The Pain Management Research Institute (“PMRI”) is unique in its integration of research, clinical treatment, education and advocacy. PMRI creates a virtuous circle of continuous learning, management and improvement in practical measures to conquer chronic pain.
Supported by funds raised by the Pain Foundation, PMRI is focused on a range of important initiatives for 2020/ 2021. A small investment will deliver significantly improved outcomes for those affected by chronic pain and broader cost-savings and benefits for the community.
1. Finding novel treatments for pain
Our pain neurobiologists Dr Karin Aubrey and Dr Yo Otsu whose lab is in the Kolling Building on the RNSH campus are studying the natural pain modulating system that descends from the brain down to the spinal cord.
Last year, Dr Otsu published his work on the role of the chemical glycine in this system in the journal Science (Otsu et al. Science, 366, 250-4, 11 October 2019). Over the next 3 years, he and Dr Aubrey will continue to explore this system, with the hope of discovering targets that could lead to the development of a new class of non-opioid analgesics.
2. Effective Tapering of Opioid Use to prepare for alternative pain management
Over the 3 years (July 2020- June 2023) we are undertaking research of using text messages to support patients with chronic pain long term opioid therapy in the difficult challenge of reducing their reliance on these medications.
As part of this research, We are seeking $42,000 for research assistants to analyse the interview responses from over 50 patients about their experiences who have demonstrated a clear desire to when reducing their use of prescribed opioid medications and to test the efficacy of a novel communication strategy to change patients’ minds about opioid tapering, thereby better preparing them for alternative programs and improving our success rates.
You have heard about the opioid crisis, here are some numbers to put some context to it.
- In a single year in Australia, extra-medical opioid use caused more than
32,000 hospital admissions
and resulted in the loss of over
70,000 years of life.
- “Extra-medical” opioid use includes both the illegal use of opioids such as heroin, and the misuse of pharmaceutical opioids – that is, when they’re not used as prescribed or intended.
- Over the financial year 2015-16, extra-medical opioid use came at a cost of an estimated
(National Drug Research Institute, Curtin University)
3. Acute to Chronic Postsurgical Pain (“CPSP”)
The objective of this study is to provide high quality evidence for statewide policy and practice including an optimal person-centred clinical pathway and a value-based model of care based on a health economic evaluation.
Patients with chronic pain pose a challenge for effective management at hospital Emergency Departments. While acute health problems are managed efficiently in NSW Emergency Departments, complex chronic conditions such as chronic pain pose significant unmet challenges.
Such patients report problems with communication, comfort, negative labelling and lack of long-term planning. They will be identified and invited to receive the assistance of a community care coordinator at home. The community care coordinator will work with the person, their community (especially GP) and hospital teams to optimise care.
4. Integrated Care Pathway for chronic pain patients presenting frequently to Hospital Emergency Departments (“ED”)
The objectives of this study are:
to develop and evaluate a screening tool which will assist in identifying patients at risk of transitioning from acute to CPSP and
to assess the incidence of continuing opioid use in post-surgical patients and whether the screening tool can predict this outcome.
Several studies have investigated possible risk factors for the transition from acute to chronic pain after surgery, and highlighted the importance of being able to identify, in advance, patients at risk.
In order to successfully complete the project, we need an additional $50,000 in 2020/21 to fund further research assistance.
PMRI Executive Team
Professor Paul Glare, MBBS FRACP FFPMANZCA
Director Pain Management Research Institute Faculty of Medicine & Health, University of Sydney
Dr Charles Brooker, Director Pain Management Research Centre and Board Member, Pain Foundation Ltd
Staff Anaesthetist & Pain Specialist
Professor Michael Nicholas, Director Education & ADAPT Pain Management Program
University of Sydney, Royal North Shore Hospital
Conjoint Associate Professor Paul Wrigley
Head, Pain Pathways Research
Senior Staff Specialist Pain Medicine, University of Sydney, Royal North Shore Hospital