# Pain Response Evaluation of a Combined Intervention to Cope Effectively (PRECICE)

> **NIH NIH UG3** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2020 · $3,929,419

## Abstract

Chronic musculoskeletal pain (CMP) is the most common, disabling, and costly of all pain problems. While
evidence exists for the efficacy (albeit modest benefits) of both duloxetine and web-based cognitive behavioral
therapy (CBT) as monotherapy, it is time to consider study of treatment components that may complement
each other. In addition, given the reported association between patient’s adherence and treatment outcomes,
strategies are needed to enhance participant’s motivation to maintain continued use of newly learned pain
coping skills from CBT. Using motivational interviewing (MI), a phone based adherence-focused guidance by a
nurse clinician could make web-based CBT more effective. The objective of the UH3 application is to
determine if combination therapy (duloxetine + web-based CBT) is more effective than duloxetine monotherapy
for treating patients with CMP. Given the interactions of biological, behavioral and psychological mechanisms
in the pathogenesis of chronic pain, our central hypothesis is that combination therapy will be more effective
than duloxetine monotherapy. The objective of this UG3/UH3 application is to conduct a 24-week randomized
clinical trial of primary care patients with CMP. In the UH3 trial, 450 participants will be randomized to one of
three treatments: (1) combination treatment [duloxetine + web-based CBT] with nurse support, (2) combination
treatment without nurse support, and (3) duloxetine monotherapy. This project could optimize pain-related
treatment outcomes by combining duloxetine and web-based CBT at the primary care level where most pain
patients are managed. Importantly, the use of nurse clinician providing adherence-focused guidance to
maintain long term use or practice of pain coping skills (web-based CBT) increases the likelihood that our
proposed intervention is scalable.

## Key facts

- **NIH application ID:** 9870024
- **Project number:** 1UG3NR019196-01
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Dennis Chua Ang
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $3,929,419
- **Award type:** 1
- **Project period:** 2020-09-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9870024

## Citation

> US National Institutes of Health, RePORTER application 9870024, Pain Response Evaluation of a Combined Intervention to Cope Effectively (PRECICE) (1UG3NR019196-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9870024. Licensed CC0.

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