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

项目摘要/摘要 慢性疼痛和成瘾是高度普遍且经常并存的疾病，可产生协同作用。 对个人、提供者和卫生保健系统的影响。然而，到目前为止，还没有研究进行过 老年人慢性疼痛和药物使用并存的综合评估(年龄 ≥65)。关注老年人是至关重要的，因为这一群体更容易受到有害疼痛的影响--而且 与药物使用相关的影响，有较高的多发病和多药并存的比率，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 而在这一人群中共同发生的慢性疼痛和药物使用的影响是迫切需要的。 在亲本R01(AG064947)中，研究小组正在进行基于种群的纵向研究 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)，来自 NORC在芝加哥大学内部开发的ameriSak®面板。参与者已经被 受邀完成两波数据采集。在本行政补充资料中，我们将利用 父母R01的基础设施，以包括对共同发生的慢性疼痛和 老年人在第三波数据收集期间的物质使用情况。具体地说，我们将增加评估措施 阿片类和非阿片类(即酒精、大麻、尼古丁)物质的使用数量/频率以及 有问题的物质使用模式/严重程度。这种方法将使我们能够确定 有或无慢性疼痛的老年人中物质使用的流行率和特征。在……里面 此外，我们将研究慢性疼痛、有问题的物质使用及其共同出现的影响 患者报告的重要结果(即身体和认知功能以及生活质量)。最后，我们会 从理论上探讨慢性疼痛状态对健康影响的生物心理社会调节因子 物质使用。该项目将是对慢性疼痛和药物使用进行的第一次全面研究 具有全国代表性的老年人样本。从这项研究中获得的信息将提供一个 关键的科学起点，以了解慢性疼痛的患病率和影响 老年人的物质使用情况。这些发现将为未来的描述性和干预性研究提供信息 共同发生的慢性疼痛和物质使用并改善患者报告的结果 患有慢性疼痛的老年人的弱势群体。

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.