Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT)

针灸减少疼痛治疗结果的差异 (ADDOPT)

• 批准号: 7531356
• 负责人: MELISSA DIANE MCKEE
• 金额: $ 22.43万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7531356
• 关键词: Acupuncture procedure; Adoption; Back Pain; Caring; Collaborations; Communities; Community Health Centers; Complementary and alternative medicine; Consultations; Data; Degenerative polyarthritis; Effectiveness; Evaluation; Experimental Designs; Future; General Population; Goals; Healed; Health; Healthcare; Impairment; Institutes; Intervention; Joint Commission on Accreditation of Healthcare Organizations; Literature; Low income; Measures; Minority; Neck; Neck Pain; New York City; Outcome; Pain; Pain management; Pain-Free; Patients; Pattern; Pharmaceutical Preparations; Phase; Physicians; Practice based research; Prevalence; Primary Health Care; Process; Provider; Public Health; Quality of life; Recruitment Activity; Reporting; Research; Research Infrastructure; Sampling; Schools; Services; Site; Specialist; Training; Visit; Vulnerable Populations; chronic pain; cost; cost effectiveness; day; design; directed attention; effectiveness trial; experience; functional status; healing; health care service utilization; health disparity; health related quality of life; improved; medical specialties; programs; psychologic; research and development; safety net; uptake

DESCRIPTION (provided by applicant): Chronic pain is a significant public health problem, associated with impairments of physical and psychological functioning. While a third or more of the general population may suffer from chronic pain, it is often under recognized and under treated in health care settings. Low income and minority samples experience disparities in the prevalence of chronic pain, in perceived access to effective pain treatment, and in consultations for pain. A great deal of literature suggests that acupuncture offers potential benefit in the management of chronic pain, but it is rarely available to low income patients. The Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) project will introduce and evaluate the addition of acupuncture to the management of chronic pain for ethnically diverse, low-income primary care patients. The project represents a collaboration between the New York City Research and Improvement Networking Group (NYC RING), a practice-based research network dedicated to decreasing health disparities through primary care research, the Continuum Center for Health and Healing, and The Swedish Institute School of Acupuncture. Our intervention will involve addition of weekly acupuncture sessions at 3 urban primary care practices. During training sessions at each practice, primary care providers will become familiar with acupuncture and indications for referral. Patients will be eligible if they experience chronic pain due to neck pain, back pain, or osteoarthritis. Our process evaluation, guided by Glasgow's RE- AIM framework, will assess barriers to implementation and adoption of the intervention in busy urban practices and acceptability to patients and providers. We will employ a quasi- experimental design to assess primary outcomes (pain and quality of life) and obtain preliminary estimates of secondary outcomes (health care utilization and costs) of the intervention at each health center. This design will permit comparison across sites to discern practice level differences in uptake and outcomes. PUBLIC HEALTH REVELANCE: Chronic pain is often under recognized and under treated, especially in vulnerable populations. Acupuncture offers a potentially effective addition to pain management often not available to low-income patients. Our project will introduce acupuncture into chronic pain treatment in urban safety net primary care sites and evaluate the acceptability to patients, the effectiveness of acupuncture in reducing pain and improving quality of life, and obtain preliminary estimates of the effect on health care utilization, medication use, and cost.

描述（由申请人提供）：慢性疼痛是一个重要的公共卫生问题，与身体和心理功能障碍有关。虽然一般人口的三分之一或更多可能患有慢性疼痛，但它往往在医疗保健机构中被认识和治疗。低收入和少数民族样本在慢性疼痛的患病率、获得有效疼痛治疗的感知和疼痛咨询方面存在差异。大量文献表明，针灸在慢性疼痛的管理中提供了潜在的益处，但它很少适用于低收入患者。针灸减少疼痛治疗结果的差异（ADDOPT）项目将介绍和评估将针灸添加到种族多样性，低收入初级保健患者的慢性疼痛管理中。该项目代表了纽约市研究和改进网络组（NYC RING），一个致力于通过初级保健研究减少健康差距的基于实践的研究网络，连续健康和治疗中心和瑞典针灸学院之间的合作。我们的干预措施将包括在3个城市初级保健实践中增加每周针灸课程。在每次实践的培训课程中，初级保健提供者将熟悉针灸和转诊指征。如果患者因颈部疼痛、背痛或骨关节炎而出现慢性疼痛，则符合条件。我们的过程评估，由格拉斯哥的RE-AIM框架指导，将评估在忙碌的城市实践中实施和采用干预措施的障碍以及患者和提供者的可接受性。我们将采用准实验设计来评估每个卫生中心干预的主要结局（疼痛和生活质量），并获得次要结局（卫生保健利用和成本）的初步估计。这种设计将允许在不同地点进行比较，以辨别吸收和结果的实践水平差异。 公共卫生：慢性疼痛往往认识不足，治疗不足，特别是在弱势群体中。针灸提供了一个潜在的有效的除了疼痛管理往往无法提供给低收入的患者。我们的项目将在城市安全网初级保健站点中将针灸引入慢性疼痛治疗，并评估患者的可接受性，针灸在减轻疼痛和改善生活质量方面的有效性，并获得对卫生保健利用，药物使用和成本的初步估计。