PCORI’s newly approved awards focus on cancer pain and opioid use disorders

The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors today approved $44.6 million to fund 12 studies comparing the best ways to treat a range of health conditions that impose high burdens on patients, caregivers and the healthcare system.

The newly approved awards include four focused on improving the availability and effectiveness of treatment for opioid use disorder (OUD), which affects 2.5 million Americans aged 12 and older, including 8 to 12 percent of people prescribed opioids for chronic pain. Three awards focus on patients treated for OUD in doctors' offices with the medication buprenorphine and seek to determine which psychosocial treatments work best in combination with that medication to help these patients abstain from opioid use:

• A $5.5 million Philadelphia College of Osteopathic Medicine study comparing three psychosocial treatments for people being treated at federally qualified health centers. The study looks at which kind of psychosocial treatment -- cognitive behavioral therapy, peer recovery support or a combination of both -- is most effective.
• A $4.9 million RAND Corporation study of whether incorporating a patient's support system into their treatment with buprenorphine can improve outcomes. The study will examine whether a counseling program for someone close to the patient, such as a family member, spouse or friend, can improve recovery.
• A $4.4 million Johns Hopkins School of Medicine project comparing ways to improve outcomes by using patient incentives. One method will be standard care and two others will involve incentives for people who use buprenorphine daily to stay on their medication and not use drugs.

The fourth opioids-related award is $5.6 million for a Yale University School of Medicine study comparing two approaches for supporting obstetricians who treat pregnant women with OUD with medication-assisted treatment. One is a collaborative care model where a care manager supports the obstetrician with patient screening, intake, education, treatment and care coordination. The other uses remote education to provide obstetricians with expert mentorship and guidance via video conferencing. The study looks at which model is better for patients.

"PCORI is committed to funding studies across the broad range of issues that need to be considered if we are to reduce the toll that opioid use disorders, and inappropriate use of opioids more broadly, is taking on patients, their families and the healthcare system," said PCORI Executive Director Joe Selby, MD, MPH. "We believe PCORI's approach to helping combat this major public health challenge -- by comparing which care approaches work best, based on relevant outcomes -- can help patients and their doctors make better-informed decisions about their treatment options."

These latest awards bring to nearly three-dozen the number of patient-centered comparative clinical effectiveness (CER) studies PCORI has funded related to opioid use. These are part of PCORI's broader focus on addressing the opioid epidemic by finding better ways to help people manage chronic pain, prevent inappropriate opioid use, improve long-term pain management while reducing the risk opioids can pose, and increase access to and quality of OUD treatment.

Other awards approved include:

• $5.7 million to examine strategies for improving treatment of insomnia in rural areas, looking at how well a commonly prescribed drug works compared with cognitive behavioral therapy
• $5.6 million for a study comparing ways to enhance prenatal care to improve maternal and child health.
• $2.7 million in funding for a study comparing two non-drug approaches - acupuncture and massage therapy -- to improve care for severe pain in people with cancer

Details of all projects approved for funding by the Board appear on PCORI's website. All awards were approved pending a business and programmatic review by PCORI staff and issuance of formal award contracts.

With these latest awards, PCORI has invested $2.4 billion to fund more than 460 patient-centered CER studies and to support other projects designed to enhance CER methods and the infrastructure necessary to conduct CER rigorously and efficiently.