Michael G. DeGroote Institute for Pain Research and Care - 2024 Annual Report

Annual Report n 2024

The Michael G. DeGroote Institute for Pain Research & Care

Toward the conquest of pain

Vision

To further the understanding of the origins and management of chronic pain by bringing together behavioural, clinical and basic scientists to explore underlying mechanisms and therapeutic paradigms.

TABLE OF CONTENTS About Michael G. DeGroote & His Gift A Message from the Scientific Director Year at a Glance Budget

Education and Outreach

Communications Trainee Network Opioid Series eChronic Pain Recommendation Map Pain Symposium Annual Research Day Canadian Pain Care Forum Centre for Medicinal Cannabis Research Chronic Pain Centre of Excellence for Canadian Veterans Chronic Pain Network At McMaster and Around the World A Brief History

Research

Graduate Studentships Fellowships Seed Grants Catalyst Grant Team

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A Lasting Legacy...

A Pivotal Gift

About Michael G. DeGroote and his gift

In 2003, businessman Michael G. DeGroote made history when he made the largest single donation ever to a Canadian university or institution. His donation of $105 million has had a wide impact on health sciences research, education and care, and accelerated the pace of discovery at McMaster.

“Mr. DeGroote’s gift has been pivotal to advancing pain research in Canada. Not only did it enable the creation of the Institute for Pain Research and Care, but it also paved the way for both the Chronic Pain Network and the Chronic Pain Centre of Excellence for Canadian Veterans.”

- Dr. Norm Buckley, Scientific Director of the Michael G. DeGroote Institute for Pain Research and Care

McMaster’s Faculty of Health Sciences followed a “people first” strategy in allocating the $105 million gift from Mr. DeGroote.

Emphasis was placed on hiring international caliber experts in health education, research and care, particularly in the

areas of pain, infectious diseases, stroke prevention and cancer. One of the key initiatives was the Michael G. DeGroote Institute for Pain Research & Care, which received a $15 million endowment. “With this gift,” Mr. DeGroote said, “I know McMaster will be able to make new breakthroughs and make a real difference in more people’s lives.”

Michael G. DeGroote died in September 2022, at the age of 89. Though he is no longer with us, his generosity and philanthropic efforts ensure his legacy will live on and enable innovation in research for years to come.

4

“Though more than 20% of Canadians

will experience chronic pain within their lifetime, it still remains an underfunded area of research accounting for less than 1% of research funding provided by the Canadian Institutes of Health Research. ” - Dr. Norm Buckley

Scientific Director, Institute for Pain Research and Care

5

Message from the Scientific Director Singers

and

songwriters

have

long

For many Canadians, the experience of

their music, drawing attention to the ways

wait times to see pain specialists and

explored the depths of human suffering in

in which emotional pain can overshadow daily life. Joni Mitchell’s lyrics in her song

“Man from Mars” reflect this intimately,

as she sings, “Since I lost you, I can’t get through the day without at least one big

boo-hoo. The pain won’t go away. What

am I to do?” These words capture the raw experience of grief, a profound emotional pain

that

lingers

and

transforms,

sometimes even presenting with physical manifestations. Music frequently gives voice

to

this

connection

between

emotional and physical pain - something

that science is only starting to scratch the surface of.

Studies

have

shown

that

individuals

experiencing significant emotional pain,

such as depression, anxiety, or grief, report

higher levels of physical pain and have a

greater risk of acute pain developing into chronic.

Norm Buckley, BA (Psych), MD, FRCPC

Scientific Director Michael G. DeGroote Institute for Pain Research and Care McMaster University

6

chronic pain is compounded by long limited access to interdisciplinary pain

clinics, particularly in rural areas. Most

pain clinics are concentrated in urban

centers, creating barriers for those in need of comprehensive care. This lack of access

can contribute to the persistence of both physical and emotional pain, leaving many patients feeling frustrated and unsupported.

Emerging technologies, such as virtual

care platforms, are beginning to bridge the gap for rural patients, providing them

with

access

to

mental

health

professionals, pain specialists, and self-

management tools. Meanwhile, initiatives like the development of the e-Chronic Pain Recommendation Map (RecMap) are

working to consolidate the best available evidence to guide healthcare providers and patients in making informed decisions about pain management.

Year at a Glance Fast Facts

10 $738 thousand

24 59 7 20

Research awards and projects funded every year.

Spent on research awards and projects

Multidisciplinary research team members from 10 health disciplines.

Publications on the topic of pain by our members last year.

Full-time and 11 part-time Institute staff members overseeing all operations and activities.

Years advancing the understanding and treatment of pain through research and innovation.

7

Budget 2023-2024

Percentage

Amount

Administrative Costs

29%

$344,748

Operating Costs

9%

$105,591

Research Awards and Projects

62%

$738,315

TOTAL

100%

$1,188,654

Budget Categories

Sixty-two percent of our annual budget was spent directly on research awards

Research Awards & Projects (62%)

(grad studentships and postdoctoral fellowships) and research projects (seed grants, IPRC/MIRA catalyst

grant, and other funded research projects). Annual administrative

cost was 29% of the total budget,

while the operating cost (including

community engagement throughout

IPRC Symposium, Canadian Pain Care Forum meetings, National Faculty meetings) made up of 9% of the annual expenses.

8

Operating Costs (9%)

Administrative Costs (29%)

Budget 2023-2024 Additional to the research and operational activities within the Institute, our IPRC research and operational team administers 30 current projects funded in the last seven years by various sponsors:

SPONSOR

AMOUNT

NUMBER OF PROJECTS

Canadian Institutes for Health Research

$6,158,878

9

Chronic Pain Centre of Excellence

$249,282

2

Health Canada

$636,973

1

McMaster University

$1,493,839

16

University Health Network

$50,000

1

Workers’ Compensation Board of Manitoba

$160,396

1

$8,749,368

30

TOTAL Amount Awarded to Research by Year $4,000,000 $3,500,000

The current balance available amounts to $4M for research projects to complete by 2030.

$3,601,425

$3,000,000 $2,500,000

$2,250,182

$2,000,000

$1,732,680

$1,150,000 $1,000,000

$821,388

$500,000

$343,693

$0 Before 2020

11 Awards Granted

2020

3 Awards Granted

2022

3 Awards Granted

2023

7 Awards Granted

2024

6 Awards Granted 9

Education and Outreach Communications Over the past several years, the Institute for Pain Research & Care has

seen significant growth across both digital and traditional media. Our efforts on X (formerly Twitter), LinkedIn,

Instagram and Threads have led to steady increases in followers and engagement, while our web pages

continue to serve as key means of disseminating research findings.

On X, our audience has grown by

nearly 10% over the last year, with top-performing tweets taking place during the Canadian Pain Society’s

Annual Scientific Meeting generating 1,145

impressions.

Our

strategy

includes leveraging more videos and

infographics to enhance engagement.

The IPRC grew to 1,350 followers and

tweets received more than 36,000 impressions and 1,763 engagements.

LinkedIn remains an area of growth for

the

IPRC

Business2Business

communication. Strong engagement

with posts has been a highlight, with an engagement rate of 7.1%, and we are looking into boosting posts to

expand our reach. Posts received nearly

4,000

281 engagements.

impressions

and

This year, the Instagram and Threads accounts were launched. The coming year will be spent looking to increase 10

audiences on both platforms.

The Institute was one of 444 unique participants to take part in the 2024

National Pain Awareness Week social

media campaign. The aim of the

campaign was to create dialogue and draw attention to chronic pain.

Led by Pain Canada, the overarching

40,412 Impressions

campaign saw a reach of 2.2 million, with 7.6 million impressions.

Both the IPRC website and the

National Pain Centre (NPC) website

continue to serve as our key means of disseminating information. Over the

reporting

period,

traffic

to

2,044 Engagements

the IPRC website saw more than

15,000 page views, with significant contributions

from

organic

searches. The NPC website saw

more than 22,000 page views, with most traffic directed to the page hosting NPC-produced guidelines.

Looking ahead, the IPRC aims to enhance its social media presence by

increasing

collaboration

and

5.1% Engagement Rate

(per impression across platforms)

cross-platform

maintaining

its

current level of engagement. The

IPRC will also investigate expanding paid

advertising

campaigns

and

will explore partnerships to expand

our reach to our target audiences more effectively.

307 Post Link Clicks

Education and Outreach Trainee Network In addition to its ongoing funding

including information on funding

communicate their work effectively

the Institute for Pain Research &

and guidance for writing research

support

of

studentships

and

fellowships,

Care (IPRC) has spent the last

year focusing on expanding its

trainee network and offering more

opportunities for mentorship and collaboration. July 2024 marked the

opportunities,

networking

events,

proposals. As it develops, the hub will

become

a

comprehensive

platform for trainees to grow their expertise and connections within

to broader audiences. With ongoing and

a

commitment

to

mentorship, the IPRC is dedicated to shaping the next generation of pain researchers.

the pain research community.

The IPRC is not only educating the next generation of healthcare professionals, but also fostering a community of learners who are committed to advancing evidence-based medicine. I'm particularly drawn to its focus on building leaders in this field and the way it brings together students from a variety of healthcare disciplines.

- Dr. Nora Bakaa first of our lunch and learn sessions, with special guest Filipe Reis from the Federal Rural University of Amazonia discussing

the

role

of

artificial

intelligence in pain research. These

sessions are designed to provide trainees with opportunities to share

their research, gain feedback, and

improve their presentation skills, particularly for explaining complex topics

to

those

immediate field.

outside

their

The IPRC also launched a new

Trainee Hub on its website. Still in its early days, the hub aims to provide

trainees with valuable resources,

2021 Graduate Studentship Recipient

In

addition

to

expanding

the

Trainee Hub and hosting lunch

and learn sessions, the IPRC has

set specific goals to grow its

trainee network further. Increasing

membership and fostering a more robust

network

researchers

will

of

early-career

create

more

opportunities for collaboration and learning.

The ultimate goal is to offer an

environment

trainees

can

not

experts

but

also

learn

from

where only

established gain

the skills necessary to

Pictured Right: Lisandra Alemida de Oliviera, a PhD candidate and a member of the IPRC Trainee Network, presents during a project blitz at a lunch and learn session.

11

Education and Outreach Opioid Series With addiction-related issues and

providing a platform to disseminate

Canadian Pain Task Force, highlighting

imperative for healthcare providers,

from IPRC experts to a broader

collaboration among pain experts.

understand the role of opioids and

succinct resource for stakeholders,

overdose deaths increasing, it is policymakers and the public to better grasp the nuances of opioid therapy.

With so much at stake, and so much misinformation readily available, Drs Jason Busse and Norm Buckley worked

with Open Access Government an open access digital publication

based in the UK - to create a series of informative articles addressing

some of the most prominent issues surrounding opioids.

The series, which began with five

articles - the first of which was

published in April 2023, represents a new route to Knowledge Translation

for the Institute for Pain Research and

Care (IPRC). The series focuses on understanding the complexities of

opioid use, pain management, and the implications for public health

policy. Articles cover topics such as the role of opioids in treating chronic pain,

challenges

with

prescribing

guidelines and current prescribing

practices, the impact of the opioid crisis in Canada and government response and strategies.

Open Access Government plays a crucial role in this partnership by 12

research

findings

and

insights

audience.

This series serves as a

including healthcare professionals,

policymakers, and the general public, facilitating and

informed

promoting

decision-making.

discussions

evidence-based

The opioid crisis has been an issue in

Canada for nearly 25 years. Tragically,

even though prescribing has declined

since 2010, the number of deaths

associated with opioids has soared.

Most deaths are now associated with highly potent synthetic opioids

acquired through illicit markets and often mixed with other drugs or sold as other drugs without user awareness of their high potency.

Following the success of the first series of articles, the Institute for Pain Research and Care (IPRC) decided

to expand its efforts by producing

even

more

insightful content. The most recent article reports on the Canadian Pain Care and

Forum

the

the pressing need for enhanced It is only through fostering these

connections that we will continue to

improve pain management practices

and find a more cohesive approach

to addressing the challenges faced by individuals living with pain in Canada.

Articles can be accessed by visiting: openaccessgovernment.org/stakeholder/ michael-g-degroote-institute-for-painresearch-and-care/147553/

Education and Outreach

e-Chronic Pain Recommendation Map

Chronic pain is a condition that

researchers, clinical experts, policy

summaries, decision aids for patient-

but despite its prevalence, many

experience,

trustworthy recommendations and

affects

one

in

people

receive

due in part

five

Canadians,

suboptimal

care

to the inconsistent

quality of guidelines and varying

recommendations. In response to

this issue, the Canadian Institute of Health Research has backed

the creation of the e-Chronic Pain

makers, and individuals with lived including

those

from

equity-deserving groups. This structure will include an equity committee and

an advisory board composed of both national and international advisors,

with a steering committee overseeing

the entire process from development to mobilization.

physician discussions,

identifying

guidance on contextualizing them.

Ultimately,

the

e-Chronic

Pain

RecMap is expected to promote

shared decision-making and support evidence-based management for individuals living with chronic pain.

"The pursuit of evidence-based care for people living with chronic pain is complicated due to the presence of hundreds of guidelines of variable quality often providing inconsistent recommendations. My hope is that the development and dissemination of this RecMap, will help users identify trustworthy recommendations to better align clinical care with current best evidence.”

- Dr. Andrea Darzi Recommendation map (e-Chronic

Pain RecMap). Led by Dr. Andrea

Darzi, this project will create a freely

accessible

consolidate appraised

tool

to

recommendations

in

and

digital

present

pre-

key areas, including opioid use, cannabis

for

medical

purposes,

and interventional procedures for chronic pain.

To achieve this, several methods will be employed. First, we will collaborate with

national

and

international

Relevant

guidelines

employing

manual

systematically

are

gathered

being

by

searches

of

specific websites and conducting

a thorough search of electronic databases. is

being

Existing

utilized

to

infrastructure extract

key

information, including data aligned with the PROGRESS PLUS framework.

Knowledge mobilization activities are

being

such

as

developed

with

stakeholders, including resources plain

language

13

Education and Outreach Pain Symposium The Pain Symposium, hosted annually

and remotely. The event featured a

through informed movement, and Dr.

for Pain Research & Care (IPRC)

Stanford University, who discussed

of chiropractic care in reducing opioid

by the Michael G. DeGroote Institute

at McMaster University, has been pivotal in advancing chronic pain

research. The event draws clinicians, researchers, and trainees to explore

persistent post-surgical pain as a model for understanding chronic pain.

keynote by Dr. Brice Gaudilliere from biomarker recovery Other

analysis

and

to

post-surgical

presentations

predict

explored

pain. risk

assessments for surgery, enhanced recovery programs, and pre-surgical

rehabilitation. McMaster’s Dr. Gurmit

At the 2019 symposium, 11 speakers

Singh presented compelling research

speaker Dr. Karen Davis from the

disease,

shared cutting-edge insights. Keynote

on chronic pain as an autoimmune showing

how

immune

Peter Emary, who discussed the role use for non-cancer spinal pain.

The symposium continues to be a

vital platform for collaboration and

innovation, pushing the boundaries of

chronic

management.

pain

• Dr. Manon Choinière

• Dr. Jane Quinlan

• Dr. Mike Salter

• Dr. Karen Davis

• Dr. Brice Gaudilliere

University of Montreal

modulation differs between men and

chronic pain relief after treatment.

the immune response in males and a

• Dr. Matthew Chan

University

pain perception in females.

• Dr. Martin Angst

of

Toronto

the use of functional MRI to predict

women, with testosterone dampening

Dr.

stronger immune system impacting

Jennifer

of

Rabbitts

from

Washington

the

focused

on pediatric post-surgical pain and

The 2023 symposium saw Dr. Jason

pain. Dr. Manon Choinière from the

around opioid use in chronic pain,

the transition from acute to chronic

University of Montreal emphasized the need for clinical research beyond randomized

controlled

trials

to

improve pain management, while Dr. Mark Lema from the University of

Buffalo provided an engaging talk on new developments in chronic pain pathophysiology.

Busse

furthering

the

discussion

highlighting the rising number of opioid-related deaths in Canada, as

well as identifying risk factors for fatal

and non-fatal overdoses after opioid prescriptions. Dr. Kristin Schreiber from

Harvard Medical School introduced patient

phenotyping

and

the

biopsychosocial model as tools for

After a two-year hiatus due to the

predicting chronic post-surgical pain.

returned as a hybrid event - allowing

Shirin Modarresi, who focused on

COVID-19 pandemic, the symposium

Other notable speakers included Dr.

participants to join both in person

managing

14

knee

osteoarthritis

Pictured Right: Dr. Norm Buckley and Dr. Kristin Schreiber at the 2023 MGD Pain Symposium.

and

Keynote Speakers over the years include:

discussed

University

research

University of Toronto Chinese University of Hong Kong Stanford University

University of Oxford

University of Toronto Stanford University

• Dr. Kristin Schreiber Harvard University

Education and Outreach Annual Research Day The inaugural Michael G. DeGroote Institute for Pain Research & Care (IPRC) Research Day took place in

2019, bringing together researchers, clinicians, and trainees to discuss pain and

research

foster

advancements

collaboration

disciplines.

Held

on

across

February

14, 2019, at McMaster University, the

event

showcased

a

wide

range of studies, including NMDA antagonists, cannabidiol for post-

surgical pain, and the role of T cells in chronic pain and sex differences.

Notable

presenters

included

Dr.

Harsha Shanthanna and Dr. Jason

Dr. Thomas E. Doyle, of McMaster’s Department of Computer and Electrical Engineering, discusses the role of artificial intelligence in medicine, health research and chronic pain at the MGD 2024 Annual Research Day.

cannabis legalization and persistent

allodynia and Dr. Parminder Raina

higher rates than in both civilian

research in aging populations.

topics included childhood anxiety

Busse, who examined the effects of post-surgical pain.

Since

then,

Research

Day

has

highlighting opportunities for pain

women and veteran men. Other

expanded to include contributions

In 2023, Research Day moved to

in medical contexts, skeletal muscle

School of Rehabilitation Science,

discussions

statin-induced

and AI’s role in pain research. The

brain-computer

how pain research is evolving across

from the Department of Pathology,

and others. Topics have ranged from post-surgical pain to pain management

for

veterans

and

using proteomics and deep learning to predict susceptibility to Complex Regional Pain Syndrome.

After a brief hiatus, the 2022 Research

Day returned in a hybrid format at the Royal Botanical Gardens, with

Dr. Tara Packham presenting on

the Rock Garden Bistro, featuring

damage in Type 1 Diabetes patients,

muscular

pain,

event continued to demonstrate

interfaces,

opioid

coherence

on

corticomuscular reduction

in

surgeries, and the cognitive effects of postoperative pain.

The most recent Research Day was

held at The Gas Works in Hamilton.

Dr.

Eleni

Hapidou

opened

disciplines,

with

on

pain

for

mechanisms

aging-related

osteoarthritis processes.

presentations

and

in

knee

chronic

pain

biomarkers

with

a presentation on chronic pain among veteran women, revealing

15

Education and Outreach Canadian Pain Care Forum Established in 2016, the Canadian Pain

for better physician training. Other

Veterans in managing pain; Ontario

initiative

in pain education for nurses and

Chris Auger, providing an overview of

Care Forum (CPCF) is a collaborative pain

care

focused and

on

advancing

education

across

researchers,

and

Canada. It brings together healthcare professionals,

individuals with lived experiences of

chronic pain to promote knowledge

exchange, research collaboration and policy advocacy.

Speakers have included a wide range

of people. Katie Gasparelli, (Six Nations

Health Services) discussed McMaster

University’s Pain Program, focusing on Indigenous experiences with chronic

pain. Dr. Fiona Campbell (University of

Toronto)

and

Maria

Hudspith

(PainBC) , co-chairs of the Canadian Pain Task Force, provided an overview of the work that group. The Task

Force developed a comprehensive national pain strategy, emphasizing

interdisciplinary care that includes the voices of people living with pain.

During the COVID-19 pandemic, CPCF meetings transitioned from a hybrid

format to online, with a heightened focus on improving pain education

for healthcare professionals. Early

2021 discussions included Dr. Lisa Graves and Fran Kirby, addressing

the opioid crisis and a new curriculum 16

speakers have highlighted the gaps psychologists.

The

forum

presented

pain

care.

Presentations

importance Dr.

Hillel

pain

of

and Susan Tupper, of Saskatchewan

included

storytelling to challenge stigma with

interdisciplinary

management

prescription drug diversion in Canada

the

on

Finestone’s

Provincial Police Detective Constable

nurse-led

program

Health Authority, looking at graphic chronic pain and substance use.

and

Over the years, a reoccurring theme has

Jennifer Nash and Dr. Fiona Webster.

for pain research, as, historically, less

discussions on equity in care led by Dr. These

discussions

examined

the

challenges marginalized populations face in accessing adequate pain care.

been the need for increased funding

than 1% of the Canadian Institutes of Health Research’s budget has been allocated to this area. With more

In 2023, initiatives like the Power Over Pain

than 130 members representing 80

highlighted, exploring individual pain

to push for improved pain care

approaches to pain management.

education across Canada.

Portal and the Circa Pain Project were

organizations,

experiences and non-pharmacological

through collaboration, advocacy and

Most

In the coming year, the Canadian

recently,

presenters

have

the

CPCF

continues

included Julie Masse and Dr. Joanne

Pain Care Forum aims to strengthen

occupational

chronic

advocating for the implementation

interdisciplinary

findings into actionable policy. Our goal

of

its engagement with policymakers,

David

of the Canadian Pain Task Force’s

approaches in the Atlantic Mentorship

is to ensure these recommendations

People in Pain Network, sharing her

improve pain care across the country.

Higgins, pain

Flusk,

discussing

therapy

management;

highlighting

Network;

Virginia

the

in

Dr.

McIntyre,

role

of

the

story as a chronic pain patient; Veteran and advocate Tom Hoppe, addressing the

unique

challenges

faced

by

translate into meaningful changes that

Partnerships & Collaborations Centre for Medicinal Cannabis Research A collaboration between McMaster

University and St. Joseph’s Healthcare Hamilton, the Michael G. DeGroote

Centre for Medicinal Cannabis Research (CMCR)

leverages

world-class

scientists and acclaimed expertise in

health research and evidence-based

medicine to advance the science of medical cannabis, assessing its

potential benefits and risks. Since 2017, it has united nearly 50 McMaster faculty and initiated 26 research projects.

The Centre’s vision is to establish a research-based

understanding

of

medical cannabis, encompassing its therapeutic effects and potential risks.

Its mission revolves around three key strategies: 1.

Curating

existing

literature

determine the state of evidence.

to

2. Conducting cutting-edge research for generating new evidence.

3. Establishing a network of cannabis researchers to support its vision.

The Centre’s commitment to advancing cannabis

knowledge

is

reflected in its funded external grants totaling

$7.54

million,

supporting

topics like cannabis and psychosis, metabolism,

pain

is also leading the Canadian Medical

Talks.” A character named Bud presents

which seeks to meaningfully connect

audience in an approachable, engaging

Cannabis

Clinical

cannabis

management,

anxiety, and more. Recently, the CMCR

Trials

researchers

Network,

and

experts

Communications, Events Continued Education

and

across the country.

The

Research Grants and Projects medical

CMCR launched its "Bud Talks" initiative earlier this year and has covered topics such as cannabis use in older adults and cannabis use disorder.

Centre

outreach

channels,

continues

via

its

to

prioritize

communication

enhancing

knowledge

sharing on medicinal cannabis through revamped social media and newsletters.

This past year saw the launch of the CMCR

launch

its

new

knowledge

translation initiative known as “Bud

scientific evidence to a mainstream way. Medical cannabis patients are currently receiving information from

a variety of sources who may not have received specialized training on cannabis. “Bud Talks” combines the expertise

of

researchers,

clinicians,

learning design specialists and a team of talented animators to breakdown the

latest cannabis research in a way that is accessible to everyone.

To learn more about Bud Talks, visit: budtalks.ca

17

Partnerships & Collaborations Chronic Pain Centre of Excellence for Canadian Veterans The Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE) is honoured to have a collaborative relationship with the Michael G. DeGroote Institute for Pain Research and Care (IPRC). The IPRC was integral to the creation of the CPCoE and embedded our organization with a focus on the importance of working with people with lived experience. The CPCoE continues to uphold this principle of engagement and have recently adopted a new priority setting process. Using a process based on the work of the James Lind Alliance, the CPCoE solicited issues of importance from the Veteran, clinician and policymakers’ stakeholders. The research team then explored these issues with the assistance of their Advisory Council for Veterans (ACV) and then prioritized the areas to be explored through research. Through this challenging but rewarding process, the ACV identified top research priorities for the CPCoE that will help set the scientific direction for their research over the next few years.

In fiscal year 2023-2024, the CPCoE funded 10 new research projects bringing the total number of active research projects focused on chronic pain in Veterans to 34.

18

The CPCoE hosted a special lunch even at the Canadian Pain Society's Annual Scientific Meeting. The panel was moderated by Chief Scientific Officer Dr. Abhimanyu Sud and featured Drs Robin Campbell Bromhead and Joy MacDermid, and retired Canadian Armed Forces Sergeant Anouk Beauvais.

To date, the CPCoE has partnered with a total of 29 different research institutions across Canada as well as in the United States and Australia.

To accelerate the knowledge mobilization of research findings, the CPCoE actively collaborates with funded researchers to support the development and dissemination of knowledge mobilization resources. Knowledge mobilization projects can include anything from lay summaries of projects and presenting at conferences to more interactive ones, such as courses for journalism students

and interactive videos.

The IPRC looks forward to working with the CPCoE to reach new milestones in the goal of keeping hope alive through Veteran-first chronic pain research.

To learn more about the CPCoE visit: http://veteranschronicpain.ca

Partnerships & Collaborations Chronic Pain Network: Knowledge Mobilization & Implementation Science This past year marked a significant period of growth and achievement for the Chronic Pain Network (CPN), as we successfully completed the second year of our Knowledge Mobilization Implementation Science focused grant. A key highlight was the addition of Rachel Roy, our new Knowledge Broker based at McMaster University.

Rachel’s immediate contributions were evident with the launch of our In Motion series, which distills the research outcomes of CPN-funded projects into accessible, publicfriendly formats.

CPN hosted a high-profile breakfast panel at the inaugural Canadian Pain Society/Health Canada National Congress on Pain in Ottawa. This event provided a crucial platform to showcase CPN’s work to federal policymakers, including the Hon. Ya’ara Saks, Minister of Mental Health and Addictions. The panel featured insightful contributions and discussion from Drs. Rachael Bosma, Norm Buckley, and Nader Ghasemlou, along with Jennifer Daly-Cyr, a person with lived experience and co-chair of the CPN Executive committee, further underscoring the importance and impact of our initiatives.

Left to Right: Dr. John Pereira (President of the Canadian Pain Society), The Honourable Ya’ara Saks, Dr. Norm Buckley, Tania Di Renna (Medical Director of the Toronto Academic Pain Medicine Institute (TAPMI)), Kate Nicholson (Executive Director of the United States National Pain Advocacy Centre), Dr. Hance Clarke (President Elect of the Canadian Pain Society), Maria Hudspith (Director of PainBC), Virginia McIntyre (President of the People in Pain Network) and Jennifer Daly Cyr (patient partner with the Chronic Pain Network) at a meeting held in Ottawa following the National Congress on Pain.

Looking ahead, CPN anticipates several accomplishments in the coming year. Our annual meeting in October will debut our firstever hackathon for trainees, where teams will tackle challenges outlined in the Action Plan for Pain in Canada, with a strong emphasis on knowledge mobilization. Another milestone will be the official launch of Pain Connect during National Pain Awareness Week (NPAW) in November, a dynamic new hub designed to link researchers

with individuals living with pain.

Additionally, during NPAW, we will co-host a virtual panel event on chronic pain with Research Canada and the Parliamentary Health Research Caucus.

Stay connected and informed by visiting our newly updated website: https://cpn-rdc.ca/

19

Partnerships & Collaborations At McMaster and Around the World Collaboration is an essential dimension of research. It brings together diverse expertise and perspectives from different cultural and clinical contexts. It allows for the sharing of ideas, data, best practices, research methodologies and even solutions, accelerating discoveries and ensuring projects are relevant to broader audiences - across disciplines, across conditions and across countries.

The Institute for Pain Research and Care continues to strive towards creating meaningful opportunities to

collaborate at the institutional level within McMaster; at the national level, engaging with researchers across the country; and at the international level, forming relationships with health researchers abroad to include more diverse populations, addressing widespread issues and incorporating new best practices and approaches.

This year, saw the Institute form partnerships across Canada, at postsecondary institutions like Western University, the University of Toronto,

Queen’s University, the University of Montreal, the University of Alberta and the University of British Columbia; as well as around the world, in countries like the United States, Australia, the United Kingdom, Iran, Switzerland, China, Denmark, Netherlands, Norway, Brazil, Ireland, India, Spain, Greece, Poland, Germany, Finland, Italy and Sweden.

Institute research and collaborations have produced more than 340 publications since 2018, resulting in more than 5,000 citations.

The Institute for Pain Research and Care has produced more than 300 publications since 2018, with more than 1,800 co-authorships and representing collaborations with more than 50 organizations and institutions.

20

“The IPRC serves as an interdisciplinary incubator for trainees. Reflecting the diversity of our members, students from different programs and professional backgrounds are engaged and mentored in our work. They gain valuable experience in conducting research built on innovation, robust methods, patient engagement and multidisciplinary collaborations across the Faculty of Health Sciences and beyond.”

- Dr. Tara Packham

Assistant Professor, School of Rehabilitation Science and 2017 Pain Fellowship Recipient

Over the last 20 years, the Institute for Pain Research and Care (IPRC) has been instrumental in laying the groundwork for several key initiatives that have advanced pain research in Canada. A prime example of this is the Canadian Pain Task Force (CPTF), which arose out of a deliberative dialogue, held in conjunction with the McMaster Health Forum and the IPRC’s Canadian Pain Care Forum (CPCF). Attendees, which included people with lived experience, identified key steps needed to begin the process of creating a national pain strategy. Insights gained during the discussion inspired Health Canada to form the CPTF, an important body responsible for providing recommendations on pain care policies across the country. The IPRC’s Scientific Director, Norm Buckley, served as a member of the external advisory panel for the Task Force, helping to shape its direction and impact.

Beyond its work on national pain policy, the IPRC hosts and was a key part of establishing the Chronic Pain Network (CPN), one of five research networks funded through the Strategy for Patient Oriented Research, which engages people with lived experience actively as partners throughout the research process to ensure Network-funded research is relevant to the needs of patients and that outcomes are directly applicable to improving patient care, access to treatment and health outcomes. Acting as the host institution, the IPRC provided logistical support—such as staffing and office space—and strategic guidance to ensure the Network’s success.

Further expanding its influence, the IPRC helped support the development of the Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE).

This Centre focuses on the unique pain management needs of veterans, blending research, clinical care and educational initiatives to improve outcomes for those who have dedicated their lives serving our country.

Twenty twenty-four marks 20 years since the founding of the Institute for Pain Research and Care, and 10 years since the Institute launched its fellowships, studentships and seed grant awards. Since 2014, the IPRC has provided more than $870,000 in funding to 11 pain fellows, who represent seven different disciplines and have authored more than 462 publications. It has provided more than $260,000 in funding through 13 graduate studentships. And it has provided 29 research projects with more than $865,000 in funding. One of the key initiatives aimed at promoting groundbreaking research is the Catalyst Grant, introduced in 2019. This joint effort with McMaster’s Institute for Research on Aging (MIRA) supports interdisciplinary studies exploring novel pain treatment methods.

IPRC awards have funded projects that span a wide range of approaches to pain management. For instance, the Topicals for Osteoarthritis Pain In Knee Surgery (TOPIKS) trial is examining the use of topical treatments postknee surgery. Other studies, such as Opioid Reduction in Orthopedic Surgery (OREOS), explore strategies to minimize opioid use in following surgery, critical to addressing the ongoing opioid crisis. The IPRC is also leading research on cannabinoids and their potential in pain management.

One such project investigates the Analgesic Effects of Cannabinoids in an Animal Model of Post-Surgical Chronic Pain, particularly examining sex differences in response to treatment. This exploration into sex-based differences extends to other studies, including one on the Neuroprotective Mechanisms of Progesterone and Pregabalin for treating chronic neuropathic pain. With its commitment to advancing the understanding of pain, the IPRC has also embraced cutting-edge technologies. Projects like the use of Artificial Intelligence to Understand the Biological Mechanisms of Chronic Neuropathic Pain and the development of a Corticomuscular Coherence Brain-Computer Interface for treating chronic neck pain highlight the Institute’s drive to innovate. Through its research initiatives, the IPRC seeks to improve pain management for those living with chronic pain and guide future researchers in developing evidence-based treatments.

A Brief H 24

2003

2004

2011

2014

2016

McMaster University receives an unprecedented donation of $105 million from Michael G. DeGroote.

The Institute for Pain Research and Care is founded.

The National Pain Centre is founded.

The Institute for Pain Research and Care establishes Pain Postdoctoral Fellowships, Graduate Studentships and Seed Project Awards.

The Institute for Pain Research and Care becomes the host institution and home of the coordinating centre for the Chronic Pain Network - one of five national networks addressing chronic disease, funded through the Strategy for Patient Oriented Research.

McMaste Healthc G. De Canna a par medicin of $1 m relea C

History...

2017

er University and St. Joseph’s care Hamilton launch the Michael DeGroote Centre for Medicinal abis Research, which becomes ner toto the Institute inin funding the rtner the Institute funding al Cannabis for a a total total nal cannabis Research research for million. The National Pain Centre ases the Opioid Guideline for Chronic Non-Cancer Pain..

Pain.

2019

2021

2022

2024

In April, the Honorable Ginette Petitpas-Taylor announces the Canadian Pain Task Force and its External Advisory Panel, which includes Dr. Norm Buckley. In July 2019, the Honorable Lawrence MacAulay visits McMaster to announce the Chronic Pain Centre of Excellence for Canadian Veterans, seeking to develop therapies for health professionals nationwide.

The National Pain Centre receives funding from Canadian Institutes of Health Research (CIHR) to develop a guideline for medical cannabis use to treat chronic pain.

The Chronic Pain Network receives additional funding to support Knowledge Translation efforts. The National Pain Centre receives funding from Substance Use and Addiction Program to update the Opioid Guideline for Non-Cancer Chronic Pain.

eChronic Pain Recommendation Map receives $750,000 in funding from CIHR. National Pain Centre finalizes revisions to the Opioid Guideline for Non-Cancer Chronic Pain.

27

“In the next 10 years, I would like to see the IPRC and NPC achieve groundbreaking advancements in pain research and management.

Establishing conditions that leverage AI and novel technologies will position them as flagship institutions in pain research and evidence synthesis.

This strategy will drive innovative, evidence-based treatment protocols, foster international collaborations, and support interdisciplinary research initiatives.”

- Dr. Malahat Khalili 2022 Pain Fellowship Recipient

28

Institute for Pain Research & Care Graduate Studentships

“The IPRC Graduate Studentship has provided me direct financial support to pursue research training and project work focused on guideline development pertaining to pain research. It has also connected me to a broader network of talented trainees, clinicians, and researchers.”

- Arnav Agarwal

Arnav Agarwal, BSc Masters Student

Project Titles: The development of trustworthy guidance addressing whether spinal fusion surgery, when added to spinal decompression, improves patient-important outcomes among individuals with low back pain related to lumbar spinal stenosis and spondylolisthesis Supervisor: Dr. Jason Busse

Brief Overview and Progress to Date

The proposed work was a trustworthy practice guideline

regarding spinal decompression with or without fusion surgery for adults with low back pain related to lumbar spinal stenosis

and spondylolisthesis. Landmark longitudinal five-year data

from a multi-centre, non-inferiority randomized trial has been

published in recent months, officially triggering initiation of the Rapid Recommendation process. A multi-disciplinary, unconflicted guideline panel has been identified and invited

to participate. Linked systematic reviews and meta-analyses have been initiated to inform the guideline, one including

randomized trials evaluating benefits and harms of spinal decompression with versus without fusion surgery; and

another of observational studies regarding infrequent and serious harms. The guideline panel will be convened shortly, initially to define the definitive clinical question, any subgroups

of interest and values and preferences of average patients that will underly recommendations; and subsequently to review summaries of available evidence and to move from evidence to recommendations. We anticipate completion of this work

by early spring 2025. Evidence summaries and associated

practice guidance will be made available via MAGICapp, and recommendations will be cross-published in The BMJ with an international readership, accompanied by interactive visual infographics and decision aids for shared decision-making.

29

Institute for Pain Research & Care Graduate Studentships Stevie Foglia, BSc PhD Candidate

Project Title: Understanding the mechanisms that underpin the development of chronic post-surgical pain; predicting risk using neurophysiology and predictive modeling Supervisor: Dr. Harsha Shanthanna

Brief Overview and Progress to Date

Chronic post-surgical pain (CPSP) following thoracic

surgery has been shown to be one of the most prevalent

with an incidence of 30-50% following both thoracotomy and thoracoscopy procedures. CPSP is a debilitating

condition associated with depression, anxiety, and

decreased quality of life. Despite this, challenges remain in identifying accurate preoperative risk factors that

may predict the development of CPSP following thoracic surgery. Transcranial magnetic stimulation (TMS) and electroencephalography (EEG) offers an opportunity to

investigate neurological biomarkers that may contribute to the development of CPSP. The goal of this project is to

identify pre-operative risk factors that may make some more likely to develop CPSP. The goal of this project is

also to investigate cortical changes associated with the

genesis of CPSP. This project has been submitted to the

Hamilton Integrated Research Ethics Board and study recruitment is planned to commence in August 2024.

30

“The IPRC funding has been integral in supporting my PhD and allowing me to conduct my research in chronic post surgical pain. The support has allowed me to gain the skills and knowledge necessary to conduct the research.”

- Stevie Foglia

Institute for Pain Research & Care Fellowships

“Our IPRC funding is instrumental in helping us to establish feasibility of a definitive trial, which if successful will be critical to supporting a grant for a definitive cluster RCT.” - Peter Emary

Peter Emary, DC Postdoctoral Fellow

Project Title: Impact of Chiropractic Care on Opioid Use for Non-Cancer Spinal Pain: A Systematic Review and Pilot Cluster Randomized Controlled Trial Supervisor: Dr. Jason Busse

Brief Overview and Progress to Date

This past year, I was awarded funding in excess of $200,000 from the CIHR, the Michael G. DeGroote IPRC,

and the Canadian Chiropractic Research Foundation to support our pilot cluster RCT on the impact of

chiropractic care on opioid use among adults with chronic non-cancer spinal pain. This trial has been registered on ClinicalTrials.gov (ID: NCT06160947),

and we are currently working with Dr. Sheila Sprague,

PhD and her team at the Surgical Methods Centre at McMaster University to finalize our study protocol

and data collection forms. We are also preparing a submission for ethics approval. We have successfully

engaged four Ontario Community Health Centres

(CHCs) in Cambridge, Kitchener-Waterloo, Guelph, and Cornwall to participate in our pilot trial. Our next

step is to train physicians at each CHC on trial-related activities and Good Clinical Practice guidelines. Our

aim is to conduct onsite initiation visits and enroll our first trial participants in December, 2024.

31

Institute for Pain Research & Care Fellowships Malahat Khalili, MSc, PhD Postdoctoral Fellow

Project Title: Comparative effectiveness of pharmacological prophylaxis for chronic migraine: a systematic review and network meta-analysis of randomized controlled trials Supervisor: Dr. Behnam Sadeghirad

Brief Overview and Progress to Date We

have

(NMA)

on

conducted

a

network

pharmacological

meta-analysis

prophylaxis

for

migraine management. The research includes 185 RCTs with 41,642 participants, aiming to provide

insights

into

the

most

indicate

that

calcium

effective

and

tolerable

channel

blockers,

interventions for preventing migraines. Key findings CGRP

antagonists, and beta-blockers are among the

most effective treatments for reducing monthly migraine days The results highlight the importance of these pharmacological treatments in managing

chronic migraines and provide a hierarchy of their effectiveness based on high to moderate certainty evidence. Clinicians can use our findings to prescribe

and decide the best treatment for patients based on

their profiles. The primary draft of the manuscript is

ready.

I am also working on another NMA focused on

pharmacological prophylaxis for patients with a history of preventive treatment failure; findings would

be interesting for clinicians in this topic.

32

“The IPRC award has allowed me to concentrate fully on my research, providing a valuable opportunity to collaborate with experts and significantly advance my NMA project on migraine management.”

- Dr. Malahat Khalili

Institute for Pain Research & Care Seed Grants

“This study will facilitate the development of a robust prognostic model to guide clinical decisions or enrolment in interventional studies, with the ultimate goal of identifying pathways for effective prevention and management of chronic pain after knee replacement surgery.”

- Dr. Behnam Sadeghirad

A systematic review and individual patient data (IPD) meta-analysis of perioperative prognostic factors associated with chronic pain after total knee arthroplasty and development of a risk prediction model Primary Investigator: Behnam Sadeghirad, Pharm.D., M.P.H., Ph.D. Co-Investigator: Jason Busse, DC, PhD Start Date: 2023

Brief Overview and Progress to Date

Mac-PROSPER project aims to perform a systematic review

of

prospective

randomized

and

non-

randomized studies to identify eligible data, design and develop an international repository of individual

patient data for perioperative prognostic factors of chronic post-surgical pain after TKA, and develop and validate a prediction model for the development

of chronic pain after knee replacement surgery. We have recruited an international group of researchers

willing to collaborate on this project and have acquired commitments from investigators to provide

access to their ongoing or completed study data which exceeds 22,000 patients. We have developed a website (https://mac-prosper.ca) for the project

that provides details of our plans, collaborators, data sharing requirements, and resources available for

knowledge

collaborators.

users,

and

current

and

future

33

Institute for Pain Research & Care Seed Grants A Persistent Post-Surgical Pain Survey Primary Investigator: Jason Busse, DC, PhD Start Date: 2020

Brief Overview and Progress to Date

An influential survey of 5,130 patients attending 10

outpatient chronic pain clinics found that 23% attributed their complaints to a surgical procedure. According

to Google Scholar, this survey has been cited over 350 times; however, there are limitations with this report.

The sample was restricted to patients in North Britain,

there are no details reported regarding the response

rate, and the data was acquired between 1989 and 1992. These issues suggest that generalizability to the current Canadian context is uncertain.

We surveyed

756 Canadian adults living with chronic pain to establish

to what cause they attributed the development of their pain, and what interventions they have pursued and perceived effectiveness.

Due to the complexity of collected data on chronic pain, there were some inconsistencies on initial data analyses.

As such, we have reviewed the validity of

multiple variables and other strategies with investigators

and researchers to ensure accurate regression analysis

and other statistical analyses. We are now creating and organizing data into tables and figures, in order to finalize

the manuscript for publication.

34

“Surgery is a controlled injury and allows an opportunity to understand the genesis of chronic pain. Our survey will help inform this issue, and identify which interventions have been associated with improvement.”

- Dr. Jason Busse

Institute for Pain Research & Care Seed Grants

“Cannabis products are increasingly used to manage pain, but often with little empirical evidence. Our pilot trial will provide critical information about the feasibility of a definitive trial to explore the effectiveness of cannabidiol for reducing persistent pain after total knee replacement.”

- Dr. Jason Busse

Feasibility of a Definitive Trial to Evaluate the Effect of Cannabinoid Oil, Versus Placebo, on Chronic Pain Post-Surgical Pain and Functional Outcomes in Patients Undergoing TKA Primary Investigator: Jason Busse, DC, PhD Start Date: 2017

Brief Overview and Progress to Date

We were funded to launch a pilot randomized

controlled trial of cannabidiol (CBD; a non-psychotropic

cannabinoid) vs. placebo for patients undergoing total knee replacement. Demonstration of feasibility would

support a definitive trial to explore the effectiveness for reducing persistent post-operative pain. A complication that we estimate affects 1 in 4 patients.

Our efforts were complicated as Health Canada only

requires that cannabis producers adhere to Good Production Practices (GPP) in order to sell to consumers,

but require products that are compliant with Good Medical Practices (GMP) for use in a clinical trial. The latter

is a much higher bar, and after meeting with close to 200

producers we were unable to find any that had developed a GMP product. We were not alone, and other groups

attempting randomized trials of cannabis products had been similarly affected.

In response, we arranged for an open letter signed by 200 scientists across Canada to Heath Canada alerting them to this problem.

In response, Health Canada changed their regulations

to permit use of GPP cannabis products in pilot trials.

We have now completed enrollment of 40 patients

undergoing total knee replacement, randomized to CBD

or placebo, and are completing follow-up. We anticipate completion of our trial in 2025.

35

Institute for Pain Research & Care Seed Grants Advanced controlled transcranial magnetic stimulation to modulate neural plasticity and alleviate pain in diabetic neuropathy’ and uses a new TMS technology that aims to reduce pain symptoms in diabetic neuropathy Primary Investigator: Aimee Nelson, PhD Start Date: 2023

Brief Overview and Progress to Date

The goal of the research is to improve symptoms of pain in individuals living with painful diabetic

neuropathy. In a double-blinded cross-over design, individuals will receive two weeks of real or sham

non-invasive brain stimulation, followed by a washout period, followed by the opposite brain stimulation (real or sham).

Measures of pain intensity, and

neurophysiological measures are performed before

and after each arm of the intervention. To date, we have acquired data from ~6 participants.

“Funding from IPRC has allowed this pilot study to occur - these funds have been used to pay transportation costs to and from McMaster and provide study honorariums. The funds have also been used to purchase a biothesiometer for an objective assessment of vibrotactile perception.”

- Dr. Aimee Nelson

36

Institute for Pain Research & Care Seed Grants

“Using AI one can predict the electrophysiological patterns of neuropathic pain.”

- Dr. Gurmit Singh

Artificial Intelligence to Improve Understanding of the Biological Mechanism(s) of Chronic Neuropathic Pain Primary Investigator: Gurmit Singh, PhD Start Date: 2022

Brief Overview and Progress to Date

The project was based on computer modelling using experimental data from electrophysiological

studies in an animal model of neuropathic pain.

We used the Huxley model to fit data to the sodium

channel Nav1.8. This was the first study to accurately

predict the functionality of sodium channel using experimental data.

Publications: https://doi.org/10.3389/fncom.2024.1327986

37

Institute for Pain Research & Care Seed Grants A Pilot Study of Association of BIOmarkers and Neuropathic Pain with Intercostobrachial Nerves Sparing in breast surgery to improve Persistent post-surgical pain-an International RandomizEd controlled trial (BIO-INSPIRE) Primary Investigator: Harsha Shanthanna, MD, PhD, FRCPC Start Date: 2021

PBMT for Pain Relief After Caesarean Section Primary Investigator: Harsha Shanthanna, MD, PhD, FRCPC Start Date: 2023

Brief Overview and Progress to Date

In this RCT, 180 pregnant women planned for elective CS will be randomized to receive either active or inactive

Brief Overview and Progress to Date

PBMT. Pain outcomes along with wound healing, post

levels of IL-1β, IL-6, and TNFα and neuropathic pain in

collected.

BIO-INSPIRE is a feasibility study that evaluated cytokine

natal depression and chronic post surgical pain will be

patients participating in the INSPIRE study (a multi-

So far, we have randomized 85 of 100 patients recruited

centre pilot study of 50 patients to establish the effect of intercostobrachial nerve preservation on persistent post-surgical pain following breast cancer surgery) and underwent axillary lymph node dissection during breast cancer surgery. The INSPIRE study recruited

participants from two hospitals in Canada and two hospitals in India and 46 of the 50 patients were

included in the BIOINSPIRE study. Study samples of BIOINSPIRE were analyzed at Hamilton (Canada) and

Bangalore (India) separately. We plan to publish the study results in the next few months.

38

(50% of the target). The study has been going well. We plan to complete the study in the next 6-12 months.

“The funding from IPRC has been an important source of support and encouragement.”

- Dr. Harsha Shanthanna

Institute for Pain Research & Care Seed Grants Topicals for Osteoarthritis Pain in Knee Surgery (TOPIKS): A Pilot Randomized Controlled Trial Primary Investigator: Harsha Shanthanna, MD, PhD, FRCPC Start Date: 2019

Brief Overview and Progress to Date

Opioid Reduction in Orthopedic Surgery (OREOS): A Feasibility Randomized Controlled Trial in Total Knee Replacement Patients Primary Investigator: Harsha Shanthanna, MD, PhD, FRCPC Start Date: 2022

Topicals for Osteoarthritis Pain In Knee Surgery (TOPIKS) is a

Brief Overview and Progress to Date

(CBD) with or without non-steroidal anti-inflammatory

feasibility of a multicomponent pathway on patients

been started because of the regulatory (Health Canada)

clinical objectives are to determine the effects of the

proposed pilot trial evaluating the effect of topical cannabis

The main objective of this pilot trial is to assess the

drugs (NSAIDS) as against placebo. The trial has not yet

having elective total knee arthroplasty, while the

requirements necessary for a Cannabis based trial.

pathway on opioid-free pain control, persisting pain

We also had challenges in obtaining the product from a

suitable manufacturer. Presently, we are working with Dr. Joseph Gabriele of Delivra and we are testing the CBD

patches for safety. This is a crucial step in obtaining Health Canada approval for the study. We are hopeful that we

will be ready to apply for regulatory approval and start the study in the next 12-18 months.

and opioid use, functional knee outcomes, quality of life, and return to function. Patients in the intervention

group will undergo a multicomponent intervention pathway that will be facilitated by an intervention

coordinator linking each patient and their surgical/ perioperative team.

Full recruitment and follow up has been completed.

100 patients were recruited from 3 centres, with 56% of

them being women. Nearly one third patients reported increased pain after knee arthroplasty with 17%

qualifying as CPSP. We demonstrated that a largescale trial comparing our intervention pathway is

feasible. We will be applying for the main study grants.

39

Institute for Pain Research & Care Seed Grants An Investigation into the Effectiveness of a New Transitional Pain Service (TPS) on Opioid Cessation After Broad Range of Surgeries Done at Hamilton Health Sciences (HHS) and its Affiliated Hospitals Primary Investigator: James Paul, MD, MSc, FRCPC Start Date: 2019

Brief Overview and Progress to Date

Hamilton Health Sciences (HHS) affiliated hospitals use the Transitional Pain Service (TPS) model. Collecting

data from the Acute Pain Service (APS), TPS and

chronic pain clinic, our retrospective study seeks to elucidate risk factors associated with the development

of chronic post-surgical pain (CPSP) and long-term opioid use and evaluate the efficacy of TPS in reducing

opioid use in the Hamilton-Niagara Region.

Very few studies have taken a comprehensive large-

scale approach in assessing whether a TPS is more effective at getting patients off opioid analgesia (in comparison to patients in a control group with usual

pain care), instead choosing to examine the incidence

of and risk factors for developing CPSP. Results from our study will provide additional evidence for TPS as

a standard of care for managing CPSP, decreasing opioid use and giving insight into the role of the pain clinician’s increasing role in the opioid crisis.

40

“The IPRC funding has enabled us to develop the tools necessary to evaluate our newly established Transitional Pain Service to see if it’s achieving its objective of providing high quality analgesia to our complex pain patients and assisting them in transitioning off opioid analgesia after surgery.”

- Dr. James Paul

Institute for Pain Research & Care Seed Grants

“The IPRC-MIRA funding has allowed to start my program on the relationship between pain and cognition in older people, in the perioperative setting.”

- Dr. Maura Marcucci

Who is Susceptible to Developing CPSP? A HighThroughput Clinical Proteomics-Based Approach for the Prediction of Susceptibility Primary Investigator: Maura Marcucci, MD, MSc Start Date: 2021

Brief Overview and Progress to Date

The ArthroCaP project is a mixed methods study exploring the association between chronic post-

surgical pain and cognitive decline in ≥50 years old

patients who are undergoing total arthroplasty. The quantitative part is a cohort study of patients who are longitudinally followed after surgery and assessed

remotely upon their pain and cognitive function; it includes also the evaluation of biomarkers associated with pain and cognitive dysfunction. We just closed the

study with the completion of the 1-year follow-up for the last participant. We recruited 93 participants, of whom, 67 completed the 1-year visit. 30 participants consented

to the biomarkers evaluation. We obtained extension of the project timeline (at the same funding). We are

currently cleaning the database for analyses for the first

publication. Given the disruption due to the pandemics

we decided to put the qualitative component of the

study (which would explore expectations and lived experience with surgery) on hold.

41

Institute for Pain Research & Care and McMaster Institute for Research on Aging Catalyst Grants Quantitative Measurements of Chronic Pain Primary Investigator: Matiar Howlader, B.Eng, PhD Start Date: 2023

Brief Overview and Progress to Date

Aging and chronic diseases are closely intertwined. As

we grow older, our bodies experience significant cellular and molecular damage. Conditions such as diabetes,

cancer, Post-Traumatic Stress Disorder (PTSD), and depression often accompany chronic pain, making

diagnosis and management challenging due to the pain’s invisible nature and the variability in patient-

reported scales. To address these challenges, this project aims to develop electrochemical sensors for biomarker

detection, revolutionizing the diagnosis of chronic pain and aging-related health issues. We are working on

creating and validating electrochemical technology for the quantitative monitoring of biomarkers, with the goal of correlating this data with pain treatment efficacy for personalized pain management. However, the start of

the project was delayed due to difficulties in finding a

suitable postdoctoral fellow to carry out the research.

The project officially began on December 18, 2023.

42

“These biosensors will enable personalized medicine, monitor pain medication effects, and offer an affordable device for home and clinical use, tracking pain and alternative therapies like yoga and mindfulness.”

- Dr. Matiar Howlader

Institute for Pain Research & Care and McMaster Institute for Research on Aging Catalyst Grants

“IPRC has been instrumental in allowing for this important work to occur by providing funds to accommodate the participants costs associated with travel to and from McMaster and parking expenses.”

- Dr. Aimee Nelson

Corticomuscular Coherence Brain-Computer Interface to Treat Chronic Neck Pain Primary Investigator: Aimee Nelson, PhD Start Date: 2022

Brief Overview and Progress to Date

This project aims to reduce pain in individuals living with chronic neck pain.

Using a combination of

augmented reality sensorimotor training targeting the muscles of the neck and head movement,

combined with non-invasive brain stimulation, the

goal is to increase the range of motion of head

movements and reduce the perception of pain. This

work involves participants allocated to receive either real or placebo brain stimulation immediately prior to augmented reality sensorimotor training of the

neck. It is anticipated that the real brain stimulation

group will experience greater benefits than those experienced by the placebo brain stimulation group.

43

Institute for Pain Research & Care and McMaster Institute for Research on Aging Catalyst Grants A Feasibility Study to Assess the Added Value of Integrated Musculoskeletal BioFeedback Device (IMBED) Combined with Neuromuscular Exercise and Education (GLA-Dtm) to Decrease Chronic Pain in Older Adults with Osteoarthritis Primary Investigator: Pasqualina Santaguida, PhD, PT, Stuart Phillips, PhD, MSc, BSc and Qiyin Fang, BSc, MSc, PhD, LEL Start Year: 2020

Brief Overview and Progress to Date

The goal of our research project was to use technology to improve training in a group exercise format and

evaluate the impact on patient outcomes. We developed a system to capture muscle activity and

motion (IMBED) but found it did not work well in a group exercise format setting. We have switched technologies

and are now adapting an artificial intelligence (AI)

based technology in the osteoarthritis exercise group training. Early results of our user testing of patients

and clinicians find the MOTRACK acceptable. We are

preparing for the commencement of a pilot feasibility trial to evaluate the impact on patient outcomes and clinician acceptability with the MOTRACK.

44

“The funding has allowed us to develop and explore two types of technology to monitor movement while performing a standardized group exercise program.

We will shortly start the pilot trial to evaluate effects on patient training outcomes and acceptability to patients and clinicians for the use of MOTRACK.”

- Dr. Pasqualina Santaguida

Team Director

Norm Buckley

Scientific Director, Michael G. DeGroote Institute for Pain Research and Care; Professor Emeritus, Department of Anesthesia, McMaster University

Eugene Maida

Medical Director, Michael G. DeGroote Pain Clinic; Assistant Clinical Professor, Division of Physical Medicine & Rehabilitation, Department of Medicine; Assistant Clinical Professor (Adjunct), Department of Anesthesia, McMaster University

Scientific Advisory Board Members Manon Choinière

Ian Gilron

Professor, Centre de recherche du Centre hospitalier de l’Université de Montréal

Director of Clinical Pain Research, Professor of Anesthesiology and Biomedical Sciences, Faculty in the Centre for Neuroscience Studies at Queen’s University

Mark Lema

Mike Salter

Professor and Chair, Department of Anesthesiology, Jacobs School of Medicine & Biomedical Sciences State University of New York, Buffalo

Executive Members Jason Busse

Joel Katz

Distinguished Research Professor of Psychology, Canada Research Chair in Health Psychology York University

Professor, Departments of Physiology and Institute for Medical Sciences and Faculty of Dentistry, University of Toronto

Lisa Carlesso

Eleni Hapidou

Professor, Department of Anesthesia; Director, Michael G. DeGroote National Pain Centre; Joint Member, Department of Health Research Methods, Evidence and Impact (HE&I), McMaster University; Canada Research Chair in Prevention & Management of Chronic Pain

Associate Professor, School of Rehabilitation Sciences, McMaster University

Associate Clinical Professor (PT), Department of Psychiatry and Behavioural Neurosciences; Psychologist, Michael G. DeGroote Pain Clinic, McMaster University Medical Centre, Hamilton Health Sciences

Luciana Macedo

Michael McGillion

James Paul

Assistant Professor, School of Rehabilitation Sciences, Institute for Applied Health Sciences, McMaster University

Associate Professor and Assistant Dean Research, School of Nursing, Heart and Stroke Foundation/Michael G. DeGroote Endowed Chair of Cardiovascular Nursing Research, McMaster University

Professor & Chair of Anesthesia, Research Chair & Director, Acute Pain Services, Department of Anesthesia, McMaster University

Ian Rodger

Gurmit Singh

Florentina Miftodi

Professor Emeritus, Department of Medicine, McMaster University

Professor, Department of Pathology and Molecular Medicine, McMaster University

Manager, Finance and Administration Michael G. DeGroote Institute for Pain Research and Care; Michael G. DeGroote National Pain Centre, McMaster University

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Research Members James Bain

Mohit Bhandari

Philip J. Devereaux

Professor, Department of Surgery; Head, Division of Plastic Surgery, McMaster University

Professor and Chair, Department of Surgery; Associate Faculty, Department of Health Research Methods, Evidence and Impact, McMaster University

Director, Division of Perioperative Care, Department of Health Research Methods, Evidence and Impact; Professor, Department of Medicine, McMaster University

Laura Katz

Joy MacDermid

Randi McCabe

Assistant Clinical Professor (PT), Department of Psychiatry and Behavioural Neurosciences, McMaster University; Psychologist, Community Practice

Professor (PT), School of Rehabilitation Sciences, Institute for Applied Health Sciences, McMaster University; Professor, School of Physical Therapy, Western University

Professor, Department of Psychiatry and Behavioural Sciences, McMaster University

Aimee Nelson

Tara Packham

Irena A Rebalka

Professor, Department of Kinesiology, Associate Professor, Department of Biomedical Engineering, McMaster University

Assistant Professor, School of Rehabilitation Sciences, McMaster University

Assistant Professor, Pathology and Molecular Medicine, McMaster University

Behnam Sadeghirad

Louis Schmidt

Holger Shünemann

Assistant Professor, Department of Anesthesia; Biostatistician, Michael G. DeGroote National Pain Centre, McMaster University

Professor, Department of Psychology, Neuroscience & Behaviour, McMaster University

Professor, Department of Health Research Methods, Evidence and Impact, Director, Michael G. DeGroote Cochrane Canada Centre; McMaster University

Harsha Shanthanna

Li Wang

Kim Madden

Assistant Professor, Department of Anesthesia; Michael G. DeGroote National Pain Centre, McMaster University

Research Director, St. Josheph’s Healthcare, Hamilton

Brandon Van Dam

Rachel Couban

Librarian, Michael G. DeGroote National Pain Centre, McMaster University

Megan Groves

Communications Coordinator, Michael G. DeGroote Institute for Pain Research and Care, McMaster University

Jessica Bottomley

Rachel Roy

Sandra Rodwell

Associate Professor, Department of Anesthesia, McMaster University

Staff

Managing Director, Chronic Pain Network, McMaster University

Administrative Assistant, Chronic Pain Network, McMaster University (Maternity Leave)

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Knowledge Broker, Chronic Pain Network, McMaster University

Administrative Assistant, Chronic Pain Network, McMaster University

Mission

The mission of the Michael G. DeGroote Institute for Pain Research and Care is to become a cutting-edge institute in the field of chronic pain and to establish a network of researchers and trainees in the field.

Institute for Pain Research and Care, McMaster University 1280 Main Street West, MDCL 2101, Hamilton ON, Canada, L8S 4K1

Phone: 905.525.9140 Ext. 22743 npc@mcmaster.ca | pain-institute.healthsci.mcmaster.ca