COPC Administrative Supplement to Group-Based Mindfulness for Patients with Chronic Low Back Pain in the Primary Care

COPC 针对初级保健中慢性腰痛患者的团体正念行政补充

• 批准号: 10521941
• 负责人: Natalia E. Morone
• 金额: $ 59.19万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10521941
• 关键词: Address; Administrative Supplement; African American population; Age; Anatomy; Caring; Characteristics; Chronic; Chronic Fatigue Syndrome; Chronic low back pain; Conditioned Reflex; Development; Discrimination; Economics; Education; Enrollment; Fibromyalgia; Food; Health; Health Personnel; Health Services Accessibility; Hospitals; Housing; Insurance Carriers; Interstitial Cystitis; Intervention; Interview; Irritable Bowel Syndrome; Knowledge; Lead; Learning; Life; Light; Literature; Location; Measures; Medical; Migraine; Neighborhood Health Center; New England; North Carolina; Pain; Pain intensity; Pain interference; Pain management; Participant; Patients; Persons; Pragmatic clinical trial; Prevalence; Primary Health Care; Reporting; Research; Risk Factors; Role; Rural; Sampling Studies; Severities; Socioeconomic Status; Stress; Symptoms; Syndrome; Telemedicine; Temporomandibular Joint Disorders; Tension Headache; Translating; Underrepresented Populations; Visit; Vulvodynia; Woman; base; biopsychosocial factor; central sensitization; chronic pain; chronic pain management; chronic painful condition; cost; demographics; disability; endometriosis; ethnic diversity; evidence base; experience; health care settings; health disparity; intervention participants; low socioeconomic status; marginalized population; mindfulness; mindfulness intervention; mindfulness meditation; mindfulness-based stress reduction; pain outcome; pain processing; pain-related disability; perceived discrimination; primary care setting; psychologic; psychological distress; racial diversity; racism; recruit; resilience; response; safety net; skills; social health determinants; study population; tool; treatment as usual

PROJECT SUMMARY/ABSTRACT Chronic pain is one of the most common conditions treated in the primary care setting, with chronic low back pain (cLBP) costing over 30 billion dollars a year; yet treatment remains unsatisfactory for many patients. Chronic pain is commonly defined by anatomic location; however, the underlying mechanisms of chronic pain conditions may be more closely related to the central sensitization of pain processing with significant overlap existing among chronic pain syndromes. The term Chronic Overlapping Pain Conditions (COPCs) refers to commonly coexisting or co-prevalent idiopathic pain conditions, and cLBP is one of the conditions identified as a COPC. Other examples include fibromyalgia and chronic migraine. It is estimated that among people with chronic low back pain, two-thirds have additional COPCs. Although COPCs are common, risk factors and protective mechanisms are not well characterized. This study will use a tool called the Chronic Overlapping Pain Conditions screener to identify people with COPCs among participants enrolled in the OPTIMUM study (Optimizing Pain Treatment in Medical settings Using Mindfulness). The first aim of this study is to measure the prevalence and risks factors associated with Chronic Overlapping Pain Conditions in our study sample. The second aim is to identify how the response to the OPTIMUM intervention differs between people with isolated cLBP and those with additional COPCs. The third aim is to explore the experiences of study participants with COPCs from historically marginalized populations. The OPTIMUM study is a pragmatic clinical trial of mindfulness-based stress reduction (MBSR) adapted to address chronic pain and delivered via telemedicine in a primary care setting as group medical visits. The OPTIMUM study is recruiting people with cLBP from three primary care health settings that together provide for a racially and ethnically diverse study population. Given the “real life” setting of the OPTIMUM study, we expect findings to be highly relevant across multiple primary care settings including urban and rural safety net organizations. Additional findings regarding the prevalence and demographics of COPCs, the response of participants with COPCs to the OPTIMUM intervention, and the interviews with people with COPCs from historically marginalized populations, will advance knowledge about the characteristics and potential treatments for COPCs.

项目摘要/摘要 慢性疼痛是在初级保健环境中治疗的最常见疾病之一，慢性下背部 疼痛（CLBP）每年耗资超过300亿美元；然而，对于许多患者来说，治疗仍然不令人满意。 慢性疼痛通常由解剖位置定义。但是，慢性疼痛的基本机制 条件可能与显着重叠的疼痛处理的中心灵敏度密切相关 存在于慢性疼痛综合征中。一词慢性重叠疼痛条件（COPC）是指 通常是共存或共存的特发性疼痛状况，CLBP是确定的条件之一 一个COPC。其他例子包括纤维肌痛和慢性偏头痛。据估计，有 慢性下腰痛，三分之二还有其他COPC。尽管COPC很常见，但风险因素和 保护机制没有很好地表征。这项研究将使用称为慢性重叠的工具 疼痛条件筛选器鉴定参加最佳研究的参与者中的COPC患者 （使用正念在医疗环境中优化疼痛治疗）。这项研究的第一个目的是测量 在我们的研究样本中，与慢性重叠疼痛状况相关的患病率和风险因素。这 第二个目的是确定孤立者对最佳干预差异的反应 CLBP和具有其他COPC的人。第三个目的是探索研究参与者的经验 历史上边缘化人群的COPC。最佳研究是一项务实的临床试验 基于正念的压力减轻（MBSR）适用于解决慢性疼痛并通过远程医疗进行 作为小组医疗访问的初级保健环境。最佳研究是招募三个CLBP的人 初级保健健康环境共同提供了大致和种族多样化的研究人群。给出 最佳研究的“现实生活”设置，我们预计在多个主要主要的研究中将有很高的相关性 护理环境在内，包括城市和粗糙的安全网组织。有关患病率的其他发现 和COPC的人口统计，COPC参与者对最佳干预的反应以及 与历史上边缘化人群的COPC的人的访谈，将促进有关 COPC的特征和潜在处理。