The Patient-Centered Outcomes Research Institute (PCORI) announced that its Board of Governors approved just under $10 million to fund two studies comparing the effectiveness of strategies designed to reduce unsafe opioid prescribing by improving pain management.
The organization said the studies will focus on strategies that payers and health systems can employ to better ensure appropriate and safe use of opioids, along with a range of other therapies, to help relieve patients’ pain and improve the quality of their lives, and those of their caregivers. Some of the strategies that will be examined as part of these studies include prompts in electronic health records (EHRs) as one type of intervention to influence healthcare providers toward using more evidence-based care for patients with acute non-cancer pain.
These studies are the latest in a growing portfolio of PCORI-funded research, which represents $150 million in funding for 50 comparative clinical effectiveness research (CER) projects related to pain treatment, as well as opioid overuse and misuse.
"We clearly need more evidence-based information about how to better treat pain as a central component to the efforts to address our nation’s opioid crisis,” PCORI Executive Director Joe Selby, M.D., said in a statement. “The studies PCORI is funding in this area are addressing questions about the comparative effectiveness of strategies to reduce unsafe prescribing, manage long term opioid therapy, and prevent and treat opioid use disorders—questions that patients and other healthcare stakeholders have told us are most important to them.”
One of the new studies was approved for $5.7 million to focus on a Medicaid payer strategy that expands access to nondrug strategies for treating low back pain, such as cognitive behavioral therapy, exercise therapy, physical or occupational therapy, and complementary medical approaches such as acupuncture, osteopathic or chiropractic manipulation, yoga, and massage, while restricting access to opioids. The study based at the Kaiser Foundation Research Institute will take the form of a “natural experiment,” comparing outcomes in patients with low back pain who are enrolled in the Oregon Medicaid program, which provides access to substantially expanded options for nondrug treatments, to similar patients in California’s Medicaid program, which offers access to only conventional low back pain treatments and services, the organization said.
The other project was approved for $4.1 million to assess whether different interventions can influence healthcare providers toward using more evidence-based care for patients with acute non-cancer pain. This study based at the University of Pittsburgh will compare strategies, such as using prescription guidelines from the Centers for Disease Control and Prevention, prompts in electronic health records (EHRs) requiring prescription justification, comparison with other providers’ prescription rates and a combination of these interventions, to see which is most effective at reducing opioid prescription rates and improving patient and provider satisfaction.
In addition to these awards, the Board approved another $35.7 million to support 15 studies focusing on other conditions and problems that impose high burdens on patients, caregivers, and the healthcare system, as well as $74 million for seven studies comparing the effectiveness of different strategies for delivering palliative care.
With these latest awards, PCORI’s Board has approved $1.7 billion in funding since 2012 for 600 patient-centered CER studies and related projects to enhance the methods and infrastructure needed to support rigorous, efficient CER.