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

项目摘要/摘要 慢性疼痛是初级保健环境中最常见的疾病之一，患有慢性腰痛。 疼痛(CLBP)每年花费超过300亿美元；然而，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来定义；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化更密切相关，并有显著的重叠 存在于慢性疼痛综合征中。术语慢性重叠疼痛条件(COPC)指的是 通常并存或并存的特发性疼痛情况，cLBP是被确认为 一个COPC。其他例子包括纤维肌痛和慢性偏头痛。据估计，在患有癌症的人中 慢性下腰痛，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描述。这项研究将使用一种名为慢性重叠的工具 疼痛状况筛查以在参加最佳研究的参与者中识别患有COPC的人 (使用正念优化医疗环境中的疼痛治疗)。这项研究的第一个目的是测量 在我们的研究样本中，与慢性重叠疼痛状况相关的患病率和风险因素。这个 第二个目的是确定孤立性疾病患者对最佳干预措施的反应有何不同 CLBP和具有额外COPC的那些。第三个目标是探索研究参与者在 来自历史上被边缘化人口的COPC。该优化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，并通过远程医疗在 初级保健设置为集体就医。最优研究是从三个人中招募慢性下腰痛患者 初级保健保健环境，共同提供种族和民族多样化的研究人群。vt.给出 在最佳研究的“现实生活”背景下，我们预计研究结果将与多个主要研究高度相关 护理机构，包括城市和农村的安全网组织。关于流行率的其他发现 和COPC的人口统计数据，COPC参与者对最佳干预的反应，以及 采访来自历史边缘人群的COPC患者，将增进对以下方面的了解 慢性前列腺癌的特点和可能的治疗方法。

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.