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

点击翻译按钮获取中文摘要

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.