Pain in Hidradenitis Suppurativa: Adolescent Phenotypes and Perspectives

化脓性汗腺炎的疼痛：青少年表型和观点

• 批准号: 10861570
• 负责人: Lauren Anne Vigil Orenstein
• 金额: $ 7.27万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10861570
• 关键词: 17 year old; 21 year old; Abscess; Accident and Emergency department; Activities of Daily Living; Address; Adolescence; Adolescent; Adult; Advocate; Affect; Age; Analgesics; Anxiety; Applications Grants; Award; Black race; Caring; Categories; Child; Childhood; Chronic; Cicatrix; Classification; Clinic; Clinical; Clinical Trials; Communities; Complex; Consent; Cross-Sectional Studies; Data; Dermatologic; Dermatologist; Dermatology; Development Plans; Disease; Doctor of Philosophy; Enrollment; Environment; Family; Future; Goals; Guidelines; Gynecologist; Hidradenitis Suppurativa; International; Intervention; Interview; K-Series Research Career Programs; Knowledge; Linear Regressions; Longevity; Measurement; Measures; Mental Depression; Mentors; Mentorship; Neuropathy; Nociception; Opiate Addiction; Opioid; Pain; Pain Measurement; Pain interference; Pain management; Pain quality; Palliative Care; Parents; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Pattern; Pediatric Research; Phenotype; Population; Process; Prospective cohort; Prospective, cohort study; Quality of life; Recommendation; Recurrence; Reporting; Research; Research Infrastructure; Research Personnel; Sensory; Severities; Site; Structure; Surgeon; Symptoms; Techniques; Testing; Time; Training; Underserved Population; Work; adolescent patient; aged; career; career development; chronic inflammatory skin; cohort; comparison control; daily functioning; daily pain; design; experience; improved; instrument; intervention mapping; medical specialties; opioid sparing; opioid use; pain outcome; pain reduction; pain score; painful neuropathy; prevent; prospective; recruit; skin disorder; suicidal risk; systemic inflammatory response; therapy development; validation studies

Project Summary/Abstract Candidate: This competitive revision to a K23 career development award will prepare Lauren Orenstein, MD, MSc to conduct studies in adolescent patients with hidradenitis suppurativa (HS), a chronic inflammatory skin disease characterized by recurrent painful scarring abscesses. She will adapt techniques to understand their pain mechanisms and develop recommendations for targeted interventions to reduce adolescents’ pain and prevent progression to chronic opioid use. In addition to the career development objectives of her original K23, this revision provides mentored experience in multi-site recruitment, research in pediatric populations, and adolescent stakeholder engagement. Mentoring and Environment: In addition to her internationally renowned K23 mentorship team, this competitive revision will add mentorship in pediatric research and adolescent populations from Leslie Lawley, MD (expertise: pediatric dermatology, validating study instruments in pediatric populations). It will also establish relationships with community pediatric dermatologists, gynecologists, and surgeons for multi- site study recruitment. She will continue her ongoing relationships with K23 primary mentors (Rachel Patzer, PhD MPH and Dio Kavalieratos, PhD), other co-mentors (Suephy Chen, MD MS, Amit Garg, MD, and Daniel Harper, PhD), and consultants (John Ingram, MA MSc DM FRCP FAcadMedEd, Kimberly Curseen, MD, and Anne-Marie McKenzie-Brown, MD). Research: This research aims to address knowledge gaps related to HS pain in adolescents and develop recommendations for family-centered interventions to alleviate pain and prevent long-term opioid use. Specific Aims: An ongoing 16-week prospective cohort study in adults will be adapted for adolescents aged 12-17 years who have moderate-to-severe HS. Comprehensive assessments, including clinical disease activity, systemic inflammation, and sensory profiles using quantitative sensory testing, will be used to characterize HS pain mechanisms in adolescents compared to adults, identify pain trajectories, and optimize pain measurement in adolescents for clinical trials. In a separate study, semi-structured interviews with adolescents and their parents/guardians will explore unmet needs in HS pain management. These data will inform a Stakeholder Panel consisting of adult and adolescent HS patients, care partners, community advocates, and experts in HS, palliative care, and pain management. The panel will use Intervention Mapping to develop recommendations for designing and evaluating complex interventions aimed at addressing pain and suffering in adults and adolescents with HS. This study represents one of the first prospective cohorts of adolescents with HS. It will yield an engaged stakeholder panel with the preliminary data needed for intervention development in future R01 grant proposals focusing on a unique window of opportunity in adolescence to prevent progression to chronic opioid dependence.

项目总结/摘要 候选人：这个对K23职业发展奖的竞争性修订将为劳伦·奥伦斯坦做好准备， MD，MSc在患有化脓性汗腺炎（HS）的青少年患者中进行研究， 一种炎症性皮肤病，特征是反复出现的疼痛的疤痕。她会调整技巧 了解他们的疼痛机制，并制定有针对性的干预措施，以减少 青少年的疼痛，并防止进展为慢性阿片类药物使用。除了职业发展 她原来的K23的目标，这一修订提供了指导的经验，在多个地点的招聘， 儿童群体研究和青少年利益相关者参与。 导师和环境：除了她的国际知名的K23导师团队， 竞争性修订将增加指导儿科研究和青少年人口从莱斯利 Lawley，MD（专长：儿科皮肤病学，在儿科人群中确认研究仪器）。它将 还与社区儿科皮肤科医生、妇科医生和外科医生建立关系， 研究中心招募。她将继续与K23主要导师（Rachel Patzer，PhD MPH和Dio Kavalieratos，PhD），其他共同导师（Suephy Chen，MD MS，Amit Garg，MD， 和丹尼尔哈珀，博士）和顾问（约翰英格拉姆，硕士DM FRCP FAcadMedEd，金伯利 Curseen，MD和Anne-Marie McKenzie-Brown，MD）。 研究：这项研究旨在解决与青少年HS疼痛相关的知识差距并开发 建议以家庭为中心的干预措施，以减轻疼痛和防止长期使用阿片类药物。 具体目的：一项正在成人中进行的16周前瞻性队列研究将适用于青少年 年龄在12-17岁，患有中度至重度HS。全面评估，包括临床 疾病活动，全身性炎症，和感官档案使用定量感官测试，将是 用于表征青少年与成人相比的HS疼痛机制，确定疼痛轨迹， 并为临床试验优化青少年的疼痛测量。在一项单独的研究中， 与青少年及其父母/监护人的访谈将探讨HS疼痛管理中未满足的需求。 这些数据将告知由成人和青少年HS患者，护理伙伴， 社区倡导者和HS、姑息治疗和疼痛管理专家。该小组将使用 干预措施绘图，为设计和评估复杂的干预措施提出建议 旨在解决成人和青少年HS的疼痛和痛苦。这项研究代表了 第一批HS青少年前瞻性队列。它将产生一个参与的利益攸关方小组， 在未来的R 01赠款提案中开发干预措施所需的初步数据， 在青春期的机会窗口，以防止进展为慢性阿片类药物依赖。