Chronic low back pain is among the most common conditions treated in primary care settings, yet treatment remains unsatisfactory for many patients. The American College of Physicians now recommends mindfulness-based stress reduction as initial treatment for patients with chronic low back pain. Yet, despite strong evidence of effectiveness, this therapy has not been integrated into clinical care.

OPTIMUM, a new NIH Collaboratory Trial, will study the integration of a group-based mindfulness program for chronic low back pain into usual care in primary care settings. We spoke with Dr. Natalia Morone, the principal investigator of OPTIMUM, at the NIH Collaboratory’s PRISM kickoff meeting in November about the rationale for her study and her hopes for advancing pragmatic clinical research.

“The efficacy studies have been done; they have been very rigorous randomized controlled trials,” Dr. Morone explained. “Now we need to demonstrate to stakeholders—to patients, to clinicians, to healthcare administrators—how this can actually be done in the clinic and what are the results when you now deliver this program in a real-world setting.”

OPTIMUM is supported by the PRISM program (Pragmatic and Implementation Studies for the Management of Pain to Reduce Opioid Prescribing), part of the NIH’s Helping to End Addiction Long-term (HEAL) Initiative. The NIH Collaboratory Coordinating Center serves as the PRISM Resource Coordinating Center.

“I’m very excited to be in the Collaboratory, because it has been such a challenge bringing mindfulness and mindfulness-based stress reduction into the clinic,” Dr. Morone said. “I think our trial will really benefit from the collective experience and wisdom of the pragmatic trials that [the Collaboratory has] helped carry out.”

OPTIMUM and the NIH Collaboratory PRISM Resource Coordinating Center are supported by the National Center for Complementary and Integrative Health. Support is also provided by the NIH Common Fund through a cooperative agreement from the Office of Strategic Coordination within the Office of the NIH Director.