High Impact Chronic Pain and UK Biobank: presentation, transitions and targets for intervention

高影响慢性疼痛和英国生物库：介绍、过渡和干预目标

• 批准号: MR/W026872/1
• 负责人: Daniëlle Van Der Windt
• 金额: $ 129.31万
• 依托单位: Keele University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FW026872%2F1
• 关键词: Impact; Chronic; Pain; UK; Biobank

BACKGROUNDNearly half of UK adults have pain in their muscles or joints lasting longer than three months (chronic pain). While most people manage well, about 25% of people have pain that has far-reaching, negative impacts on their lives, leading to disability, distress, social isolation, and high healthcare needs. Chronic pain presents in many different ways, and it is not clear why some people experience such 'high impact chronic pain' whereas others don't. We also don't know yet why some people improve, whereas others experience ongoing or even increasing impact from their pain. AIMS OF THE RESEARCHWe aim to find out the possible causes (or 'risk factors') of high impact chronic pain. This will inform the design or choice between selfcare or treatment options that may more effectively address people's individual needs. Early care or support that target specific risk factors may also help prevent the onset of high impact chronic pain. Specifically, we plan to use existing data from a large, national study of older adults (UK Biobank) to1. Identify groups of people with distinct patterns of high impact chronic pain who may have different outcomes and different care needs2. Understand the reasons why high impact chronic pain affects some more than others, and why this can change over time, focusing on the influence of: a. psychological factors, including mood, attention, memory, ability to problem-solve b. trauma or traumatic events that may occur at different times in people's lives (e.g., fracture, bereavement, sudden illness)3. Identify selfcare or treatment options that can reduce the influence of these risk factors for people with chronic pain. DESIGN AND METHODSWe will use data from UK Biobank, which includes health information from 500,000 people in the UK, who were aged 40-69 years when data collection started in 2006-2010. A questonnaire on the nature and impact of chronic pain was completed by over 173,000 participants in 2019. A second pain questionnaire will be sent to participants in 2023. The study team will work together with patient partners on the following three workpackages:(1) We will use state-of-the art statistical and artificial intelligence methods to identify subgroups with distinct patterns of chronic pain, and describe its impact on daily activity, mood, and healthcare use. (2) We will use data from questionnaires and healthcare records collected over a period of more than 15 years, to investigate the role of factors that may explain changes over time in the impact of chronic pain, including (a) mood, attention, memory, problem-solving, and (b) physical or psychological trauma. (3) Based on the results from (2) we will identify factors that can be effectively targeted by selfcare or treatment. We will then estimate how much benefit could be achieved if such interventions would successfully be offered to people with chronic pain. PATIENT AND PUBLIC INVOLVEMENTResearch questions have been informed by patient partners, who shared their life stories, and suggested factors that may explain the development of chronic pain, and how impact can change over time. They will continue to be involved in defining and prioritising factors for analysis; reviewing interventions; interpreting results; formulating key messages and dissemination of findings. COMMUNICATING FINDINGSWe will work together with patient partners and clinical advisors to- Publish results in scientific journals and during (international) pain conferences- Share our findings with other research teams and the PPIE network in APDP, and with UK Biobank - Engage with our existing networks, including Versus Arthritis, Public Health England, NHS partners, research funders - Design infographics, visual animations, or YouTube videos to communicate key findings in a way that is suitable for a wide audience- Hold webinars to discuss findings and implications

近一半的英国成年人有持续三个月以上的肌肉或关节疼痛（慢性疼痛）。虽然大多数人处理得很好，但约有25%的人患有对他们的生活产生深远负面影响的疼痛，导致残疾、痛苦、社会孤立和高医疗保健需求。慢性疼痛以多种不同的方式表现出来，目前还不清楚为什么有些人会经历这种“高强度慢性疼痛”，而另一些人却不会。我们也不知道为什么有些人会有所改善，而另一些人则会持续甚至越来越多地受到疼痛的影响。研究目的我们的目标是找出高强度慢性疼痛的可能原因（或“风险因素”）。这将为设计或选择自我护理或治疗方案提供信息，从而更有效地满足人们的个人需求。针对特定风险因素的早期护理或支持也可能有助于预防高影响慢性疼痛的发作。具体来说，我们计划利用一项针对老年人的大型全国性研究（UK Biobank）的现有数据进行研究。确定具有不同模式的高影响慢性疼痛的人群，他们可能有不同的结果和不同的护理需求2。理解为什么高强度慢性疼痛对一些人的影响大于其他人，以及为什么这种情况会随着时间的推移而改变，重点关注以下因素的影响：a.心理因素，包括情绪、注意力、记忆、解决问题的能力；b.创伤或创伤事件，可能发生在人们生活的不同时期（例如骨折、丧妻之痛、突发疾病）。确定自我护理或治疗方案，可以减少这些风险因素对慢性疼痛患者的影响。设计与方法我们将使用英国生物银行的数据，其中包括来自英国50万人的健康信息，这些人在2006-2010年开始收集数据时年龄在40-69岁之间。2019年，超过17.3万名参与者完成了一份关于慢性疼痛的性质和影响的调查问卷。第二份疼痛问卷将于2023年发给参与者。研究团队将与患者合作伙伴一起开展以下三个工作包：(1)我们将使用最先进的统计和人工智能方法来识别具有不同慢性疼痛模式的亚组，并描述其对日常活动，情绪和医疗保健使用的影响。(2)我们将使用收集超过15年的问卷调查和医疗记录数据，调查可能解释慢性疼痛影响随时间变化的因素的作用，包括(a)情绪、注意力、记忆、解决问题的能力和(b)身体或心理创伤。(3)根据(2)的结果，我们将确定可以通过自我护理或治疗有效针对的因素。然后，我们将估计如果这些干预措施成功地提供给患有慢性疼痛的人，可以获得多少好处。患者和公众的参与研究问题已经被患者的伴侣告知，他们分享了他们的生活故事，并提出了可能解释慢性疼痛发展的因素，以及影响如何随着时间的推移而变化。他们将继续参与确定供分析的因素并确定其优先次序；评估干预措施;翻译结果;制定关键信息和传播调查结果。沟通研究结果我们将与患者合作伙伴和临床顾问共同努力-在科学期刊和（国际）疼痛会议上发表研究结果-与APDP的其他研究团队和PPIE网络以及英国生物银行分享我们的研究结果-与我们现有的网络，包括Versus Arthritis，英国公共卫生，NHS合作伙伴，研究资助者-设计信息图表，视觉动画，或YouTube视频，以一种适合广大受众的方式传达关键发现——举办网络研讨会，讨论发现和影响

项目成果

The establishment, maintenance, and adaptation of high- and low-impact chronic pain: a framework for biopsychosocial pain research.

• DOI: 10.1097/j.pain.0000000000002951
• 发表时间: 2023-10-01
• 期刊: Pain
• 影响因子: 7.4