COPC Administrative Supplement to Group-Based Mindfulness for Patients with Chronic Low Back Pain in the Primary Care

COPC 针对初级保健中慢性腰痛患者的团体正念行政补充

• 批准号: 10521941
• 负责人: Natalia E. Morone
• 金额: $ 59.19万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10521941
• 关键词: Address; Administrative Supplement; African American population; Age; Anatomy; Caring; Characteristics; Chronic; Chronic Fatigue Syndrome; Chronic low back pain; Conditioned Reflex; Development; Discrimination; Economics; Education; Enrollment; Fibromyalgia; Food; Health; Health Personnel; Health Services Accessibility; Hospitals; Housing; Insurance Carriers; Interstitial Cystitis; Intervention; Interview; Irritable Bowel Syndrome; Knowledge; Lead; Learning; Life; Light; Literature; Location; Measures; Medical; Migraine; Neighborhood Health Center; New England; North Carolina; Pain; Pain intensity; Pain interference; Pain management; Participant; Patients; Persons; Pragmatic clinical trial; Prevalence; Primary Health Care; Reporting; Research; Risk Factors; Role; Rural; Sampling Studies; Severities; Socioeconomic Status; Stress; Symptoms; Syndrome; Telemedicine; Temporomandibular Joint Disorders; Tension Headache; Translating; Underrepresented Populations; Visit; Vulvodynia; Woman; base; biopsychosocial factor; central sensitization; chronic pain; chronic pain management; chronic painful condition; cost; demographics; disability; endometriosis; ethnic diversity; evidence base; experience; health care settings; health disparity; intervention participants; low socioeconomic status; marginalized population; mindfulness; mindfulness intervention; mindfulness meditation; mindfulness-based stress reduction; pain outcome; pain processing; pain-related disability; perceived discrimination; primary care setting; psychologic; psychological distress; racial diversity; racism; recruit; resilience; response; safety net; skills; social health determinants; study population; tool; treatment as usual

PROJECT SUMMARY/ABSTRACT Chronic pain is one of the most common conditions treated in the primary care setting, with chronic low back pain (cLBP) costing over 30 billion dollars a year; yet treatment remains unsatisfactory for many patients. Chronic pain is commonly defined by anatomic location; however, the underlying mechanisms of chronic pain conditions may be more closely related to the central sensitization of pain processing with significant overlap existing among chronic pain syndromes. The term Chronic Overlapping Pain Conditions (COPCs) refers to commonly coexisting or co-prevalent idiopathic pain conditions, and cLBP is one of the conditions identified as a COPC. Other examples include fibromyalgia and chronic migraine. It is estimated that among people with chronic low back pain, two-thirds have additional COPCs. Although COPCs are common, risk factors and protective mechanisms are not well characterized. This study will use a tool called the Chronic Overlapping Pain Conditions screener to identify people with COPCs among participants enrolled in the OPTIMUM study (Optimizing Pain Treatment in Medical settings Using Mindfulness). The first aim of this study is to measure the prevalence and risks factors associated with Chronic Overlapping Pain Conditions in our study sample. The second aim is to identify how the response to the OPTIMUM intervention differs between people with isolated cLBP and those with additional COPCs. The third aim is to explore the experiences of study participants with COPCs from historically marginalized populations. The OPTIMUM study is a pragmatic clinical trial of mindfulness-based stress reduction (MBSR) adapted to address chronic pain and delivered via telemedicine in a primary care setting as group medical visits. The OPTIMUM study is recruiting people with cLBP from three primary care health settings that together provide for a racially and ethnically diverse study population. Given the “real life” setting of the OPTIMUM study, we expect findings to be highly relevant across multiple primary care settings including urban and rural safety net organizations. Additional findings regarding the prevalence and demographics of COPCs, the response of participants with COPCs to the OPTIMUM intervention, and the interviews with people with COPCs from historically marginalized populations, will advance knowledge about the characteristics and potential treatments for COPCs.

项目总结/摘要 慢性疼痛是在初级保健环境中治疗的最常见的疾病之一， 慢性腰痛（cLBP）每年花费超过300亿美元;但许多患者的治疗仍然不令人满意。 慢性疼痛通常由解剖位置定义;然而，慢性疼痛的潜在机制 条件可能与疼痛处理的中枢敏感性更密切相关， 存在于慢性疼痛综合征中。慢性重叠性疼痛（COPC）是指 通常共存或共同流行的特发性疼痛病症，而cLBP是被鉴定为 COPC。其他例子包括纤维肌痛和慢性偏头痛。据估计， 慢性腰痛，三分之二有额外的COPC。虽然COPC很常见，但风险因素和 保护机制没有得到很好的表征。这项研究将使用一种称为慢性重叠的工具， 疼痛状况筛选器，用于在OPTIMUM研究入组的受试者中识别COPC患者 （使用正念优化医疗环境中的疼痛治疗）。本研究的第一个目的是测量 在我们的研究样本中，与慢性重叠性疼痛疾病相关的患病率和风险因素。的 第二个目标是确定隔离人群对OPTIMUM干预的反应如何不同。 cLBP和具有额外COPC的那些。第三个目的是探讨研究参与者的经验， 从历史上被边缘化的人群COPC。OPTIMUM研究是一项实用的临床试验， 基于正念的压力减轻（MBSR）适用于解决慢性疼痛，并通过远程医疗提供， 一个初级保健设置为团体医疗访问。OPTIMUM研究正在招募来自三个国家的cLBP患者 初级保健卫生机构，共同提供了一个种族和民族多样化的研究人群。给定 OPTIMUM研究的“真实的生活”环境，我们预计结果在多个主要 护理机构，包括城市和农村安全网组织。关于流行率的其他调查结果 COPC的人口统计学特征，COPC参与者对OPTIMUM干预的反应，以及 与来自历史上边缘化人群的COPC患者进行访谈，将促进对 COPCs的特点和潜在的治疗方法。