Data Coordinating Center for Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK)
预防急性至慢性背痛的脊柱手法和患者自我管理数据协调中心 (PACBACK)
基本信息
- 批准号:10895775
- 负责人:
- 金额:$ 13.82万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-09-01 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AcuteAddressAdultAffectBackBehaviorBehavioralCaringChronic low back painDataData Coordinating CenterDissemination and ImplementationDrug usageEffectivenessEnrollmentGuidelinesHealth OccupationsHealthcareHybridsInterventionLow Back PainMedicalMethodsNational Center for Complementary and Integrative HealthOpioidOverdosePain managementPatientsPharmaceutical PreparationsPharmacotherapyPreventionPsychosocial FactorRandomizedRecommendationRecoveryResearchRisk FactorsRoleScreening procedureSecondary PreventionSelf ManagementSocietiesSpinal ManipulationStrategic PlanningStructureSubgroupTestingTranslatingTranslationsaddictionbiopsychosocialchronic back painchronic painchronic painful conditionclinical practicecostdesigndisabilityeffectiveness evaluationempowermentfuture implementationhigh riskimplementation strategyimprovednondrug therapynovelopioid misusepain chronificationpain reductionpain-related disabilitypreventprimary outcomeproductivity losspublic health prioritiesrandomized trialsecondary outcometargeted treatmentuptake
项目摘要
SUMMARY. The US is in the midst of an unprecedented pain management crisis. Low back pain (LBP) is the
most common chronic pain condition in adults and the leading cause of disability worldwide. Guidelines have
recommended non-pharmacologic treatments like spinal manipulation and behavioral approaches for LBP for
nearly a decade, however uptake in practice has been poor. Little is known about the role of these treatments
in secondary prevention of chronic LBP (cLBP), especially for patients with biopsychosocial risk factors. With
burgeoning costs of cLBP and mounting evidence of ineffectiveness and harms of commonly used drug
treatments, including opioids, there is a critical need for research on non-pharmacological treatments for cLBP
prevention that can be readily translated to practice.
The long-term objective is to reduce overall LBP burden by testing scalable first-line non-pharmacologic
strategies that address the biopsychosocial aspects of acute/sub-acute LBP and prevent transition to cLBP.
We propose a novel randomized hybrid trial addressing both effectiveness and implementation. A total of 1000
patients will be enrolled with nonspecific LBP of 2-12 weeks duration, at medium and high risk of developing
cLBP using the Subgroups for Targeted Treatment (STarT) Back Screening Tool (SBST). Aim 1 will assess
the effectiveness of Spinal Manipulation Therapy (SMT), Structured Self-Management (SSM), and SMT+SSM
relative to Usual Medical Care (UMC) in a randomized trial using a 2x2 factorial design. Primary outcomes are
cLBP Impact at 12 months; and cumulative reduction of pain and disability over 1 year. Secondary outcomes
include recovery from acute/sub-acute LBP at 6 months, PROMIS-29, productivity loss, health care use, and
medication use (including opioids). Aim 2: will use mixed methods to gather data about important influences
on the interventions that could affect results interpretation and future implementation.
Aligned with the National Center for Complementary and Integrative Health’s (NCCIH) Strategic Plan 2016, this
project has the potential to significantly transform LBP management by providing definitive and generalizable
evidence regarding front-line non-pharmacologic interventions addressing physical and psychosocial factors
for the prevention of cLBP. By empowering patients to engage in healthy pain management behaviors, we
anticipate LBP related disability, productivity loss, and reliance on continued health care and medication use
(including opioids) will be reduced. The comprehensive dissemination and implementation strategy, informed
by major stakeholders, will facilitate translation into clinical practice across health professions.
摘要美国正处于前所未有的疼痛管理危机之中。下背痛(LBP)是
成人最常见的慢性疼痛状况,也是全球残疾的主要原因。准则
推荐的非药物治疗,如脊柱推拿和行为方法治疗腰痛,
然而,近十年来,在实践中的吸收一直很差。人们对这些治疗的作用知之甚少
在慢性LBP(cLBP)的二级预防中,特别是对于具有生物心理社会危险因素的患者。与
cLBP的成本迅速上升,越来越多的证据表明常用药物无效和有害
治疗,包括阿片类药物,对cLBP的非药物治疗的研究是迫切需要的
预防可以很容易地转化为实践。
长期目标是通过测试可扩展的一线非药物治疗,
解决急性/亚急性LBP的生物心理社会方面并防止向cLBP过渡的策略。
我们提出了一种新的随机混合试验解决有效性和实施。共1000
将招募持续时间为2-12周的非特异性LBP患者,这些患者具有中度和高度的发展风险。
cLBP使用靶向治疗亚组(STarT)回筛工具(SBST)。目标1将评估
脊柱推拿疗法(SMT)、结构化自我管理(SSM)和SMT+SSM的有效性
相对于家庭医疗护理(UMC),在一项随机试验中使用2x2析因设计。主要结局
12个月时的cLBP影响;以及1年内疼痛和残疾的累积减轻。次要结局
包括6个月时急性/亚急性LBP恢复、PROMIS-29、生产力损失、卫生保健使用,
药物使用(包括阿片类药物)。目标2:将使用混合方法收集有关重要影响的数据
关于可能影响结果解释和未来执行的干预措施。
根据国家补充和综合健康中心(NCCIH)2016年战略计划,
该项目有可能通过提供明确的和可推广的LBP管理,
关于解决身体和心理社会因素的一线非药物干预措施的证据
用于预防cLBP。通过让患者参与健康的疼痛管理行为,我们
预计LBP相关的残疾,生产力损失,以及对持续医疗保健和药物使用的依赖
(包括阿片类药物)将减少。全面传播和执行战略,
由主要利益攸关方提供的信息,将有助于转化为跨卫生专业的临床实践。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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PATRICK J HEAGERTY其他文献
PATRICK J HEAGERTY的其他文献
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{{ truncateString('PATRICK J HEAGERTY', 18)}}的其他基金
Data Coordinating Center for Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK)
预防急性至慢性背痛的脊柱手法和患者自我管理数据协调中心 (PACBACK)
- 批准号:
10226960 - 财政年份:2017
- 资助金额:
$ 13.82万 - 项目类别:
Data Coordinating Center for Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK)
预防急性至慢性背痛的脊柱手法和患者自我管理数据协调中心 (PACBACK)
- 批准号:
10460354 - 财政年份:2017
- 资助金额:
$ 13.82万 - 项目类别:
Data Coordinating Center for Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK)
预防急性至慢性背痛的脊柱手法和患者自我管理数据协调中心 (PACBACK)
- 批准号:
9923235 - 财政年份:2017
- 资助金额:
$ 13.82万 - 项目类别:
High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) DCC
高剂量促红细胞生成素治疗窒息和脑病 (HEAL) DCC
- 批准号:
9174290 - 财政年份:2016
- 资助金额:
$ 13.82万 - 项目类别:
High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) DCC
高剂量促红细胞生成素治疗窒息和脑病 (HEAL) DCC
- 批准号:
9355476 - 财政年份:2016
- 资助金额:
$ 13.82万 - 项目类别:
Preterm Epo Neuroprotection Trial (PENUT Trial) DCC
早产儿 Epo 神经保护试验(PENUT 试验)DCC
- 批准号:
8773752 - 财政年份:2013
- 资助金额:
$ 13.82万 - 项目类别:
Preterm Epo Neuroprotection Trial (PENUT Trial) DCC
早产儿 Epo 神经保护试验(PENUT 试验)DCC
- 批准号:
8497375 - 财政年份:2013
- 资助金额:
$ 13.82万 - 项目类别:
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