权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Data Coordinating Center for Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK)

预防急性至慢性背痛的脊柱手法和患者自我管理数据协调中心 (PACBACK)

基本信息

批准号：
10226960
负责人：
PATRICK J HEAGERTY
金额：
$ 43.55万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10226960
关键词：
Acute Address Adherence Adult Affect Back Behavior Behavioral Caring Chronic Chronic low back pain Clinic Clinical Clinical Research Clinical Trials Data Monitoring Committees Committee Members Communication Complementary Health Data Data Analyses Data Collection Data Coordinating Center Databases Doctor of Philosophy Documentation Drug usage Effectiveness Electronic Mail Enrollment Future Goals Guidelines Health Occupations Healthcare Hybrids Individual Integrative Medicine Internet Intervention Leadership Link Low Back Pain Manuals Medical Methodology Methods Monitor Online Systems Opioid Overdose Pain management Patients Pharmaceutical Preparations Pharmacotherapy Phase III Clinical Trials Physical therapy Preparation Prevention Primary Health Care Principal Investigator Protocols documentation Provider Psychosocial Factor Public Health Publications Quality Control Randomized Recovery Reporting Research Research Design Research Personnel Risk Risk Factors Role Screening procedure Secondary Prevention Self Management Site Societies Spinal Manipulation Strategic Planning Structure Subgroup System Testing Training Translating Translations Universities Washington Work addiction base biopsychosocial care providers chiropracty chronic back pain chronic pain chronic painful condition clinical practice clinical research site cost data quality design disability dissemination strategy effectiveness evaluation effectiveness implementation study empowered experience high risk implementation strategy improved nondrug therapy novel operation opioid misuse pain chronification pain reduction participant safety performance site prevent primary outcome productivity loss public health priorities randomized trial secondary outcome statistics targeted treatment tool uptake web site

项目摘要

SUMMARY. The US is in the midst of an unprecedented pain management crisis. Low back pain (LBP) is the most common chronic pain condition in adults and the leading cause of disability worldwide. Guidelines have recommended non-pharmacologic treatments like spinal manipulation and behavioral approaches for LBP for nearly a decade, however uptake in practice has been poor. Little is known about the role of these treatments in secondary prevention of chronic LBP (cLBP), especially for patients with biopsychosocial risk factors. With burgeoning costs of cLBP and mounting evidence of ineffectiveness and harms of commonly used drug treatments, including opioids, there is a critical need for research on non-pharmacological treatments for cLBP prevention that can be readily translated to practice. The long-term objective is to reduce overall LBP burden by testing scalable first-line non-pharmacologic strategies that address the biopsychosocial aspects of acute/sub-acute LBP and prevent transition to cLBP. We propose a novel randomized hybrid trial addressing both effectiveness and implementation. A total of 1180 patients will be enrolled with nonspecific LBP of 2-12 weeks duration, at medium and high risk of developing cLBP using the Subgroups for Targeted Treatment (STarT) Back Screening Tool (SBST). Aim 1 will assess the effectiveness of Spinal Manipulation Therapy (SMT), Structured Self-Management (SSM), and SMT+SSM relative to Usual Medical Care (UMC) in a randomized trial using a 2x2 factorial design. Primary outcomes are prevention of cLBP at 12 months; recovery from acute/sub-acute LBP at 6 months; and cumulative reduction of pain and disability over 1 year. Secondary outcomes include PROMIS-29, productivity loss, health care use, and medication use (including opioids). Aim 2: will use mixed methods to gather data about important influences on the interventions that could affect results interpretation and future implementation. Aligned with the National Center for Complementary and Integrative Health's (NCCIH) Strategic Plan 2016, this project has the potential to significantly transform LBP management by providing definitive and generalizable evidence regarding front-line non-pharmacologic interventions addressing physical and psychosocial factors for the prevention of cLBP. By empowering patients to engage in healthy pain management behaviors, we anticipate LBP related disability, productivity loss, and reliance on continued health care and medication use (including opioids) will be reduced. The comprehensive dissemination and implementation strategy, informed by major stakeholders, will facilitate translation into clinical practice across health professions.

总结。美国正处于一场前所未有的疼痛管理危机之中。腰痛（LBP）是