Duke investigators Rowena Dolor, MD, and Li-Tzy Wu, RN, ScD, MA, have received an award from the Patient-Centered Outcomes Research Institute (PCORI) to support research on health services to reduce opioid use in patients with chronic pain.
In recent years, opioid use in America has become an epidemic. According to a 2015 study by the American Society of Addiction Medicine, nearly 10 percent of Americans suffer from a substance abuse disorder involving prescription pain relievers. But for one-third of the American population that suffers from chronic noncancer pain (CNCP), opioids are a primary treatment method.
“Physicians are trying to learn how to safely prescribe opioids,” Dolor said. “Any trial that can teach people to self-manage pain without relying solely on opioid pain relievers is important.”
The study, “Integrated Health Services to Reduce Opioid Use While Managing Chronic Pain,” will examine two approaches to CNCP management. The first approach, shared decision making, will involve patients working with trained clinicians to reach a decision on whether to continue with or reduce the dose of opioid therapy. The second approach, motivational interviewing and cognitive behavioral therapy (MI+CBT), will feature patients working with clinicians in group settings to develop alternative techniques for dealing with chronic pain symptoms which may reduce their reliance on opioid therapy.
For this study, Dolor and Wu will be working with RTI International, the University of North Carolina Health System, and the Vanderbilt University Health System, as well as Duke Primary Care and Duke Pain Clinic clinicians. Researchers will be working with 1,060 patients for one year, with half the patients receiving the shared decision making approach and half receiving MI+CBT.
The research team is part of the Mid-South Clinical Data Research Network in the PCORI Patient-Centered Clinical Research Network (PCORnet). PCORnet provides access to clinical and health data to help providers obtain answers to clinical questions more efficiently. In addition, Dolor is the director of the Duke Primary Care Research Consortium (PCRC), and both resources have helped drive the study forward.
“The ability to work with an established practice-based and clinical data research network strengthens the proposal,” Dolor said.
This award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.