Characteristics and impact of chronic pain and pain management in older adults

老年人慢性疼痛和疼痛管理的特征和影响

• 批准号: 10154214
• 负责人: CHRISTINE A. MIASKOWSKI
• 金额: $ 33.49万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10154214
• 关键词: Acetaminophen; Adult; Adverse effects; Affect; Age; Age Reporting; Age-Years; Ageism; American; Anxiety; Awareness; Biological; Biological Factors; Cardiovascular system; Characteristics; Chronic; Chronic Obstructive Airway Disease; Complex; Data; Diabetes Mellitus; Effectiveness; Elderly; Enrollment; Environment; Future; Goals; Growth; Guidelines; Heart failure; Intervention; Investigation; Knowledge; Location; Longitudinal Studies; Medical; Mental Depression; Methodology; Nature; Non-Steroidal Anti-Inflammatory Agents; Opioid; Opioid Analgesics; Outcome; Pain; Pain management; Patient Outcomes Assessments; Patient-Focused Outcomes; Persistent pain; Pharmacological Treatment; Pharmacology; Physical Function; Policies; Population; Population Research; Population Study; Prevalence; Psychological Factors; Quality of life; Reporting; Research; Sampling; Severities; Site; Social support; Special Population; Stress; Subgroup; Surveys; Testing; United States; chronic pain; chronic pain management; cognitive function; comorbidity; effective intervention; epidemiology study; experience; gastrointestinal; improved; improved outcome; multiple chronic conditions; older patient; opioid therapy; overdose death; pain score; person centered; population survey; prescription opioid; psychologic; sex; side effect; social; social factors; social stigma; virtual

Project Summary/Abstract Approximately 38.5% of Americans >65 years of age report chronic pain lasting 6 months or longer. This percentage is expected to increase given the growth in the older adult population and the associated growth of chronic conditions that can contribute to pain. Chronic pain tends to be more complex in older adults with ~70% of them describing pain in multiple sites and over 60% describing multiple types of pain. To date, no large national sample of older adults provides detailed, longtitudinal information on the experience of chronic pain in older adults; the pharmacologic and nonpharmacologic strategies that older adults are using to manage their chronic pain; and the impact of chronic pain on important person-centered outcomes. The proposed study will fill these significant gaps in knowledge by conducting the first national longitudinal study focused on chronic pain in older adults. In a large national sample of 1888 older adults, of whom 1,232 have chronic pain (i.e., pain >6 months duration) and 656 do not have chronic pain, we aim to: 1) Determine the prevalence and characteristics (i.e. quality, severity, interference) of chronic pain as well as identify the pharmacologic and non-pharmacologic treatments used to manage chronic pain; 2) Evaluate for longitudinal differences in biological, psychological, social factors, as well as physical and cognitive function and QoL between older adults with and without chronic pain; and 3) Examine the longitudinal relationships between chronic pain (i.e., worst pain score) and patient reported outcomes (i.e., physical function, cognitive function, QoL). We will determine which biological, psychological, and social factors at enrollment are associated with changes in the trajectories of chronic pain, identify subgroups of older adults with distinct pain profiles using latent profile analysis, and determine how changes in the trajectories of physical function, cognitive function, and QoL are associated with these distinct pain profile classes. Informed by a better understanding of pain characteristics, factors associated with chronic pain, treatment approaches and long-term impact, we will be equipped to develop and test tailored interventions that target subgroups of older patients, with the goal of improving the management of chronic pain, as well as overall function and QoL.

项目概要/摘要 大约 38.5% 的 65 岁以上美国人报告有持续 6 个月或以上的慢性疼痛 更长。鉴于老年人口的增长，这一百分比预计还会增加 以及可能导致疼痛的慢性疾病的相关发展。慢性疼痛往往 对于老年人来说情况更为复杂，其中约 70% 的人描述了多个部位及以上的疼痛 60% 的人描述了多种类型的疼痛。 迄今为止，还没有大规模的全国老年人样本提供详细的、纵向的信息 老年人慢性疼痛的经历；药理学和非药理学 老年人用来控制慢性疼痛的策略；以及慢性病的影响 对以人为本的重要成果的痛苦。拟议的研究将填补这些重大空白 通过开展第一个针对老年人慢性疼痛的全国纵向研究来提高知识水平 成年人。在 1,888 名老年人的大型全国样本中，其中 1,232 人患有慢性疼痛（即， 疼痛持续时间 >6 个月）并且 656 没有慢性疼痛，我们的目标是： 1) 确定 慢性疼痛的患病率和特征（即质量、严重程度、干扰）以及 确定用于治疗慢性疼痛的药物和非药物治疗； 2） 评估生物、心理、社会因素以及 有和没有慢性疼痛的老年人之间的身体和认知功能以及生活质量；和 3) 检查慢性疼痛（即最严重疼痛评分）和 患者报告的结果（即身体功能、认知功能、生活质量）。我们将确定 入组时哪些生物、心理和社会因素与 慢性疼痛的轨迹，使用以下方法识别具有不同疼痛特征的老年人亚组 潜在轮廓分析，并确定身体机能轨迹的变化， 认知功能和生活质量与这些不同的疼痛特征类别相关。 通过更好地了解疼痛特征、与慢性疼痛相关的因素， 治疗方法和长期影响，我们将有能力开发和测试量身定制的 针对老年患者亚组的干预措施，目标是改善管理 慢性疼痛以及整体功能和生活质量。