December 2013

David Craig, PharmD
Editor

Departments

Funding Announcements

Education

Members

Summaries

Clinical

Research

Society

Important Dates

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APS E-News is made possible through an unrestricted educational grant from Purdue Pharma.

Funding Announcements

APS Names 2014 Annual Award Recipients

Each year, APS recognizes excellence in the field of pain management and research by presenting awards for career achievement, pain scholarship, education and public service, advocacy on behalf of children, outstanding service to APS, and early career achievement. APS is pleased to announce the 2014 recipients.

John and Emma Bonica Public Service
Award

Dennis C. Turk, PhD,
and Robert H. Dworkin, PhD





Wilbert E. Fordyce Clinical Investigator
Award
Mark P. Jensen, PhD






Frederick W. L. Kerr Basic Science Research Award
Michael J. Iadarola, PhD







Jeffrey Lawson Award for Advocacy in Children’s Pain Relief
Anna Taddio







John C. Liebeskind Early Career Scholar Award
Claudia M. Campbell, PhD







Elizabeth Narcessian Award for Outstanding Educational Achievements
Joanna Girard Katzman, MD MSPH






Distinguished Service Award
David A. Williams, PhD






Congratulations to the 2013 Future Leaders in Pain Grant Recipients

The Future Leaders in Pain Research Grant program was established in 2005 to fund pain research projects of doctoral-prepared investigators who have not yet attained National Institutes of Health RO1-level funding. The purpose of this grant is to encourage research in pain that will add to the existing body of knowledge and to allow investigators to develop pilot data to help them secure additional major grant funding for continued pain research. APS is pleased to announce the 2013 recipients.

Jessica Fales, PhD
Seattle Children's Research Institute
The Nature and Significance of Peer Victimization Among Youth with Chronic Pain





Erica Schwartz, PhD
University of Pittsburgh
Nociceptive and Inflammatory Mediators of CP/CPPS






Qing Yang, MD MS
The University of Texas Health Science Center at Houston
Novel Target for Preventing & Ameliorating Paclitaxel-Induced Neuropathic Pain






Education

Annual Scientific Meeting Registration Now Open

Join your pain professional colleagues at the 33rd Annual Scientific Meeting, April 30–May 3 in Tampa.

By attending the 2014 meeting, you will discover current information about research, diagnosis, treatment, and management of acute pain, chronic cancer, noncancer pain, and recurrent pain.

The 2014 educational program will include

  • more than 35 educational sessions, featuring workshops and symposia
  • a keynote address on healthcare reform by David Newman, MD
  • plenary lectures by Mark Zylka, PhD; Camilla Svensson, PhD MPharmSci; and John Loeser, MD
  • a Global Year Against Pain Lecture on orofacial pain by Brian Schmidt, DDS MD PhD
  • an early career forum
  • unopposed author-attended poster sessions that feature cutting-edge research
  • continuing education credit for nurses, physicians, psychologists, and pharmacists.

Keynote Lecture: Health Care’s Most Important Reform—The Provider
David Newman, MD
Increasingly, surveys show patients are dissatisfied and providers are frustrated. The provider-patient relationship is in peril, and yet, though patients don't trust insurance companies, pharmaceutical corporations, or politicians to make decisions for them, they trust their providers. Physicians are the de facto face of reform and the primary drivers of reform’s success or failure.

This raises critical questions: Can the academic medicine community reform itself, starting with the provider? Can we reform the way we think, interact with patients, or use technologies? Can we deconstruct and rewire? There is no healthcare reform without provider reform—but providers are famously headstrong. What now?

Additional information regarding the 2014 Annual Scientific Meeting can be found on the APS website. Register by March 24 to receive $100 off your registration fee. Register now!

Young Investigator Travel Support

APS is offering Young Investigator travel support for the 2014 APS Annual Scientific Meeting. A limited number of funding awards will be available to individuals presenting poster abstracts at the meeting, April 30–May 3 in Tampa. Applicants may be from any research training background (basic or clinical science, psychology, medicine, or biostatistics) and may be at any level in training (students, residents, predoctoral trainees, postdoctoral fellows, and those who have completed their postdoctoral training within the past 3 years). Applicants must be APS members and must have an abstract accepted for presentation. Applications from nonmembers will not be considered.

To apply for funding, complete the Young Investigator travel support online application, which will be available on the APS website beginning January 6. Note that an applicant’s abstract must be accepted for presentation before he or she is eligible to submit an application for this grant. The listing of accepted abstracts, by primary author, will be available on the APS website in late December. Please check the abstract acceptance list before applying for a Young Investigator award.

Applications must be completed online by February 10.

If you have difficulty completing the application, contact APS at 847.375.4715. Applications will be reviewed by the APS Scientific Program Committee, and stipends will be awarded in late February. Notifications will be sent to applicants in March. Those applicants selected to receive a 2014 award will receive their travel grants at the annual meeting.

Thank You, 2014 Abstract Submitters

APS received more than 500 abstract submissions for the 2014 APS Annual Scientific Meeting. Of the submissions, 479 are complete and have been reviewed by the Scientific Program Committee.

Primary authors will be notified by mail in late December regarding the status of their submission(s). A listing of accepted abstracts, ordered by primary author, will be posted on the APS website at the end of December.

The number of completed submissions is second only to the 2004 joint meeting with the Canadian Pain Society in Vancouver. The 2014 APS Annual Scientific Meeting is shaping up to be one of the best—you won’t want to miss it!

Clinical and Basic Science Data Blitz

The Clinical and Basic Science Data Blitz will be held Wednesday, April 30, 6–8 pm as part of the 33rd APS Annual Scientific Meeting in Tampa. The blitz will include selected presentations of new research in a rapid format, where presenters will have 5 minutes to present data and 5 minutes for questions from the audience. The blitz will be moderated by David Seminowicz, PhD, and Benedict Kolber, PhD.

APS will issue a Call for Submissions for the Data Blitz in February 2014.

Fundamentals of Pain Management: An Interdisciplinary Primer

APS is pleased to announce the application process for the 2014 Fundamentals of Pain Management: An Interdisciplinary Primer. The course will take place Monday, April 28 through Wednesday, April 30, in Tampa as part of the APS Annual Scientific Meeting.

Thirty scholarships will be awarded for attendance to the Fundamentals of Pain Management: An Interdisciplinary Primer, an intensive 1 1/2-day course primarily for third and fourth year residents and other select interdisciplinary healthcare providers in training.

Applicants in the fields of anesthesiology, emergency medicine, family practice, internal medicine, neurology, and physical and rehabilitation medicine are encouraged to apply. Physical and occupational therapy, pharmacy, nursing, advanced practice nursing, psychology, physician assistant, and social work trainees are also welcome to apply. The scholarships are awarded based on competitive review of the applications plus a recommendation from your residency program director (for resident applicants) or department director (for nonresident trainees).

The course, developed by a group of dedicated pain professionals from APS, is designed to provide each participant with a unique opportunity for interdisciplinary learning, a mentored first exposure to the APS Annual Scientific Meeting, and a foundation for lifelong learning focused on pain management. APS is proud to offer this educational opportunity and grateful to Endo Pharmaceuticals for its continued support provided through an educational grant.

The course is designed for candidates who are interested in pursuing an academic career involving pain management. Each year the grant provides funding for a specified number of participants to be selected through a competitive scholarship application process. Thirty seats for the 2014 course are available to well-qualified applicants.

Please visit the APS website for more information regarding the 2014 course and to submit an online application.

Pediatric Pain Management Intervention Video

With the lack of pediatric evidence-based pain management interventions for common procedures such as immunization, APS member and 2012–2013 Mayday Pain & Society Fellow, Christine Chambers, PhD, wanted to reach parents directly and empower them to advocate for proper pain management for their children.

In collaboration with the The Centre for Pediatric Pain Research, It Doesn’t Have to Hurt: Strategies for Helping Children with Shots and Needles is an engaging new video aimed at healthcare professionals and parents. This video highlights a young child who advises her mother on tactics parents should use and avoid to help make the experience of pain management less stressful and more effective for children. The tips in the video are backed by scientific research.

This video is a great tool to share with your colleagues, friends, and family.


Members

Member Spotlight

Sean Ustic, PharmD
Pain Management Specialist
South Florida Baptist Hospital
Plant City, FL

How has membership in APS been of value to you and your professional development?
Through APS, I have been able to network and grow as a clinician, learning from experts in various fields. APS is a unique group that gathers practitioners in a concerted effort to maximize pain management for our patients. In addition, the APS Pharmacotherapy SIG is an active listserv that shares difficult case concepts and innovative protocols. I was also able to present on the national level at the 2012 Annual Scientific Meeting in Hawaii.

What is your area of specialty?
I am currently the pharmacy clinical coordinator for South Florida Baptist Hospital, a small 147-bed BayCare hospital in Plant City. My position entails managing our pharmacists’ daily workflow and also filling the role of clinical specialist on the floor by tackling total parenteral nutrition (TPN), anticoagulation, kinetics, and pain consults. In addition, I have become the sponsor for our pain resource nurses and an active spokesperson for the BayCare Pain Management Task Force, which focuses on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores system-wide.

What has been a highlight of your work? Perhaps you and your staff are proud of a certain project or accomplishment.
The highlight of my work has been the opportunity to influence hospital and also hospital system pain management policies and practice via the catalyst of the HCAHPS pain management focus. Through multiple meetings and skills fairs, our South Florida Baptist Pain Resource Team was able to achieve enough consistent progress with our HCAHPS scores to catch the eye of the other hospitals in our system. We are now in the process of duplicating our successes throughout the BayCare hospital system. In addition, we have initiated a nursing-pharmacy collaboration, on several pilot units within each hospital, to address patients struggling with pain earlier. To be continued…

What initially sparked your interest in working in your field? Briefly describe your career path.
The spark for my interest in pain management occurred during the summer after my second year at the University of Arizona College of Pharmacy. As a Walgreens pharmacy intern in my small hometown of Coolidge, AZ, I was able to work with community patients and local physicians to assist with improving their pain, and I knew I had found my niche. I then sought out the possibility of becoming a pain management pharmacist. While looking for pharmacists specializing in pain, I found APS and became the first pharmacy student to join APS and the APS Pharmacotherapy SIG, and I also met David Craig, PharmD, pharmacy residency director of H. Lee Moffitt Cancer Center Pain and Palliative Care Residency. After interview me, he suggested a general residency at Lakeland Regional Medical Center (LRMC) where his mentor Jennifer Strickland, PharmD BCPS, was the pharmacy director.

After completing a general residency at LRMC, I went on to complete my specialty residency in pain and palliative care at Moffitt Cancer Center. Subsequently I was very lucky to find my current position as the pharmacy clinical coordinator/clinical specialist with the possibility to assist in rebuilding the current pain management policies and practices at South Florida Baptist Hospital. This opportunity has continued to flourish, and I am an active committee member of the BayCare Health System Pain Management Task Force and training other pharmacists to assist nurses with pain management.

Who is your favorite role model and why?
One of my role models is Atul Gawande, MD MPH, a well-respected surgeon and author constantly striving for the most effective and efficient practices. He has been very influential in applying successful practices of nonmedical fields, like the restaurant or skyscraper construction business, and converts their productive methods into hospital practice. I admire his resourceful approach of reinventing the fundamental crux of a problem of common practice.

Member Benefit: Grants and Fellowship Opportunities

APS provides its members with several funding opportunities as well as information on fellowships in pain. The following are some examples of how APS provides financial support to pain professionals.

Rita Allen Foundation Award in Pain
Application Deadline: Friday, January 17
APS and the Rita Allen Foundation (RAF) have announced a call for applications for the Rita Allen Foundation Award in Pain. The RAF and APS award two grants in the amount of $50,000 annually for a period of up to 3 years to those research proposals demonstrating the greatest merit and potential for success.

APS Sharon S. Keller Chronic Pain Research Grant
The APS Sharon S. Keller Chronic Pain Research Grant has been established to fund research projects that have a high likelihood of leading to new treatments and increased access to and expansion of treatment options for people with chronic pain.

APS Future Leaders in Pain Research Grants Program
The APS Future Leaders in Pain Research Grants program has been established to fund research projects of doctorally prepared investigators who have not yet attained National Institutes of Health RO1-level funding.

Fellowship opportunities can be found on the APS education page.

This information is provided as a resource and does not imply APS endorsement of any of the training programs listed.


Summaries

The Journal of Pain Highlights

The following highlights summarize selected articles from The Journal of Pain (Volume 14, Number 12, December 2013 Issue).

Prescribing Practices Amid the OxyContin Crisis: Examining the Effect of Print Media Coverage on Opioid Prescribing Among Physicians
Borwein, A., Kephart,G., Whelan, E., and Asbridge, M. Dalhousie University, Nova Scotia, Canada

Extensive negative media coverage in North America about the extended-release form of OxyContin coincided with reduced prescribing of the medication, according to a Canadian study.

The extended release form of OxyContin was approved in Canada in 1996 and at first was portrayed as an advance for its ability to provide sustained pain relief. Soon it was discovered that when crushed, chewed, or inhaled, the active drug is released and absorbed rapidly, producing a heroin-like euphoria. Within 5 years, mainstream media in the United States and Canada began to report that extended-use oxycodone was widely diverted and abused, causing overdoses and death.

Researchers from Dalhousie University explored whether ongoing media attention led to changes in prescribing of extended-release oxycodone. They measured the proportion of monthly prescribing volume for all opioids represented by the extended-release form and assessed whether the impact of media coverage effected prescribing of oxycodone extended-release based on overall prescribing volume, physician specialty, and geographic region. Some 924 newspaper articles were published between 1995 and 2005 covering oxycodone extended release, of which 172 were in Canadian newspapers. In Canada and the United States, newspaper coverage during that time centered on drug thefts, overdoses, and deaths.

This is the first study to examine the impact of media reporting of opioids and changes in the prescribing of these drugs. The authors reported that media coverage describing extended-release oxycodone as a social problem changed physician prescribing practices. However, the media coverage did not change overall opioid prescribing. Physicians replaced extended-release oxycodone with prescriptions for other strong opioids.

Changes in Opioid Prescribing for Washington Workers Compensation Claimant After Implementation of an Opioid Dosing Guideline for Chronic Non-Cancer Pain
Garg, R. K., Fulton-Kehoe, F., Turner, J. A., Bauer, A. M., Wickizer, T., Sullivan, M. D., et al. University of Washington and Washington State Department of Labor and Industries.

In 2008, the opioid mortality rate in the state of Washington was 50% higher than the national average. Deaths related to opioids increased from less than 50 in 1995 to more than 500 in 2008. In response, the state developed a prescribers’ guideline to assist primary care doctors in prescribing opioids more safely and effectively for chronic noncancer pain and prevent new patients from escalating to high-dose opioid use. The state guideline was the first to provide specific opioid dosing guidance.

In this study, researchers from the University of Washington and the Washington State Department of Labor and Industries evaluated opioid use and dosing patterns before and after the guideline implementation. They assessed the incidence of opioid use, chronic use among incident opioid users and high-dose opioid use, including all prescription opioids and all workers’ compensation claimants. They identified 161,283 workers ages 18–64 with an accepted injury claim and at least one paid opioid prescription dispensed between April 1, 2004, and December 31, 2010.

The analysis showed that, overall, the mean monthly prevalence of opioid use declined by 24% in the 80-month time period. Further, the proportion of incidence users who became chronic users decreased by 53%. The authors concluded that the findings of the study suggest that clinical opioid dosing guidelines that specify a “yellow flag” dosing threshold may be a useful tool for improving safety of opioid prescribing by discouraging further dose escalation.

PAIN Highlights

The following highlights summarize selected articles from PAIN (Volume 154, Number 11, November 2013 Issue).

Limb-Specific Autonomic Dysfunction in Complex Regional Pain Syndrome Modulated by Wearing Prism Glasses
G. Lorimer Moseley, Alberto Gallace, Flavia Di Pietro, Charles Spence, Gian Domenico Iannetti; The Sansom Institute for Health Research, University of South Australia, Adelaide; Neuroscience Research Australia, Barker Street, Randwick 2031; Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; Department of Psychology, South Parks Road, Oxford OX1 3UD, UK; Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, WC1E 6BT, London, UK

Complex regional pain syndrome (CRPS) is characterized by severe pain with autonomic, sensory, and endocrine dysfunction. A spatially defined deficit relates to thermoregulation; patients with CRPS have a “cool side of space.” In unilateral upper-limb CRPS, hand temperature is modulated by arm location relative to the body midline. Investigators hypothesized that this effect depends on the perceived location of the hands and not on their actual location or anatomical alignment. Prism glasses that laterally shifted the visual field were used to investigate this issue.

In two cross-sectional randomized experiments, 10 unilateral patients (including 6 women) with CRPS wore prism glasses that laterally shifted the visual field by 20°. Skin temperature was measured before and after 9-minute periods during which the position of one hand was changed. Placing the affected hand on the healthy side of the body at midline increased skin temperature but not if prism glasses made the hand appear to be on the body midline. Similarly, when prism glasses made the affected hand appear to be on the healthy side of the body midline (even though it was not), the affected hand warmed up. When prism glasses made the healthy hand appear to be on the affected side of the body midline (even though it was not), the healthy hand cooled down.

These results highlight the close relationship that exists between the cortical maps of the body in external space and the homeostatic regulation of the body itself. Results demonstrate that, in patients with cold-type CRPS of one arm, the space-based disruption of thermoregulation of either hand is not determined by anatomical factors related to the location or configuration of the hands but genuinely depends on the cortical representation of the hand’s location within a body-centered frame of reference. These findings extend a growing body of evidence that implicates disruption of mechanisms within the cerebral cortex in the multiple-efferent system dysfunction seen in CRPS.

Transcutaneous Electrical Nerve Stimulation Reduces Pain, Fatigue, and Hyperalgesia While Restoring Central Inhibition in Primary Fibromyalgia
Dana L. Dailey, Barbara A. Rakel, Carol G. T. Vance, Richard E. Liebano, Anand S. Amrit, Heather M. Bush, Kyoung S. Lee, Jennifer E. Lee, Kathleen A. Sluka; Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City; College of Nursing, University of Iowa, Iowa City; University of the City of Sao Paulo, Physical Therapy Department, Sao Paulo, Brazil; Department of Rheumatology, University of Iowa, Iowa City; Department of Biostatistics, University of Kentucky, College of Public Health, Lexington, KY

Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological treatment modality that delivers electrical stimulation through the skin and is used for control of both acute and chronic pain. In this study, researchers tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition.

Although TENS is shown to be effective for several pain conditions such as osteoarthritis, chronic musculoskeletal pain, and postoperative pain, its effectiveness in treatment of people with FM is virtually unknown. The primary aim of this study was to test the effectiveness of TENS on pain, fatigue, and function in a crossover study for patients with FM who were randomly assigned to one of three treatments: no TENS control, placebo TENS, and active high-frequency TENS. A secondary aim was to test the effect of TENS on central inhibition and hyperalgesia as an indicator of central excitability. Investigators hypothesized that the application of TENS to people with FM would reduce pain and fatigue, reduce central excitability, and restore conditioned pain modulation (CPM), which would manifest as improved function.

There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. Pressure pain thresholds increased at the site of TENS (spine) and outside the site of TENS (leg) when compared to placebo TENS or no TENS. During active TENS, conditioned pain modulation was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. These investigators suggest that TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active.

Researchers demonstrated increased CPM in the active TENS treatment group, suggesting that TENS restores central inhibition. It is important to note that the current study examined only a single treatment of TENS. Whether longer-duration or repeated TENS applications will provide more effective and sustained pain management in patients with FM remains to be determined, ideally in a large-scale clinical trial.

Pain Medicine Highlights

The following highlights summarize selected articles from Pain Medicine (Volume 14, Number 11, November Issue).

Under Treatment of Pain: A Prescription for Opioid Misuse Among the Elderly?
Maria A. Levi-Minzi, Hilary L. Surratt, Steven P. Kurtz, and Mance E. Buttram; Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL

Few studies have specifically examined the characteristics, sources, and motivations for prescription drug misuse among those over age 60, and little is known about the misuse of prescription opioids for untreated pain among older adult populations. This study examined the demographic, physical, and mental health characteristics; current drug use patterns; motivations for use; and diversion sources among elderly prescription opioid misusers. A subsample of 30 elderly people reporting substantial prescription drug misuse was chosen for an in-depth interview (mean age of 63.3 years). Fifty percent reported being admitted to a drug treatment program in the past; several reported recent illicit drug use involving powder cocaine and/or crack (35.2%), marijuana (30.7%), or heroin (14.8%). The majority reported past-year severe physical pain and discomfort (86.4%) and misuse of their primary opioid for pain (80.7%). More than half (52.3%) of participants obtained their primary opioid from their regular doctor.

Although patients have access to medications through physicians, it appears they are often prescribed lower-potency medications, making undertreatment of pain a significant issue. These findings suggest that prescription opioid medications may be underprescribed to legitimate patients (in terms of number and potency), causing patients to take more than indicated to achieve adequate pain relief. Qualitative findings support the idea that doctors seem to be cautious about the types of medications prescribed. Very few participants had been prescribed higher-potency opioids such as oxycodone, which likely could be attributable to recent local crackdowns on physicians prescribing pain medications or a concern that patients may develop dependence on prescription opioids.

With prescription opioid misuse on the rise, there is an ongoing need to understand the factors involved in misuse, particularly among older populations, to combat addiction and prescription drug diversion. These data highlight the need for continued education and training for physicians and others prescribing pain medications to older populations. Among patients at increased risk for misuse, including those who are younger in age and have a current, past, or family history of substance abuse or concurrent psychiatric disorders, it has been suggested that prescribing physicians use treatment contracts, structured prescribing, and urine testing.

PTSD and Pain: Exploring the Impact of Posttraumatic Cognitions in Veterans Seeking Treatment for PTSD
Katherine E. Porter, E. Brooke Pope, Rebecca Mayer, and Sheila A. M. Rauch; Mental Health Service and Research Service, VA Ann Arbor Healthcare System, Ann Arbor, MI; Department of Psychiatry, University of Michigan Medical School, Ann Arbor; Mental Health Service, Battle Creek VA Medical Center, Battle Creek, MI

Certain cognitions or cognitive styles are linked to posttraumatic stress disorder (PTSD) and pain. The purpose of this study was to explore whether negative posttraumatic cognitions associated with PTSD are related to pain in 136 veterans seeking treatment for PTSD and to see if these cognitions mediate the relationship between PTSD and pain. The majority of patients (86.8%) reported some problems with pain.

Findings revealed that posttraumatic cognitions were not related to the level of pain experienced, but they were related to pain interference in this population. In particular, negative cognitions regarding the self were associated with the level of pain-related interference and partially mediated the relationship between PTSD and pain.

Further, findings indicate a significant relationship between the level of PTSD symptoms and the level of pain reported. However, contrary to initial predictions, posttraumatic cognitions were not related to the level of pain experienced in this population but were shown to be related to certain areas of pain interference. In particular, a person’s negative beliefs about him or herself were associated with the level of pain-related impairment; this subscale was significantly related to all but one type of interference (walking) measured on the Brief Pain Inventory-Short Form. This is commensurate with previous literature suggesting that negative cognitions regarding the self are most strongly related to symptomatology.

Among patients with comorbid conditions, therapies addressing posttraumatic cognitions (e.g., prolonged exposure and cognitive processing therapy) may provide additional benefit beyond PTSD symptom reduction. Additional research among this comorbid population is warranted.


Clinical

APS Guidelines Set High Standard of Excellence

Keela Herr, PhD RN AGSF FAAN, Chair, APS Clinical Practice Guidelines Committee

The Annals of Internal Medicine* recently published a systematic review and appraisal of guidelines for use of opioids to treat chronic pain. The authors used the AGREE II method and the AMSTAR ratings system to evaluate 13 guidelines and the underlying systematic reviews. Of the 13 guidelines evaluated, only two received high scores on both ratings systems, one being the APS-American Academy of Pain Medicine Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain**. Reviewers noted the outstanding guidelines were developed by using comprehensive systematic reviews and rigorous methods for formulating recommendations and frequently link recommendations to evidence.

This finding is consistent with the APS commitment to produce the highest quality guidelines following the most rigorous standards and methods for guideline development.

In the coming months, two new guidelines will be published in The Journal of Pain. The first of these is Methadone Safety: Clinical Guidelines, which will be published online in the first quarter of 2014. The Methadone Safety Guideline is the product of a collaboration with the College on Problems of Drug Dependence and the Heart Rhythm Society.

Publication of the guideline for Management of Acute Post-Operative Pain will follow shortly thereafter. The acute postoperative pain guideline has been developed collaboratively with the American Society of Anesthesiology, the Department of Veterans Affairs, and the Department of Defense.

APS members consistently rate the evidence-based guidelines of our organization among the top three most valued programs of the society. While there is high value in developing guidelines for pain treatment, it is an expensive endeavor to do so. APS has recently embarked on a focused effort to secure funding to support our guideline development program. As part of this effort, methods are being implemented to obtain data regarding guideline implementation and impact on practice change. With stronger outcomes data on the impact of APS guidelines, we hope to build the case for funding the updating of existing guidelines and the development of new guidelines. The APS Clinical Practice Guidelines Committee welcomes ideas and comments about future guidelines and potential funding avenues.

*Opioid Prescribing: A Systematic Review and Critical Appraisal of Guidelines for Cronic Pain
Nuckols, T. K., Anderson, L., Popescu, I., Diamant, A. L., Doyle, B., Di Capua, P. [Published online November 12, 2013]. Annals of Internal Medicine. doi:10.7326/0003-4819-160-1-201401070-00732

**Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
Chou, R., Fanciullo, G. J., Fine, P. G., Adler, J. A., Ballantyne, J. C., Davies, P., et al. (2009). The Journal of Pain, 10(2): 113–130. doi: 10.1016/j.jpain.2008.10.008


Research

Rita Allen Foundation Scholar Identifies Possible Target for Treating Chronic Pain

Yuan-Xiang Tao, a member of the 2011 class of Rita Allen Foundation Scholars and associate professor at the Johns Hopkins University School of Medicine, has published new research in Nature Neuroscience identifying a long noncoding RNA that may be a new target for treating neuropathic pain. The discovery will also have an impact on research in other fields by challenging current molecular methodologies. Visit the Rita Allen Foundation website for more information.

Rita Allen Foundation Request for Applications Now Open

The Rita Allen Foundation (RAF) and APS announce the 2014 Rita Allen Foundation Award in Pain. The RAF and APS award two grants in the amount of $50,000 annually for a period of up to 3 years to those research proposals demonstrating the greatest merit and potential for success.

Candidates must have completed their training and provide persuasive evidence of distinguished achievement or extraordinary promise in basic science research in pain. Candidates should be in the early stages of their career with an appointment at faculty level. The entire award is to be allocated to projects specifically chosen by the recipient. Overhead is not supported.

To learn more about the Rita Allen Foundation Award in Pain, please visit the APS website.

Clinical Psychology Fellowship with Emphasis on Pain Psychology Seeks Applicants

The Tampa VA Medical Center is currently seeking applicants for its postdoctoral fellowship in clinical psychology with an emphasis in pain psychology.

The position is a 1-year fellowship with various experiences treating chronic pain patients, including training in the only inpatient interdisciplinary pain program in the U.S. Department for Veterans Affairs system. The program emphasizes clinical activity as well as research and professional development.

The deadline to apply is January 1. Visit the VA website for a more details. Direct inquiries can be sent by e-mail to Daniel Agliata at Daniel.Agliata@va.gov.


Society

SIG Update

Pain and Disparities SIG Member Spotlight
Burel R. Goodin, PhD, is an assistant professor of psychology and anesthesiology at the University of Alabama at Birmingham (UAB). A significant portion of his research program focuses on examining ethnic/racial differences in the experience of pain, and the biopsychosocial predictors of these differences. Along with colleagues at the University of Florida and UAB, he has recently authored several peer-reviewed manuscripts describing ethnic and racial differences in pain sensitivity among individuals with osteoarthritic knee pain. Dr. Goodin serves as a member-at-large of the APS Pain and Disparities special interest group.

Tell us about your pain disparities manuscript that was recently published in the November issue of Health Psychology.
“Perceived Racial Discrimination, But Not Mistrust of Medical Researchers, Predicts the Heat Pain Tolerance of African Americans with Symptomatic Knee Osteoarthritis,” was published as part of a special section addressing health disparities in pain. Despite increasing evidence attesting to ethnic and racial differences in the experience of pain, explaining how such differences are manifested and perpetuated remains a challenge. This study sought to determine whether perceived racial discrimination was predictive of ethnic and racial differences in sensitivity to painful heat stimuli among individuals with knee osteoarthritis. African Americans were more sensitive to heat pain and reported greater frequency of perceived lifetime racial discrimination compared to Caucasians. Interestingly, greater frequency of perceived lifetime racial discrimination significantly predicted lower heat pain tolerance for African Americans but not Caucasians. These results are the first to suggest that perceived racial discrimination may directly alter the nociceptive processing of painful stimuli among African Americans.

Are you currently involved with any other pain disparities research?
Yes, I am. This past summer, I received a pilot grant from the National Institutes of Health–funded Deep South Resource Center for Minority Aging Research (RCMAR) to conduct a study looking at whether sleep differentially impacts the pain experiences of aging African Americans and Caucasians. Sleep and pain disorders have been shown to disproportionately affect ethnic and racial minorities, and the prevalence of sleep and pain disorders generally increases with advancing age. Furthermore, poor sleep and worsening pain experiences often go hand-in-hand. My study is attempting to determine if older African Americans are at greater risk for poor sleep and whether this poor sleep, in turn, predicts greater pain sensitivity and severity.

What are your plans for future study?
My plans for future study center around the development and implementation of interventions specifically tailored for the management of pain in ethnic and racial minorities. I hope that my current line of research can contribute to my future study efforts by identifying individuals at the greatest risk for experiencing acute and chronic pain (e.g., older African Americans) and by helping to distinguish mechanisms (e.g., sleep) that might serve as modifiable interventional targets. In the event that my work casts light upon potentially promising pain management interventions or strategies, my goal as a clinical scientist would then be to determine how to best translate these findings into clinical applications that are implemented by other healthcare providers.

APS Public Relations Consultant Named PR Professional of the Year

APS is pleased to announce that Chuck Weber, APS public relations (PR) consultant, was named PR Professional of the Year for Nonprofit/Association in the PR People Awards, sponsored by PR News. Weber was chosen as one of three finalists and will be presented with the award at a December luncheon in Washington, DC.

PR News showcases top talent, passionate professionals, and budding PR leaders and creative practitioners who are making communications and benchmarks of excellence in public relations.

Weber, of Weber & Associates Public Relations, has worked with APS for 14 years generating extensive national and international media coverage for APS.


Important Dates

Young Investigator Travel Support Applications
Opens Monday, January 6, 2014
Learn More

Fundamentals of Pain Management: An Interdisciplinary Primer Course
Closes Friday, January 10, 2014
Learn More

Rita Allen Foundation Award in Pain
Closes Friday, January 17, 2014
Learn More

Clinical and Basic Science Data Blitz Submissions
Opens February 2014
Learn More

Annual Scientific Meeting Early-Bird Deadline
Monday, March 24, 2014
Register Now


Call for Submissions

Do you have a topic that is relevant to APS members? Is there a member who is doing work that APS should spotlight? Is there a funding opportunity APS members need to know about? Please submit stories, events, and more to enews@americanpainsociety.org for consideration.


Copyright © 2013 American Pain Society. All Rights Reserved.