PREventing Pain after Surgery: A feasibility and acceptability study of Acceptance and Commitment Therapy for the prevention of chronic post surgical pain (PREPS)

预防手术后疼痛：接受和承诺疗法预防慢性术后疼痛（PREPS）的可行性和可接受性研究

• 批准号: 10850150
• 负责人: Samantha M Meints
• 金额: $ 14万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10850150
• 关键词: Adverse event; Biological; Black Populations; Black race; Brain-Derived Neurotrophic Factor; Certified registered nurse anesthetist; Chronic; Clinical; Collaborations; Collagen; Complex; Cysteine; DNA Methylation; DNA Sequence; Data; Development; Disparity; Education; Environmental Exposure; Environmental Risk Factor; Epigenetic Process; Future; Genes; Genetic; Genetic Processes; Goals; Heritability; Hypermethylation; Immune; Immune Response Genes; Individual; Inequity; Inflammatory; Intervention; Measures; Meditation; Methylation; Mind-Body Intervention; Nociception; Opioid Receptor; Pain; Pain management; Participant; Pathogenesis; Pathway interactions; Patient Schedules; Patients; Postoperative Pain; Prevention; Prevention therapy; Process; Promoter Regions; Protein Secretion; Proteins; Psychologist; Psychosocial Factor; Race; Randomized, Controlled Trials; Reporting; Research Personnel; Role; Schedule; Severities; Signal Pathway; Socioeconomic Status; Spinal Fusion; Spine surgery; Stress; Stressful Event; Tai Ji; Time; Violence; Yoga; acceptability and feasibility; adverse childhood events; biological adaptation to stress; black patient; bone; calcification; chronic pain; chronic pain management; chronic painful condition; experience; functional outcomes; improved; innovation; inter-institutional; intervertebral disk degeneration; low socioeconomic status; methylation pattern; negative affect; neuroinflammation; pain catastrophizing; pain processing; pain reduction; patient subsets; prevent; psychologic; psychosocial; racial difference; racial discrimination; racial disparity; receptor expression; social health determinants; social stigma; stress management; treatment as usual

Summary/Abstract This proposal responds to NOT-AR-23-015 by both generating supportive evidence toward a future innovative study for the prevention of chronic postsurgical pain (CPSP) and expanding the current project by collecting data on immune mechanisms of pain and social determinants of health (SDoH) through a new collaboration. A large subset of patients who undergo spine surgery experience chronic post-surgical pain, a problem that is more prevalent among Black compared to White patients. This may be due, in part, to the interaction between SDoH and genetics. Differential DNA methylation (DNAm) is associated with chronic post- surgical pain as well as SDoH and thus may help to explain race differences chronic post-surgical pain. Moreover, there is evidence that mind-body interventions may confer benefit by modifying DNAm patterns. There is a need to better understand the role of DNAm in the development of CPSP and the extent to which it serves as a mechanism of Acceptance and Commitment Therapy on the prevention of CPSP. The present project will capitalize on a randomized, controlled trial of Acceptance and Commitment Therapy + treatment as usual compared to treatment as usual in 100 patients scheduled to undergo spine surgery. In this proposal we will determine the extent to which DNAm patterns are associated with SDoH, examine the relationship between DNAm patterns and CPSP, and explore the extent to which effects of Acceptance and Commitment Therapy are associated with changes in DNAm patterns. This approach will allow us to better understand the mechanism of CPSP including the complex interaction between SDoH and genetic processes. Moreover, we will further elucidate biological mechanisms of mind-body interventions such as Accetance and Commitment Therapy in the prevention of chronic pain. Together, results of this study will inform interventions aimed at reducing pain disparities and inequities.

摘要/摘要 该提案通过生成支持未来的证据来回应 NOT-AR-23-015 预防慢性术后疼痛（CPSP）的创新研究并通过以下方式扩展当前项目 通过新的方法收集有关疼痛免疫机制和健康社会决定因素（SDoH）的数据 合作。接受脊柱手术的很大一部分患者会经历慢性术后疼痛， 与白人患者相比，这个问题在黑人患者中更为普遍。这可能部分是由于 SDoH 和遗传学之间的相互作用。差异DNA甲基化（DNAm）与慢性后遗症有关。 手术疼痛和 SDoH 一样，因此可能有助于解释慢性手术后疼痛的种族差异。 此外，有证据表明身心干预可能通过改变 DNAm 模式而带来益处。 需要更好地了解 DNAm 在 CPSP 发展中的作用及其程度 作为预防 CPSP 的接受和承诺疗法的机制。现在的 项目将利用接受和承诺疗法+治疗的随机对照试验 与常规治疗相比，100 名计划接受脊柱手术的患者接受常规治疗。在这个提案中我们 将确定 DNAm 模式与 SDoH 关联的程度，检查之间的关系 DNAm 模式和 CPSP，并探讨接受和承诺疗法的影响程度 与 DNAm 模式的变化有关。这种方法可以让我们更好地理解 CPSP 的机制包括 SDoH 和遗传过程之间复杂的相互作用。此外，我们 将进一步阐明身心干预的生物学机制，例如接受和承诺 预防慢性疼痛的治疗。总之，这项研究的结果将为旨在实现以下目标的干预措施提供信息： 减少疼痛差异和不平等。

项目成果

Interactive effects of sleep disturbance and opioid use on pain-related interference and physical functioning among patients with chronic low back pain.

睡眠障碍和阿片类药物使用对慢性腰痛患者疼痛相关干扰和身体功能的交互影响。

• DOI: 10.1093/pm/pnad101
• 发表时间: 2023
• 期刊: Pain medicine (Malden, Mass.)
• 作者: Wilson,JennaM;Yoon,JiHee;Schreiber,KristinL;Edwards,RobertR;Sieberg,ChristineB;Meints,SamanthaM
• 通讯作者: Meints,SamanthaM

Let's Get Physical! A Comprehensive Review of Pre- and Post-Surgical Interventions Targeting Physical Activity to Improve Pain and Functional Outcomes in Spine Surgery Patients.

• DOI: 10.3390/jcm12072608
• 发表时间: 2023-03-30
• 期刊: JOURNAL OF CLINICAL MEDICINE
• 影响因子: 3.9
• 作者: Pester, Bethany D. D.;Yoon, Jihee;Yamin, Jolin B. B.;Papianou, Lauren;Edwards, Robert R. R.;Meints, Samantha M. M.
• 通讯作者: Meints, Samantha M. M.

Mind-body approaches for reducing the need for post-operative opioids: Evidence and opportunities

减少术后阿片类药物需求的身心方法：证据和机会

• DOI: 10.46439/anesthesia.3.016
• 发表时间: 2022
• 期刊: Journal of clinical anesthesia and intensive care
• 作者: Bethany D. Pester;R. Edwards;M. Martel;C. Gilligan;Samantha M. Meints
• 通讯作者: Samantha M. Meints

Multimodal prediction of pain and functional outcomes 6 months following total knee replacement: a prospective cohort study.

• DOI: 10.1186/s12891-022-05239-3
• 发表时间: 2022-03-29
• 期刊: BMC musculoskeletal disorders
• 影响因子: 2.3
• 作者: Edwards RR;Campbell C;Schreiber KL;Meints S;Lazaridou A;Martel MO;Cornelius M;Xu X;Jamison RN;Katz JN;Carriere J;Khanuja HP;Sterling RS;Smith MT;Haythornthwaite JA
• 通讯作者: Haythornthwaite JA

The Pain and PRAYER Scale (PPRAYERS): development and validation of a scale to measure pain-related prayer.

• DOI: 10.1093/pm/pnad020
• 发表时间: 2023-07-05
• 期刊: PAIN MEDICINE
• 影响因子: 3.1
• 作者: Meints, Samantha M.;Illueca, Marta;Miller, Megan M.;Osaji, Dikachi;Doolittle, Benjamin
• 通讯作者: Doolittle, Benjamin