IMHA's "Alleviate the Burden of Pain" Priority
SD Lead: Dr. Karim Khan

Rationale

Approximately one in five Canadians live with chronic pain which impacts physical and mental health and quality of life. People with chronic pain face challenges related to stigma and access to health services. Pain is relevant to all 13 CIHR Institutes' mandates.

Beginning in 2019, CIHR-IMHA worked closely with the Health Canada secretariat that oversaw the Canadian Pain Task Force (CPTF). The CPTF provided advice and information to guide Health Canada approach the prevention and management of chronic pain in Canada. It was comprised of people personally impacted by chronic pain, Indigenous Peoples, researchers, educators, and health professionals with expertise across many disciplines in the field of pain. An External Advisory Panel provided additional subject-matter guidance.

The first CPTF report, Chronic Pain in Canada: Laying a Foundation for Action, assessed the current state of pain and how it's currently addressed in Canada. This report identified the best practices and an improved approach to care, education and awareness, research and related infrastructure, and health system monitoring and was followed by their second report, Working Together to Better Understand, Prevent, and Manage Chronic Pain: What We Heard. Finally, based on the learnings of its first two reports, the Task Force produced its Third Report, An Action Plan for Canada to recognize and support people with pain in Canada by listing priority actions aimed at better understanding, preventing, and effectively treating pain across Canada.

The CPTF's third report highlights a number of knowledge gaps in pain research in Canada. The reports recommend investments in:

  • research engaging people living with pain
  • opportunities for dialogue and collaboration (e.g., conferences, workshops, webinars)
  • research infrastructure to enable precision and personalized care
  • strategic research priorities (e.g., basic science, effective models of pain care, research on vulnerable populations, and digital technologies for health including e-health and virtual care)
  • building research capacity.

Goals

IMHA's pain strategy builds on the research-related recommendations of the CPTF third report.

For this pain strategy, IMHA's primary areas of focus include funding research that:

  1. Engages people living with pain;
  2. Advances the study of models of care in painful musculoskeletal conditions;
  3. Builds capacity in pain research and its translation.

Additionally, IMHA will:

  1. Report annually on the investment in pain research through the CIHR Project competition
  2. Partner with Health Canada and other key stakeholders to identify areas for collaboration and convene stakeholders to coordinate research in pain and painful conditions that affect Canadians.  

Proposed Investments

Over the next five years (2022 to 2027) CIHR-IMHA will invest in:

  1. Team Grants: We will support at least three team grants in research evaluating models of care relating to painful conditions. Relevant topics might include: care pathways in a wide range of conditions including arthritis, fracture management as well as acute or chronic pain; multidisciplinary and interprofessional approaches to care including models that are designed by and valued by Indigenous communities; complementary and integrative therapies; health systems change with an Equity, Diversity, and Inclusion lens; ways to reduce fragmentation of care; studies of what types of clinical care models work best for whom, when, and under what circumstances; identifying communities that are hard to reach. This investment represents a minimum total of $5.9M over five fiscal years.
  2. Career Development Awards: We will support career development awards through The Arthritis Society's Stars Career Development Award Competition. This competition is the principal means by which the Arthritis Society invests to establish the research capacity among Early and Mid-Career investigators. The program promotes creativity in all domains of arthritis-related research responsive to the Arthritis Society's strategic priorities. This investment of a minimum of four awards over the five fiscal years will focus on supporting research geared toward reducing pain experienced by persons living with arthritis. This investment represents a minimum total of $900,000 over three fiscal years.
  3. Post-Doctoral Fellowships (PDFs): We will support at least three PDFs annually whose research focuses on reducing the burden of painful conditions. The funding vehicle will be the CIHR Health System Impact Fellowships (HSIF) which embeds PDFs within health system organizations that are committed to continuous learning & evidence-informed health system improvement. The cornerstones of the program include experiential learning, co-supervision, and mentorship from the health system and academic leaders, professional development training in enriched core competencies, and engagement in a National Cohort of fellows and mentors. This investment represents a minimum total of $1M over five fiscal years.
  4. Planning and/or Dissemination (P&D) Grants: We will support at least $80,000 per year through the P&D Grants within CIHR's Institute/Initiative Community Support (ICS) Program. Our aim is to foster research community development by providing grants and awards to individuals and organizations working to reduce the burden of painful conditions via research and knowledge translation activities. This investment represents a minimum total of $400,000 over five fiscal years.
  5. Priority Announcements: We will support at least two $100,000 awards through the CIHR Priority Announcements (PAs) Program. Being a part of the Project Grant competition, PAs provide partial funding for highly competitive ('near miss') research projects to build capacity in research areas aligning with the Institutes' goals and strategic plan. This future investment represents a minimum total of $1 million over five fiscal years which we anticipate will leverage additional research funding via successful follow-up submissions to the Project grant competition.
  6. Oral Health Data Analysis Grants: Investment in at least ten (10) data analysis grants to further the understanding of oral health and oral health care in Canada. This investment of a minimum total of $1M over 1 fiscal year will serve as an advancement to the past investment of 2021 in the Oral Health Data Platform.

Key Supporting Activities

IMHA will also contribute to the following activities:

  • The North American Pain School (NAPS)
    • NAPS brings together experts in the fields of pain research and management to provide an educational and networking experience for the next generation of pain researchers from a wide variety of disciplines. It provides scientific education, professional development, and connections with peers in an in-person setting. IMHA will invest $10,000 each year to support the NAPS conference (total 5-year investment: $50,000).
  • Support for Pain Canada
    • IMHA will support Pain Canada's annual conference for people with lived experience living with pain starting in November 2022.  
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