Diversity Supplement for Group-based mindfulness for patients with chronic pain in the primary care setting

项目概要/摘要 慢性疼痛在美国很普遍，10%的人口受到慢性腰痛（cLBP）的影响， 在初级保健诊所治疗的头号疼痛状况。传统的cLBP治疗往往不能令人满意 而且效率低下许多cLBP患者转向使用补充和替代药物（CAM），通常 而不向他们的常规护理提供者披露。虽然一些CAM治疗（例如正念， 脊椎按摩、针灸）已被证明对cLBP有效，其他疗法尽管尚无定论，但已被广泛使用 证据膳食补充剂（DS）和其他天然产品（包括大麻二酚（CBD）和大麻）， 是流行的CAM自我护理治疗慢性疼痛;但有效性的证据可能有限， 与药物结合可能是有害的。高达80%的患者不告诉他们的传统 供应商对他们使用CAM的担忧，增加了不良互动，不合规的可能性， 无记录的结果。不公开的一个主要原因是提供商没有询问CAM的使用情况。 母项目是由NIH NCCIH通过HEAL倡议资助的UG3/UH3多中心实用RCT， 题目是：在初级保健环境中对慢性腰痛患者进行基于团体的正念治疗 （OPTIMUM研究）。（Morone，PI; Gaylord/Faurot，研究中心PI），研究中心位于波士顿医疗中心， 匹兹堡大学和匹兹堡/皮埃蒙特卫生服务部。该项目的资金从2019年9月28日至 08/31/24.家长补助金的目的2是整合和测试基于证据的正念临床 疼痛计划，OPTIMUM，用于初级保健环境中的cLBP患者。基线数据收集 并将使用后续行动来确定结果。目前，OPTIMUM研究采用的数据不足 用于记录膳食补充剂（DS）和其他天然产品的使用的收集程序， cLBP的管理本管理补充的目的是增加和扩展药物 与母赠款目标2相关的收集程序，包括DS和其他天然产品， 提高候选人的研究能力。目标1：估计 DS和其他天然产品的使用，包括大麻和大麻二酚，在美国用于慢性疼痛， 加拿大，将涉及范围审查，其中候选人与导师一起设计，进行， 整理研究数据，解决DS和其他天然产品用于慢性疼痛的患病率， 找出过去10年慢性疼痛患者最常用的DS/天然产品。 管理补充目标2：在OPTIMUM范围内表征DS和其他天然产品的使用 通过定性评估的队列。候选人将利用DS迭代面试过程， 包括开放式问题，以丰富数据收集并更全面地了解CAM 使用.候选人正在积极追求临床医学的职业生涯。她将培养的指导技能 行政补充将极大地影响她在职业生涯中从事临床研究的能力。

PROJECT SUMMARY/ABSTRACT Chronic pain is prevalent in the U.S. with 10% of the population affected by chronic low-back pain (cLBP), the number one pain condition treated in primary care clinics. Conventional cLBP treatment is often unsatisfactory and ineffective. Many cLBP sufferers turn to using complementary and alternative medicines (CAM), often without disclosure to their conventional-care provider. While some CAM treatments (e.g. mindfulness, chiropractic, acupuncture) have been proven effective for cLBP, others are widely used despite inconclusive evidence. Dietary supplements (DS) and other natural products (including cannabidiol (CBD) and Cannabis), are popular CAM self-care treatments for chronic pain; yet evidence of effectiveness may be limited, and combining with pharmaceuticals may be deleterious. Up to 80% of patients do not tell their conventional providers about their use of CAM, increasing the possibility of untoward interactions, noncompliance, and undocumented outcomes. A main reason for non-disclosure is that the provider did not ask about CAM use. The parent project is a UG3/UH3 multi-site pragmatic RCT funded by NIH NCCIH via the HEAL initiative, entitled Group-based mindfulness for patients with chronic low back pain in the primary care setting (OPTIMUM Study). ( Morone, PI; Gaylord/ Faurot, UNC Site PIs), with sites at Boston Medical Center, University of Pittsburgh and UNC/Piedmont Health Services. The project is funded from 09/28/19 through 08/31/24. Aim 2 of the parent grant is to integrative and test an evidence-based mindfulness clinical pain program, OPTIMUM, for patients with cLBP in the primary care setting. Data collection at baseline and follow-up will be used to determine outcomes. Currently, the OPTIMUM study employs an inadequate data collection procedure for documenting the use of dietary supplements (DS) and other natural products for management of cLBP. The goal of this Administrative Supplement is to augment and extend the medication collection procedures associated with Aim 2 of the parent grant to include DS and other natural products, while enhancing the candidate’s research skills. Administrative Supplement Aim 1: Estimate the prevalence of DS and other natural product use, including cannabis and cannabidiol, for chronic pain in the U.S. and Canada, will involve a scoping review in which the candidate works with mentors to design, conduct, and collate data from studies addressing the prevalence of DS and other natural product use for chronic pain and to identify the most commonly used DS/natural products among chronic pain patients in the past 10 years. Administrative Supplement Aim 2: Characterize DS and other natural product use within the OPTIMUM cohort through qualitative assessments. The candidate will utilize a DS iterative interview process, including open ended questions, to enrich data collection and develop a more complete understanding of CAM use. The candidate is actively pursuing a career in clinical medicine. The mentored skills she will develop during the administrative supplement will greatly impact her capacity to include clinical research in her career.