Characteristics and impact of chronic pain and pain management in older adults

项目总结/摘要 慢性疼痛和成瘾是非常普遍和经常共同发生的条件，产生协同作用， 对个人、提供者和卫生保健系统的影响。然而，迄今为止还没有研究进行了一项 老年人慢性疼痛和药物使用共同发生的综合评价（年龄 ≥65）。关注老年人至关重要，因为这一人群更容易受到有害疼痛的影响， 物质使用相关的影响，具有较高的多药和多药比率，并经历年龄- 药代动力学和药效学的相关变化。因此，评估患病率的研究 同时发生的慢性疼痛和物质使用的影响，这一人群是迫切需要的。 在亲本R 01（AG 064947）中，研究小组正在进行一项基于人群的纵向研究， 老年人的慢性疼痛我们招募了一个具有全国代表性的老年人样本（N=2038）， NORC在芝加哥大学内部开发的AmeriSpeak®面板。参与者已经 受邀完成两波数据收集。在本行政补充文件中，我们将利用 母公司R 01的基础设施，包括对同时发生的慢性疼痛的综合评估， 第三波数据收集期间老年人的物质使用情况。具体而言，我们将增加评估措施， 阿片样物质和非阿片样物质的量/频率（即，酒精、大麻、尼古丁）物质使用和 物质使用问题模式的存在/严重程度。这种方法将使我们能够确定 有慢性疼痛与无慢性疼痛的老年人中物质使用的流行率和特征。在 此外，我们将研究慢性疼痛，有问题的物质使用的影响，以及他们的共同出现， 重要的患者报告的结果（即，身体和认知功能以及生活质量）。最后我们将 探索理论上知情的生物心理社会调节者的假设影响慢性疼痛状态， 物质使用。该项目将是第一个对慢性疼痛和物质使用进行的综合研究 一个全国范围内有代表性的老年人样本从本研究中获得的信息将提供 关键的科学起点，以了解并发慢性疼痛的患病率和影响， 老年人的物质使用。研究结果将为未来的描述性和干预性研究提供信息，以解决 共同发生的慢性疼痛和物质使用，并改善患者报告的结果，在不断增长的和高度 慢性疼痛的老年人的脆弱人群。

PROJECT SUMMARY/ABSTRACT Chronic pain and addiction are highly prevalent and frequently co-occurring conditions that produce synergistic effects on individuals, providers, and health-care systems. However, no studies to date have conducted a comprehensive evaluation of the co-occurrence of chronic pain and substance use among older adults (age ≥65). Focusing on older adults is critical given that this population is more susceptible to deleterious pain- and substance use-related effects, has higher rates of multimorbidity and polypharmacy, and experiences age- related changes in pharmacokinetics and pharmacodynamics. Therefore, research evaluating the prevalence and impact of co-occurring chronic pain and substance use among this population is sorely needed. In the parent R01 (AG064947), the research team is conducting a longitudinal population-based study of chronic pain in older adults. We recruited a nationally representative sample of older adults (N=2038) from NORC at the University of Chicago’s internally developed AmeriSpeak® Panel. Participants have already been invited to complete two waves of data collection. In this administrative supplement, we will leverage the infrastructure of the parent R01 to include a comprehensive assessment of co-occurring chronic pain and substance use in older adults during Wave 3 of data collection. Specifically, we will add measures to assess quantity/frequency of opioid and nonopioid (i.e., alcohol, cannabis, nicotine) substance use and the presence/severity of problematic patterns of substance use. This approach will allow us to determine the prevalence and characteristics of substance use among older adults with versus without chronic pain. In addition, we will examine the effects of chronic pain, problematic substance use, and their co-occurrence on important patient-reported outcomes (i.e., physical and cognitive function and quality of life). Finally, we will explore theoretically informed biopsychosocial moderators of the hypothesized effects of chronic pain status on substance use. This project will be the first comprehensive study of chronic pain and substance use conducted with a nationally representative sample of older adults. The information obtained from this study will provide a critical scientific starting point to understand the prevalence and impact of co-occurring chronic pain and substance use among older adults. Findings will inform future descriptive and intervention studies to address co-occurring chronic pain and substance use and improve patient-reported outcomes in the growing and highly vulnerable population of older adults with chronic pain.