MEDICAL CARE AND RISKS OF DYSFUNCTIONAL CHRONIC PAIN

医疗护理和功能障碍性慢性疼痛的风险

基本信息

批准号：
2236234
负责人：
Michael R Von Korff
金额：
$ 13.91万
依托单位：
GROUP HEALTH COOPERATIVE OF PUGET SOUND
依托单位国家：
美国
项目类别：
财政年份：
1993
资助国家：
美国
起止时间：
1993-09-01 至 1996-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2236234
关键词：
MEDICAL CARE RISKS DYSFUNCTIONAL CHRONIC

项目摘要

The proposed research seeks to investigate how a more rational and Cost- effective balance between medical intervention and self-care can be achieved for chronic pain. These goals will be accomplished through three interrelated studies: Study 1 assesses long-term patterns of disability, medicine use, health care use, and health care costs among primary care back pain and headache patients. Study 2 assesses approaches to integrating cognitive-behavioral interventions into health care for chronic pain. Study 1 - Primary care back pain (N=975) and headache (N=625) patients will be interviewed four years after enrollment in a completed 3 wave study. The aims of this follow-up are to: a) provide data on the long- term outcomes of dysfunctional chronic pain; b) determine how patterns of pain medication use, health care use and health care costs change over four years in relation to pain dysfunction status; and c) identify baseline characteristics of pain patients for whom long-term health care costs may outweigh costs of cognitive-behavioral interventions. Study 2 - In this study, visits with 89 back pain and 50 headache patients will be audiotaped and coded for physician-patient interaction. Study subjects will be interviewed one month after their visit to assess short-term outcomes. The objectives of Study 2 are: (i) to determine the extent to which physicians vs. patients initiate "medical model" inter- ventions for dysfunctional and nondysfunctional patients; and 2 to identify patient and provider behaviors that would impede or enhance integration of cognitive-behavioral interventions into the medical encounter.

拟议的研究旨在调查如何更合理和成本 - 医疗干预和自我保健之间的有效平衡可以是为慢性疼痛而实现。这些目标将通过三个相互关联的研究：研究1评估残疾的长期模式，医学使用，医疗保健使用和初级保健费用背痛和头痛患者。研究2评估方法将认知行为干预措施整合到医疗保健中慢性疼痛。研究1-初级保健背痛（n = 975）和头痛（n = 625）患者入学后四年将接受面试学习。此后续行动的目的是：a）提供有关长期的数据功能失调的慢性疼痛的术语结果； b）确定模式如何使用止痛药，医疗保健使用和医疗保健费用的变化与疼痛功能障碍状态有关的四年； c）确定长期医疗保健的疼痛患者的基线特征成本可能大于认知行为干预的成本。研究2-在这项研究中，有89次背痛和50个头痛的访问患者将被录音并编码用于医师患者相互作用。研究对象将在访问后一个月接受采访短期结局。研究2的目标是：（i）确定医师与患者启动“医学模型”的程度功能障碍和非功能失调患者的班级；和2 to 确定会阻碍或增强的患者和提供者行为将认知行为干预融合到医疗中遇到。