With more Americans than ever living with chronic pain, the National Institutes of Health (NIH) Pain Consortium wants the University of Maryland, Baltimore (UMB) and 10 other health professional schools to teach the next generation of health care providers to be better equipped to manage and treat such patients.
The NIH Consortium has selected 11 health professional education institutions as Centers of Excellence in Pain Education (CoEPEs) with the goal of using education to resolve inconsistencies in chronic pain care.
According to an NIH statement, "The CoEPEs will act as hubs for the development, evaluation, and distribution of pain management curriculum resources for medical, dental, nursing, and pharmacy schools to enhance and improve how health care professionals are taught about pain and its treatment."
Chronic pain affects approximately 100 million Americans, costing up to $635 billion in medical treatment and lost productivity, and producing immeasurable suffering for people of every age, the NIH reports. "Yet, pain treatment is not taught extensively in many health professional schools, and clinical approaches can be inconsistent," the statement continues.
University President Jay A. Perman, MD, says, "The importance of interprofessional education and practice is critical in health care. With almost one-third of Americans affected by chronic pain, collaboration between health care professionals is absolutely essential." Researchers from UMB's schools of dentistry, medicine, nursing and pharmacy are collaborating in the CoEPE. "I have every confidence the Schools of pharmacy, dentistry, medicine, and nursing at the University of Maryland will develop an outstanding curriculum that will be widely adopted across the country and will result in millions of Americans achieving some measure of relief from debilitating pain," adds Perman.
Each of the 11 CoEPEs is charged with translating current research findings about pain management to fill what have been recognized as gaps in curricula so that clinicians in all fields can work with their patients to make better and safer choices about pain management, says Francis S. Collins, MD, PhD, NIH director.
"We will be developing and posting an awesome curriculum for teaching interprofessional health care students and practitioners about pain management," says co-principle investigator Mary Lynn McPherson, PharmD, BCPS, CPE. "Pain is a complex and emotional state - the management of total pain mandates the inclusion of multiple health professionals working in a collaborative fashion. Our training program will meet that need, and provide educators with a menu of opportunities to implement in the U.S. and likely worldwide," says McPherson, who is a professor of pharmacy practice and science at the UM School of Pharmacy.
Co-principal investigator Sharon Gordon, DDS, MPH, PhD, director of graduate education at the UM School of Dentistry, says. "This funding opportunity will permit us to not only enhance our educational programs for our own students, but make this important curriculum available nationally and internationally."
The new Centers of Excellence in Pain Education were selected by the NIH Pain Consortium after a highly competitive contract solicitation process and review. "We were impressed with the scope and breadth of the proposals that came in from academic centers around the country---all recognizing the need for a more coordinated approach to the treatment of pain," said Story C. Landis, PhD, director of the National Institute of Neurological Disorders and Stroke (NINDS), and chair of the consortium. "We are confident that these 11 centers will lead the way in improving pain education for health care professionals, and ultimately, the quality of care for people who suffer from chronic pain."
Supported by an NIH three-year contract, the curricula will be developed by the CoEPEs to advance the assessment, diagnosis, and safe treatment of a wide variety of pain conditions while minimizing the abuse of opioid pain relievers.
Efforts by the University of Maryland and the other 10 institutions will include teaching multiple case-based scenarios, many taught in video or electronic formats. Types of pain of particular interest to the NIH Pain Consortium are rehabilitation pain, arthritis and musculoskeletal pain, neuropathic pain, and headache pain. In addition, the curricula will teach about the pathophysiology and pharmacology of pain and its treatment, the latest research in complementary and integrative pain management, factors that contribute to both under- and over-prescribing of pain medications, and how pain manifests itself differently by gender, in children, in older adults, and in diverse populations.
"While opioid pain medications have improved the quality of life for millions who suffer from pain, they can also produce harmful consequences, including addiction," says National Institue on Drug Abuse Director Nora D. Volkow, MD, a member of the consortium's executive committee. "These new CoEPEs can help prevent negative outcomes by designing curricula that promote appropriate screening and management of chronic pain patients, along with education about the risks of prescription drug abuse."
Working with the two co-investigators at UMB are faculty leaders from each of the four participating schools: School of Nursing - Deborah McGuire, PhD, RN,FAAN, professor; School of Medicine - Douglas Ross MD, PhD, professor; School of Dentistry - Richard Traub, PhD, professor; and School of Pharmacy - Lynn McPherson, PharmD, BCPS, CPE.
The other 10 CoEPE awardees are the University of Washington in Seattle; the University of Pennsylvania Perelman School of Medicine, Philadelphia; Southern Illinois University, Edwardsville; the University of Rochester, N.Y.; the University of New Mexico, Albuquerque; the Harvard School of Dental Medicine, Boston; the University of Alabama at Birmingham; the Thomas Jefferson University, Philadelphia; the University of California, San Francisco; and the University of Pittsburgh.
Last year, NIH supported $386 million in research focused on chronic pain, not including the related diseases that often cause chronic pain, such as cancer, arthritis, diabetes, and stroke.
In 2009, the NIH awarded the University of Maryland School of Nursing a $2.4 million research grant for its Center for Pain Studies, which conducts studies on cancer treatment-related pain, including peripheral neuropathy and oral mucositis. The School collaborates with researchers from UMB's School of Medicine, School of Dentistry, School of Pharmacy and the University of Maryland Marlene and Stewart Greenebaum Cancer Center. Director of the Center for Pain Studies at the School of Nursing Susan Dorsey, PhD, RN, FAAN, associate dean for research says "Our CoEPE at the University of Maryland, involving faculty from multiple schools on campus, will be synergistic with and strengthen our existing capacity in this area. It is a further demonstration of the university's leadership in pain education and research in the nation."
The UM School of Dentistry's Gordon adds, "Our proposed pain education resource entitled 'Interprofessional Foundations and Applications in Pain Management' is interdisciplinary, building on our collective strengths across the campus in four professional schools, as well as the Greenebaum Cancer Center, and the University's pain research center."