Innovations

Improving Access to Pain Care

One in three individuals worldwide is living with ongoing pain of some type, and pain is relevant to everyone during their lifetime.

That’s why I am passionate about developing interventions that equip people with the ability to shape their nervous systems toward relief. It’s a concept that is powerful for patients. This integrative approach works alongside medical treatments and has been shown to improve health outcomes. My innovations make possible quick access to this kind of care.

To make pain relief accessible at scale, I created Empowered Relief®, a 1-session pain relief skills intervention that is low-burden and can be received online in small or large groups. Empowered Relief® is being delivered by 1,100 certified instructors in 26 countries and in 7 languages. It is offered as ‘standard care’ in several Veterans Administration Medical Centers in the U.S., the Canadian VA, the National Health Service in the U.K., and many major health organizations in the U.S. (e.g., Cleveland Clinic, Lehigh Valley Health Network, Allegheny Health Network, and the University of Colorado Anschutz Medical Campus).

Learn more at: empoweredrelief.stanford.edu

Empowered Relief®

Empowered Relief® is a 1-session (2-hour) intervention that rapidly equips patients with effective pain relief skills. Four randomized controlled trials conducted at Stanford University School of Medicine show efficacy for reducing chronic pain as well as pain and need for opioids after surgery. All four trials have yielded clinically meaningful results and durable efficacy at 3 month and 6-months post-treatment. With benefits across a range of symptoms, Empowered Relief® is an all-purpose intervention for people with acute and chronic pain.

Key Study

An NIH-funded randomized controlled trial revealed that in people with chronic low back pain 1-session Empowered Relief® is clinically equivalent to 16 hours of cognitive behavioral therapy (gold-standard behavioral treatment for chronic pain) at 3 months post-treatment for reducing pain-related distress, pain intensity, pain interference, pain bothersomeness, depression, anxiety, fatigue and sleep disturbance.

Open access publication: Darnall et al. 2021 publication in JAMA Netw Open received international coverage, an NIH press release and coverage in the NYTimes.

Further Studies

A second study showed that online-received Empowered Relief® imparts clinically meaningful benefits across a broad range of symptoms (pain intensity, pain bothersomeness, pain interference, pain-related distress and sleep disturbance).

Open access publication: Ziadni et al. 2021 publication in JMIR.

Clinician Certification Workshops

Empowered Relief® instructor certification workshops are available to licensed clinicians through Stanford University.

Current Research

Funded by the Patient-Centered Outcomes Research Institute, we are testing the comparative effectiveness study of 1-session online Empowered Relief® vs. 8-session online cognitive behavioral therapy in 1,650 diverse people with different types of pain conditions receiving care at our six study sites. Learn more about the PROGRESS study.

Empowered Relief® for Surgery

I translated the Empowered Relief® formula into a digital format that is tailored to people undergoing all types of surgery. This approach expands access to whole-person pain care for underserved populations at home or in the hospital.

Study 1, Breast Cancer Surgery

Results showed that women who engaged with an automated version of Empowered Relief® (called “My Surgical Success”) required about one week less opioids after breast cancer surgery relative to women who received a health education control intervention.

Open access publication: Darnall et al. 2019 publication in Pain Medicine.
Further reading: Medscape quotes Beth Darnall in the story “Pain Expectations Before Surgery May Be a Self-Fulfilling Prophecy.”

Study 2, Orthopedic Trauma Surgery

Patients who received the on-demand version of Empowered Relief® (called My Surgical Success) reported less pain after surgery, and the analgesic benefits persisted to 3 months after surgery. Results suggest that Empowered Relief® clinically meaningful and sustained analgesia and enhances recovery after surgery.

Open access publication: Ziadni et al. June 2022 publication in Anesthesia and Analgesia.
Video: MedPage Today publishes a video interview with Beth Darnall about her colleagues’ and her research on Empowered Relief® for surgery and implications for the broader field of digital innovations in pain management.

Injured workers

Dr. Junie Carriere is principal investigator for a research award from the Canadian Institutes for Health Research that is investigating Empowered Relief® in acutely injured patients within primary care in Canada.

Patient-Centered Opioid Research

Since 2018 as principal investigator I have led the EMPOWER study, a 5-state voluntary patient-centered study on voluntary opioid tapering and behavioral medicine treatments for pain. This study includes 1,350 patients from across the U.S. and results are expected to be published in 2024. I consult with healthcare organizations, federal agencies, and clinicians on opioid stewardship for patients who wish to reduce opioids, and protecting all patients from harmful opioid reduction policies and practices. Three times I have briefed the U.S. Congress and the FDA on opioid stewardship. I believe that improving access to pain care includes ensuring that the patients who need prescription opioids have access to them.