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APS Bulletin • Volume 18, Number 2, 2007
Research Update
Norman Harden, MD, Department Editor
Pain Research Funding Addressed at NIH Pain Consortium
Jane Martinsons, Staff Writer
This year the National Institutes of Health (NIH) is funding $222,000,000 toward pain research, marking a steady trend upward in the overall budget for the NIH, Patricia A. Grady, PhD RN FAAN, director of the National Institute of Nursing Research, told attendees of the recent NIH Pain Consortium on advances in pain research. Grady acknowledged, however, that NIH budget figures differ from those presented last May at the American Pain Society (APS) Annual Meeting in Tampa, FL, and said that both NIH and APS are working to figure out the discrepancies.
| “In general, there is a fairly even distribution between basic science and clinical pain research in terms of NIH support. The NINDS has been the largest supporter of research on pain, and that continues.” —Jennifer Haythornthwaite, PhD |  |
“One of the major differences is that many institutes code for partial funding of pain. If 50% of a grant is focused on [pain], and [institutes] code the 50%, we consider that in the overall total,” said Grady, who cochairs the consortium with directors from the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute of Dental and Craniofacial Research. “We only count the 50%—but we do count that,” Grady said. “The other numbers generated count simply the applications or the grants focused completely on pain. Also, we are able to access grants, contracts, and supplements that do not show up in the regular Computer Retrieval of Information on Scientific Projects (CRISP) system, a searchable public database of the NIH.
“Regardless of the specifics, we are aware—very acutely aware—that the amount of funding for pain is modest compared to the overall problem of pain,” Grady noted. “We are facing this in a number of areas at NIH these days, and we’re doing our best to work with the scientific community to increase that awareness and to try to reach the hearts and the minds of those who can make a difference in this area.”
In her presentation to the NIH Pain Consortium, Jennifer Haythornthwaite, PhD, of Johns Hopkins University, Baltimore, MD, and APS Treasurer, acknowledged the consortium’s efforts toward increasing the visibility of pain as a public health problem. As for funding, she said that for years APS has been trying to analyze funding for pain research. “We turned to the NIH because it is the largest source of research funding in the United States,” Haythornthwaite said. “We funded the University of Utah and some investigators there, led by David Bradshaw, PhD, and Dick Chapman, PhD, to go to the CRISP database and search for and identify funded projects that were primarily or secondarily studying pain. These [findings were] published a couple of years ago in The Journal of Pain” (Bradshaw, Nakamura, & Chapman, 2005).
Haythornthwaite noted that APS will again fund the research at the University of Utah to look at the 2007 data. Still, she said, “The CRISP database is not the most accurate method for conducting this kind of research, and we very much acknowledge that. But it is what is publicly available. It has been the only tool that we, as outsiders, have available.
“In general, there is a fairly even distribution between basic science and clinical pain research in terms of NIH support,” she said. “The NINDS has been the largest supporter of research on pain, and that continues.” Haythornthwaite noted that early data show financial support for pain according to organ system targets on the neurological system, which received 100 awards for pain as a primary emphasis in 2007. Cardiac pain received two awards, the fewest awards given in 2007.
“I understand that this may be inaccurate, [but] we do have the worrisome sense that the funding level or percentage of budget may be dropping over a short period of time. Our initial analysis was from 2004 and we’re now looking at 2007. There is a sense that there is a slight decline,” she said, “However, we do not have access to some of the ancillary studies and supplements that may be contributing additionally to the pain research funding level.”
Founded in 1996, the NIH Pain Consortium of 20 institutes and centers aims to increase the visibility of pain research and the number of pain researchers. According to Grady, the comprehensive NIH pain agenda works to identify key opportunities and gaps in the field, focus on supporting and promoting interdisciplinary research, and pursue public and private partnerships.
“The major areas of research that we are funding relate to basic mechanisms of the pain response, what causes it, and how to modify it. We are still very early in our ability to manage effectively and therapeutically this area in the clinical population,” Grady said. “The explosion in genetics is opening up new areas for individualized medicine, and we are starting to take advantage of those, in particular with gender and ethnic differences. We’re very optimistic that this is going to move the science forward in ways [not done] previously.”
Haythorthwaite stressed the future need to identify gaps in knowledge, particularly in pain treatment, and called for developing better preclinical models, exploring new mechanisms of pain, and working hard to translate bench-to-clinical studies, and then clinical studies to clinical care, particularly for the use of opiates for pain management.
By the end of the Decade of Pain Control and Research, prevention of pain will play a key role, Haythornthwaite said. Developing evidence-based strategies for preventing pain, particularly chronic pain, is “the kind of societal issue that many pain researchers worry about and use to justify the significance of their applications to NIH.”
Reference
Bradshaw, D. H., Nakamura, Y., & Chapman, C. R. (2005). National Institutes of Health Grant Awards for Pain, Nausea, and Dyspnea Research: An Assessment of Funding Patterns in 2003. The Journal of Pain, 6, 277–293.
