
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This infrastructure will include human- and animalbased tissue screening platforms to support early-stage drug development; new and refined animal models that better reflect the human condition; and clinical research networks to support clinical trials, said Porter. Biomarker discovery and validation will be woven throughout all HEAL programs on 3For more information on the NIH HEAL Initiative, see https://www.nih.gov/researchtraining/medical-research-initiatives/heal-initiative (accessed February 6, 2019)
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Proposed Pipeline of Pain Programs. The transagency NIH HEAL Initiative supports research across the spectrum from discovery to implementation.
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Wendy Weber, branch chief for clinical research in the Complementary and Integrative Health Branch, Division of Extramural Research at NCCIH, mentioned a forthcoming Request for Applications that has since been announced, specifically calling for research studies within health systems that will test different models to determine how best to change care to better adhere to the current guidelines, implement services, and overcome access barriers.8 NIH Pain Management Collaboratory The Pain Management Collaboratory9 is a partnership among NIH, the Department of Defense (DoD) , and the Department of Veterans Affairs (VA)
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OBSSR was created more than 20 years ago to encourage the advancement and coordination of behavioral and social sciences research at NIH. The current OBSSR strategic priorities include increasing the synergy between basic and applied research; enhancing the methods, measures, and data infrastructures to encourage a more cumulative "behavioral and social sciences; and facilitating the adoption of behavioral and social sciences research findings in health research and practice." OBSSR also helps to encourage and support the integration of behavioral and social sciences into trans-NIH activities, including those addressing the opioid and pain crises; to communicate with various stakeholders about behavioral and social sciences research, said Wendy B
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National Center for Medical Rehabilitation Research Within the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Center for Medical Rehabilitation Research (NCMRR) 12 funds rehabilitation research and coordinates related efforts across NIH and other federal agencies, said Alison Cernich, director of NCMRR.
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As of November 2018, Goertz said PCORI had awarded nearly $94 million to fund comparative effectiveness research studies on managing or treating noncancer pain, including the use of nonpharmacological therapies such as CBT, physical therapy, manual therapy, exercise, mindfulness, and acupuncture as well as education, selfmanagement, and system-level interventions such as integrative care coordination. DEPARTMENT OF VETERANS AFFAIRS The VA manages the largest federal health system in the United States, providing integrated care to 6 million patients each year at more than 160 hospitals and more than 1,000 other care sites, said David Atkins.
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He noted that DoD initiatives must align with other federal agencies, especially the VA. Schoomaker referenced the 2010 DoD published task force report that recommended a comprehensive pain management strategy, citing good evidence of effectiveness for CIH modalities, especially yoga and tai chi.14 He questioned why payers are still debating whether these modalities should be covered and why the provider community has not embraced them, especially in light of the cumulative evidence of their effectiveness (as discussed in Chapter 3)
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. Schoomaker added that since the task force report was published, DoD has recognized acupuncture, biofeedback, meditation, music therapy, mindfulness meditation, medical massage, and chiropractic as evidence-based complementary and alternative therapeutic modes.
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