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Chronic Pain

OHSU providers are involved in several research projects to improve the safe and effective care of patients with chronic pain.

Selected Research Projects:

American Pain Society Clinical Guideline Project (APS)
Director: Roger Chou, MD
Funding agency: The American Pain Society In collaboration with the American Pain Society (APS) and multidisciplinary expert panels, this project creates evidence reviews and clinical practice guidelines to be used by patients, payers, and providers for the management of complex pain problems. For more information, see:http://www.ampainsoc.org/library/cp_guidelines.htm.

Use of Prescription Monitoring Programs to Improve Patient Care and Outcomes 
PI: Richard Deyo, MD, MPH
Funding agency:  NIH/NIDA  (R01 DA031208-01A1)

Use of Acupuncture for Chronic Pain within an Integrated Health Plan (CAM Pain)
PI: L. DeBar, Kaiser CHR.  Co-Investigator: Richard Deyo, MD, MPH
Funding agency: NIH/NCCAM.   (R01 AT005896)

Back pain outcomes using longitudinal data (BOLD)
PI: Jeffrey Jarvik, University of Washington. Co-Investigator: Richard Deyo, MD, MPH
Funding Agency:  AHRQ (R01 HS19222-01)

Methadone Safety Guideline Development
PI: Roger Chou, MD; Co-PI: Melissa Weimer, DO
The American Pain Society (APS), in partnership with the College on Problems of Drug Dependence (CPDD) and the Heart Rhythm Society (HRS), commissioned a multidisciplinary panel to develop a clinical practice guideline on safer methadone prescribing practices. As part of the guideline development process, APS commissioned a systematic review on methadone safety  to summarize the evidence on various aspects related to safety of methadone, including overdose deaths, cardiac effects, and other harms.

Sex differences in chronic pain care for VA users
PI: Melissa Weimer, DO
This retrospective cohort study evaluates the differences in chronic pain care between men and women who receive care at the VA.  

Centrality of Pain Scale
PI: Christina Nicolaidis, MD, MPH
The goal of this project was to develop and test a new scale to measure how central pain is to a patient's life.  Click here [n1]  to obtain a copy of the scale for clinical use.  Please contact nicolaid@ohsu.edu for permission to adapt the scale or use it in research studies.  

Selected Papers

  1. Chou R, Deyo RA, Jarvik JG.  Appropriate use of lumbar imaging for evaluation of low back pain. Radiologic Clinics of North America 2012 (in press).
  2. Cherkin DC, Sherman KJ, Kahn J, Wellman R, Cook AJ, Johnson E, Erro J, Delaney K, Deyo RA. A comparison of the effects of two types of massage on chronic low back pain: A randomized controlled trial. Ann Intern Med 2011; 155: 1-9.
  3. Hollingworth W, Turner JA, Welton NJ, Comstock BA, Deyo RA. Costs and cost-effectiveness of spinal cord stimulation (SCS) for failed back surgery syndrome: an observational study in a workers' compensation population. Spine 2011; 36: 2076-2083.
  4. Von Korff M, Chou R, Deyo RA, Kolodny A. Long-term opioid therapy reconsidered. Ann Intern Med 2011; 155: 325-8. 
  5. Deyo RA, Smith DHM, Johnson ES, Donovan M, Tillotson CJ, Yang X, Petrik A, Dobscha SK. Opioids for patients with back pain in primary care: prescribing patterns and use of services. J Am Board Fam Med 2011; 24: 717-727.
  6. Weimer, MB, Korthuis, PT, Behonick, G, Wunsch, MJ. The Source of Methadone in Overdose Deaths in Western Virginia in 2004. Journal of Addiction Medicine 2011 September; 5(3): 188-202. (PMID: 21844834.) 
  7. Nicolaidis, C., Chienello, T., Gerrity, M.  "Development and Preliminary Psychometric Testing of the Centrality of Pain Scale." Pain Medicine. 2011;12:612-617. (PMID:21392248)
  8. Nicolaidis, C., "Police Officer, Deal-Maker, or Healthcare Provider?  Moving to a Patient-Centered Framework for Chronic Opioid Management."  Pain Medicine.  2011.  12: 890–897. (PMID:21539703) 
  9. Chapman CR, Lipschitz DL, Angst MS, Chou R, Denisco RC, Donaldson GW, et al. Opioid pharmacotherapy for chronic non-cancer pain in the United States: a research guideline for developing an evidence-base. Journal of Pain 2010;11:807-29.
  10. Chou R, Atlas SJ, Loeser JD, Rosenquist RW, Stanos SP. Guideline warfare over interventional therapies for low back pain: Can we raise the level of discourse? Journal of Pain 2011;12:833-839.
  11. Chou R.  ACP Journal Club. Review: Gabapentin reduces some types of chronic neuropathic pain more than placebo in adults. Annals of Internal Medicine 2011;155:JC1-9 
  12. Chou R, Qaseem A, Owens DK, Shekelle P. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Annals of Internal Medicine 2011;154:181-9.
  13. Chou R, McCarberg B. Managing acute back pain patients to avoid the transition to chronic pain. Pain Management 2011;1:69-79 
  14. Turner JA, Hollingworth W, Comstock BA, Deyo RA. Spinal cord stimulation for failed back surgery syndrome: outcomes in a workers' compensation setting. Pain 2010; 148: 14-25. ¨       Sherman KJ, Cherkin DC, Cook AJ, Hawkes RJ, Deyo RA, Wellman R, Khalsa PS. Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care (YES) trial. Trials 2010; Mar 31; 11: 36. PMCID: PMC2864260 
  15. Deyo RA. Treatment of lumbar spinal stenosis: a balancing act. The Spine Journal 2010; 10: 625-7.
  16. Alford, D.P, Krebs, E.E., Chen, I.A, Nicolaidis, C., Bair, M.J., Liebschutz, J. "Update in Pain Medicine." Journal of General Internal Medicine. 2010(11):1222-6. (PMID:20632120) 
  17. Chou R.  Evidence-based evaluation and management of chronic low back pain: understanding and using clinical practice guidelines.  Critical Reviews in Physical and Rehabilitation Medicine 2010; in press
  18. Chapman CR, Lipschitz DL, Angst MS, Chou R, Denisco RC, Donaldson GW, et al. Opioid pharmacotherapy for chronic non-cancer pain in the United States: a research guideline for developing an evidence-base. Journal of Pain 2010;11:807-29. 
  19. Chou R.  What we still don't know about treating chronic noncancer pain with opioids.  Canadian Medical Association Journal 2010;182:881-2.  

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