Chronic Pain in Pediatric Primary Care

儿科初级保健中的慢性疼痛

• 批准号: 8607846
• 负责人: Amy S Lewandowski Holley
• 金额: $ 3.91万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-15 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8607846
• 关键词: Accounting; Acute; Address; Adolescence; Adolescent; Adult; Aftercare; Anesthesiology; Anxiety; Appointment; Award; Behavior Therapy; Behavioral; Child; Childhood; Chronic; Chronic disabling pain; Data; Development; Diagnosis; Early treatment; Faculty; Future; Goals; Instruction; Intervention; Investigation; Laboratories; Medicine; Mental Depression; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Musculoskeletal Pain; Online Systems; Outcome; Pain; Pain Measurement; Pain management; Pain-Free; Parents; Patients; Play; Population; Prevention; Prevention Research; Primary Health Care; Psychological Factors; Psychophysics; Recruitment Activity; Research; Research Institute; Research Training; Resources; Risk; Sampling; Schools; Site; Symptoms; Testing; Time; Training; Universities; Washington; Youth; base; career development; chronic pain; clinical phenotype; comparison group; design; disability; neurophysiology; patient oriented research; pilot trial; predictive modeling; prevent; professor; programs; protocol development; psychologic; psychosocial

DESCRIPTION (provided by applicant): Pain accounts for 20-40% of primary care appointments during childhood and adolescence with musculoskeletal pain as a principal pain complaint. Pain in childhood is significant because it increases risk for pain, disability, and psychiatric disorders in adulthood. However, the mechanisms underlying the transition from acute to chronic pain in children are not known. Using a combination of psychophysical and psychological assessment, the central aim of this proposal is to understand the mechanisms that contribute to the transition from acute to chronic musculoskeletal pain in children and adolescents. The long-term goal of this K23 award is for the candidate to establish a programmatic line of patient-oriented research focused on identification of at- risk youth and prevention of chronic pain. The K23 candidate is an acting assistant professor in the Department of Anesthesiology and Pain Medicine at the University of Washington. The candidate proposes a five-year training plan with the support of faculty mentors who have expertise in pediatric pain, laboratory pain assessment, and prevention research to obtain instruction in state-of-the-art conditioned pain modulation assessment, prevention research, and training in pain assessment, diagnosis, and treatment in primary care. The University of Washington and Seattle Children's Research Institute provide excellent institutional support and resources for this award. The research plan involves three studies. Study 1 will compare clinical phenotypes of youth with acute musculoskeletal pain, chronic musculoskeletal pain, and healthy pain-free youth. Study 2 will prospectively follow a sample of youth with acute musculoskeletal pain in primary care to identify predictors of chronic pain development. Study 3 will pilot a web-based behavioral intervention for early treatment of chronic pain in primary care. These studies will lay the groundwork for future investigations examining profiles or clinical phenotypes of children in primary care who are at-risk for chronic pain; data that can inform a predictive model of chronic pain development.

描述（由申请人提供）：儿童期和青春期初级保健预约中，疼痛占 20-40%，其中肌肉骨骼疼痛是主要的疼痛主诉。童年时期的疼痛很严重，因为它会增加成年后出现疼痛、残疾和精神疾病的风险。然而，儿童从急性疼痛转变为慢性疼痛的机制尚不清楚。该提案的中心目的是结合心理物理和心理评估，了解导致儿童和青少年从急性肌肉骨骼疼痛转变为慢性肌肉骨骼疼痛的机制。该 K23 奖项的长期目标是让候选人建立一条以患者为导向的研究计划，重点关注识别高危青少年和预防慢性疼痛。 K23候选人是华盛顿大学麻醉学和疼痛医学系的代理助理教授。候选人提出了一个五年培训计划，在具有儿科疼痛、实验室疼痛评估和预防研究方面专业知识的教师导师的支持下，以获得最先进的条件性疼痛调节评估、预防研究以及初级保健疼痛评估、诊断和治疗方面的指导。华盛顿大学和西雅图儿童研究所为本奖项提供了优秀的机构支持和资源。该研究计划涉及三项研究。研究 1 将比较患有急性肌肉骨骼疼痛、慢性肌肉骨骼疼痛和健康无痛青少年的临床表型。研究 2 将前瞻性地跟踪初级保健中患有急性肌肉骨骼疼痛的青少年样本，以确定慢性疼痛发展的预测因素。研究 3 将试行基于网络的行为干预，用于初级保健中慢性疼痛的早期治疗。这些研究将为未来调查初级保健中存在慢性疼痛风险的儿童的概况或临床表型奠定基础；可以为慢性疼痛发展的预测模型提供信息的数据。