2011 IPRCC Federal Pain Research Portfolio Analysis Report: Executive Summary
The Federal Pain Research Portfolio Analysis was undertaken to facilitate identification of gaps in the Federal pain research portfolio and to determine whether the National Institutes of Health and other Federal agencies are free of unnecessary duplication of effort. The Federal pain research portfolio has broad ranging interests, with areas of specialization within each agency based on their unique mission. The analysis revealed many areas of shared research interests between and across Federal entities, but no notable redundancies. Partnerships between Federal funding agencies have developed to leverage the research resources and data generated in some areas of shared interests. The broad, multidisciplinary nature of the portfolio reflects the complex mechanisms of chronic pain, the multifaceted risk factors for developing pain, and recognition of the need to individualize approaches to pain management through improved health care delivery. A detailed categorization of research projects identified synergy across agency interests as opportunity to collaborate in addressing specific unanswered questions.
Opportunities to advance the current research agenda emerged and gaps in the portfolio were identified by the analysis. It revealed needs for enhanced areas of research that are unique to specific chronic pain conditions and others that are relevant to all pain conditions. The research gaps that cut across pain conditions reflect promising areas to advance pain research, such as genotyping and genetic underpinnings of pain mechanisms and discovery of risk factors and mechanisms that underlie and predict the transition from acute to chronic pain. One promising area of basic research that focuses on central nervous system sensitization may help to determine the mechanisms for co-occurrence of multiple chronic pain conditions, but other avenues such as neuro-immune interactions, need to be explored to elucidate this phenomenon. Better tools for phenotyping and assessment that incorporate biopsychosocial components of pain for single and overlapping pain conditions are needed to enhance research and inform approaches to care. Translational research links basic research findings to the clinic. The development of more efficient treatment screening tools and approaches to care provides opportunities to bring needed novel pharmacological and non-pharmacological therapies into clinical evaluation. The importance of reverse translational research, applying clinical findings to direct basic research, is recognized, but remains an area in need of expansion. Clinical assessment tools for pain and outcome measures of pain management are not consistent across the research realm or in clinic practice. Development of consistent and meaningful instruments for individual patients and for population-level surveillance studies will generate quality data to further research and to inform care. Population level studies on quality of care and access to care, and the disparities that exist among different groups in obtaining appropriate pain management are of particular relevance with the changing health care environment.