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HSR&D Investigator to Present at NIH: Reframing the Management of Chronic Pain

April 18, 2018


Erin Krebs, MD, MS, part of HSR&D’s Center for Chronic Disease Outcomes Research (CCDOR) in Minneapolis, MN, will speak at the National Institutes of Health (NIH) about “Reframing the Primary Care Management of Chronic Pain.” Her presentation – to be held on April 23, 2018 – is part of NIH’s National Center for Complementary and Integrative Health’s Integrative Medicine Research Lecture Series.

Dr. Krebs currently leads two HSR&D-funded studies on pain management and opioid therapy in Veterans: Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) Trial and Effects of VHA opioid policy on prescribing and patient-centered outcomes. The SPACE randomized trial compared the benefits and harms of opioid therapy versus non-opioid medication therapy over 12 months. Study participants - seen in VA primary care - included 240 Veterans with moderate to severe chronic pain or hip/knee osteoarthritis pain despite the use of analgesics. Veterans were randomized to one of two treatment arms: opioid therapy or non-opioid medication therapy. Findings showed no significant advantage of opioid therapy compared with non-opioid medication therapy. Results support a CDC recommendation that non-opioid therapies are preferred over opioids for chronic pain. Findings also were discussed in a recently published JAMA article (Krebs et al., 2018). The main objective of Dr. Krebs’ ongoing study on VA opioid policy and patient outcomes is to understand patient-centered outcomes of opioid prescribing changes among Veterans treated with opioids for chronic pain. Investigators are surveying more than 9,000 VA primary care patients receiving long-term opioid therapy, to collect longitudinal patient-reported pain outcomes data. Study findings will help VA achieve patient-centered pain management and opioid safety goals.