Pain Center of Excellence (USUHS)
Abstract
The Pain Center of Excellence examines the relationship between acute and chronic pain and focuses on finding, implementing, and evaluating the most effective methods of relieving the acute pain caused by combat trauma and its impact on rehabilitation and recovery. The center also supports knowledge translation activities that are aimed at integrating research findings into military medicine clinical practice and policy. In addition to the primary achievement of research objectives, the program educates Federal employees as a benefit to the public they serve through Federal service, through support to civil authorities, and in non-Federal professional and academic collaborations. Description: The Pain Center of Excellence examines the relationship between acute and chronic pain and focuses on finding, implementing, and evaluating the most effective methods of relieving the acute pain caused by combat trauma and its impact on rehabilitation and recovery. The center also supports knowledge translation activities that are aimed at integrating research findings into military medicine clinical practice and policy. In addition to the primary achievement of research objectives, the program educates Federal employees as a benefit to the public they serve through Federal service, through support to civil authorities, and in non-Federal professional and academic collaborations. FY21 Accomplishments 1.Provided pain management advisory support to Congressionally Directed Medical Research Programs (CDPRP) and Clinical & Rehabilitative Medicine (CRMRP). In accordance with the Memorandum of Agreement with Defense Health Agency, provided advisory to support to DHA Deputy Assistant Director Medical Affairs and DHA Pain Management Clinical Support Service. 2.Collaborated with DHA stakeholders and Military Health System providers to implement key metrics of pain management and their associated clinical decision support tools (e.g., Opioid Prescriber Monthly Trend Report, Look Up Tool, Look Up Tool Dashboard, Opioid Registry) to support enterprise-wide process improvement. 3.Successfully implemented the Established and integrated Opioid Education and Naloxone Dispensing (OEND) program in DHA as part of the Quadruple Aim Performance Process (QPP) Plan. This activity included implementation of the Train-the-Trainer program across several Markets and Military Treatment Facilities. As such, naloxone prescribing rates have significantly increased across the DoD. 4.Led revisions and updates to the DoD Opioid Prescriber Safety Training (OPST) mandated by the 2015 Presidential Memorandum; Addressing Prescription Drug Abuse and Heroin Use and required for all DoD opioid prescribers. DVCIPM was the primary content developer for the initial FY 2017 OPST and was subsequently tasked with leading the content updates and revisions for 2021. As of June 2021, over 48,000 DoD prescribers have completed this training; over 5000 prescribers to date in 2021 alone. 5.As the designated CoE for DoD pain management, served as lead for revisions to DHA-Procedural Instruction 6025.04 Pain Management and Opioid Safety, translating emerging medical evidence and standards of practice into DoD pain management and opioid safety policy. 6.Engaged in many service activities to support research training and development for USU medical students, DoD residents, and DHA providers. These activities included mentoring several USU Capstone students, resulting in many posters and publications; implementing a residency research program at Walter Reed National Military Medical Center (WRNMMC); advising many WRNMMC Anesthesiology residents on their research projects; and providing support for research development for several military anesthesiologists. 7.Obtained another large CDMRP grant with co-investigators from Johns Hopkins Applied Physics Laboratory and School of Nursing, Georgetown University, and multiple Military Treatment Facilities. The objective of the study is to examine disparities across the Military Health System in pain management, using an Intersectionalist Framework and Health Equity Measurement Framework. 8.Obtained a grant subaward as Co-Investigator, with Cognitive Medical Systems as the prime, from USAMRDC to develop standards aligned remote control for commercially available ventilator and IV pump across the NETCCN architecture, and to inform future work regarding regulatory and/or safety requirements 9.The Pain Registry Biobank, approved in FY 19, is a clinical data registry and tissue biobank for the advancement of pain-related research. This Biobank contains PASTOR survey data, the Defense and Veterans Pain Rating Scale (DVPRS), electronic health record data, and biospecimens, (blood and saliva) on targeted individuals eligible for care within the Military Health System. Biobank Sites at Walter Reed National Military Medical Center and Naval Medical Center San Diego are enrolling. Currently, there are 200 participants, and approx. 4000 frozen samples. Permission was recently obtained to collect consents virtually, and a process to document and verify COVID-19 exposure is being explored. Applications for use of the PR Biobank data and samples are being accepted, and will be reviewed by the PR Biobank Oversight Committee. Face to face enrollment was placed on hold in March 2020, but was resumed in early 2021. 10.Published 20 articles across a range of high-impact journals related to rehabilitation, pain medicine, anesthesiology, and health services research. 11.DVCIPM Director serving as the DoD representative to the National Institute of Health’s (NIH) Interagency Pain Research Coordinating Committee (IPRCC) and the DoD Co-Chair for the HEC Pain Management Work Group. 12.Improve transitions of care from DoD to VA for Service members with complex pain conditions by continuing to integrate common or complementary DoD/VA standards for pain-related data collection and reporting, opioid safety initiatives and practices, patient and provider education; leading DoD execution of DoD/VA Joint Executive Committee (JEC) action plans for opioid safety. 13.Provided pain management functional support to DHA for the transition of the Pain Assessment Screening Tool and Outcomes Report (PASTOR) to the DHA Survey Portal. PASTOR is currently in use by over 240 DoD providers at 20 MTF pain management specialty clinics (as of 1Aug21). 14.Completed the Joint Pain Education Program study funded by DHA.
Document Details
- Document Type
- Accomplishment
- Publication Date
- Oct 01, 2023
- Source ID
- 210126bf1d63d22f9be4120168872668