Chronic Pain in Pediatric Primary Care

儿科初级保健中的慢性疼痛

• 批准号: 8906901
• 负责人: Amy S Lewandowski Holley
• 金额: $ 11.29万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-15 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8906901
• 关键词: Accounting; Acute; Address; Adolescence; Adolescent; Adult; Aftercare; Anesthesiology; Anxiety; Appointment; Award; Behavior Therapy; Behavioral; Child; Childhood; Chronic; Chronic disabling pain; Data; Development; Diagnosis; Early treatment; Faculty; Future; Goals; Instruction; Intervention; Investigation; Laboratories; Medicine; Mental Depression; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Musculoskeletal Pain; Online Systems; Outcome; Pain; Pain Measurement; Pain management; Pain-Free; Parents; Patients; Play; Population; Prevention; Prevention Research; Primary Health Care; Psychological Factors; Psychophysics; Recruitment Activity; Research; Research Institute; Research Training; Resources; Risk; Sampling; Schools; Site; Symptoms; Testing; Time; Training; Universities; Washington; Youth; base; career development; chronic pain; clinical phenotype; comparison group; design; disability; neurophysiology; patient oriented research; pediatric patients; pilot trial; predictive modeling; prevent; professor; programs; protocol development; psychologic; psychosocial

DESCRIPTION (provided by applicant): Pain accounts for 20-40% of primary care appointments during childhood and adolescence with musculoskeletal pain as a principal pain complaint. Pain in childhood is significant because it increases risk for pain, disability, and psychiatric disorders in adulthood. However, the mechanisms underlying the transition from acute to chronic pain in children are not known. Using a combination of psychophysical and psychological assessment, the central aim of this proposal is to understand the mechanisms that contribute to the transition from acute to chronic musculoskeletal pain in children and adolescents. The long-term goal of this K23 award is for the candidate to establish a programmatic line of patient-oriented research focused on identification of at- risk youth and prevention of chronic pain. The K23 candidate is an acting assistant professor in the Department of Anesthesiology and Pain Medicine at the University of Washington. The candidate proposes a five-year training plan with the support of faculty mentors who have expertise in pediatric pain, laboratory pain assessment, and prevention research to obtain instruction in state-of-the-art conditioned pain modulation assessment, prevention research, and training in pain assessment, diagnosis, and treatment in primary care. The University of Washington and Seattle Children's Research Institute provide excellent institutional support and resources for this award. The research plan involves three studies. Study 1 will compare clinical phenotypes of youth with acute musculoskeletal pain, chronic musculoskeletal pain, and healthy pain-free youth. Study 2 will prospectively follow a sample of youth with acute musculoskeletal pain in primary care to identify predictors of chronic pain development. Study 3 will pilot a web-based behavioral intervention for early treatment of chronic pain in primary care. These studies will lay the groundwork for future investigations examining profiles or clinical phenotypes of children in primary care who are at-risk for chronic pain; data that can inform a predictive model of chronic pain development.

描述（由申请人提供）：在儿童和青少年时期，疼痛占初级保健预约的20-40%，肌肉骨骼疼痛是主要的疼痛主诉。童年时期的疼痛很重要，因为它会增加成年后疼痛、残疾和精神疾病的风险。然而，儿童从急性疼痛转变为慢性疼痛的机制尚不清楚。使用心理物理和心理评估相结合，本提案的中心目的是了解有助于儿童和青少年从急性肌肉骨骼疼痛过渡到慢性肌肉骨骼疼痛的机制。该K23奖的长期目标是为候选人建立一个以患者为导向的研究项目，重点是识别高危青少年和预防慢性疼痛。K23候选人是华盛顿大学麻醉学和疼痛医学系的代理助理教授。候选人提出了一个为期五年的培训计划，并得到了在儿科疼痛，实验室疼痛评估和预防研究方面具有专业知识的教师导师的支持，以获得最先进的条件性疼痛调节评估，预防研究和疼痛评估，诊断和治疗培训的指导。华盛顿大学和西雅图儿童研究所为该奖项提供了出色的机构支持和资源。该研究计划涉及三项研究。研究1将比较急性肌肉骨骼疼痛、慢性肌肉骨骼疼痛和健康无痛青年的临床表型。研究2将前瞻性地随访初级保健中急性肌肉骨骼疼痛的青年样本，以确定慢性疼痛发展的预测因素。研究3将试行基于网络的行为干预，用于初级保健中慢性疼痛的早期治疗。这些研究将为未来的研究奠定基础，这些研究将检查初级保健中有慢性疼痛风险的儿童的概况或临床表型;这些数据可以为慢性疼痛发展的预测模型提供信息。