Pain management study designed to help patients reduce opioid use receives $8.8 million funding

Stanford Medicine was awarded funding to study and test pain management treatment strategies to help with chronic pain while reducing opioids with the help of Intermountain Healthcare, the Phoenix VA and Dr. Stieg pain clinic in Colorado. 

The $8.8 million funding award by the Patient-Centered Outcomes Research Institute (PCORI), is designed to test pain management treatment strategies that help patients with chronic pain reduce their use of opioids.

Stanford’s Beth Darnall, PhD, Clinical Professor of Anesthesiology, Perioperative and Pain Medicine is the Principal Investigator of the study and will coordinate with Intermountain’s Site Director Joel G. Porter, MD, a family practice physician. 

The pain management study is one of several Stanford and Intermountain collaborative projects that support innovation in research, patient care, and medical education.

The study seeks to compare the effectiveness of psychologist led cognitive behavioral therapy (CBT), peer led chronic pain self-management classes, and providing no behavioral treatment in the context of reducing opioids for individuals with chronic pain. 

Dr. Darnall, a pain psychologist and researcher, said people with chronic pain are often fearful about reducing opioid use. Tapering down moderate to high dose opioids while effectively managing pain, mood and function can be challenging for most individuals.

Study participants will begin a patient-centered program to taper their opioid use and will also be assigned to one of three groups: one will receive cognitive behavioral therapy, another will learn pain self-management techniques, and the third group will receive no behavioral treatment. The treatment strategies encourage the patient’s interest and willingness to actively and collaboratively reduce opioid use.

“With the collaboration between the Stanford and Intermountain and the support of the Institute, we have the potential to develop evidence-based treatment plans, tailored to meet the needs of individual patients,” says Dr. Porter. “Our goal is to deliver pain management care that helps our patients achieve meaningful and successful outcomes that last long term.” 

“Alternatives are needed to reduce opioid risks and to provide pain relief to patients,” says Dr. Darnall, adding that her study aims to reduce opioid use compassionately while testing the effectiveness of behavioral treatment for pain. “We seek to provide physicians and patients with the evidence and tools they need to treat chronic pain with less opioids.”

Darnall’s study was selected for funding through a PCORI funding announcement specifically focused on long-term opioid use for people with chronic pain. There is a shortage of high-quality evidence demonstrating the safety and effectiveness of long-term opioid therapy for the management of chronic pain, and to date no large-scale studies have assessed strategies for managing and reducing chronic opioid use in real-world clinical settings. Input from a variety of stakeholders identified this research gap and helped PCORI to refine its call for research proposals.

“This project was selected for PCORI funding for its potential to fill an important gap in our understanding of long-term opioid therapy and to give people living with chronic pain useful information to help them weigh the effectiveness and safety of their care options,” said PCORI Executive Director Joe Selby, MD, MPH. “We look forward to following the study’s progress and working with Stanford to share the results.”

Dr. Beth Darnall’s award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org

Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.

Intermountain Healthcare is a Utah-based, not-for-profit system of 22 hospitals, 180 clinics, a Medical Group with some 1,500 employed physicians, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in transforming healthcare through high quality and sustainable costs.