Real-Time and Long-Term Effects of Medical Marijuana on Older Adults: A Prospective Cohort Study

医用大麻对老年人的实时和长期影响：一项前瞻性队列研究

基本信息

批准号：
10560636
负责人：
Yan Wang
金额：
$ 59.48万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-15 至 2026-11-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10560636
关键词：
Address Anxiety Biological Biological Aging Biological Markers Cell Aging Cellular Phone Characteristics Chemicals Country Data Data Analyses Dose Drops Ecological momentary assessment Elderly Ensure Environment Equilibrium Expectancy Florida Goals Guidelines Health Benefit Individual Differences Length Life Long-Term Effects Marijuana Measurement Measures Medical Marijuana Medical Records Mental Depression Outcome Pain Pain Research Pain intensity Patients Pattern Persons Phenotype Physical Function Physical activity Physicians Prospective cohort Prospective, cohort study Psychological Factors Quality of life Research Resources Route Sampling Sativex Sleep Social Desirability Source Surveys Technology Telomere Shortening Testing Time Visit chronic pain cognitive change cognitive function comparison group disability emotional functioning fitbit health related quality of life improved improved outcome in vivo innovation male marijuana use marijuana user medical examination mobile computing novel pain reduction patient subsets protective factors randomized trial recruit response sensor sex side effect success telomere wearable sensor technology

项目摘要

ABSTRACT Older adults represent a fast-growing segment of medical marijuana (MM) users in this country, with chronic pain as the most cited reason for use. There is a critical need to systematically examine MM’s short- and long- term effects on the core outcomes including pain intensity, physical, emotional, and cognitive functioning, and overall quality of life, and to track its side effects in older adults (NOT-DA-20-014). While the ubiquity of mobile technology provides a unique opportunity to measure MM use and its outcomes in vivo, it has not been applied in MM and pain research. In addition, our research shows that telomere length, a measure of cellular aging, is negatively associated with chronic pain stage, but no study has used telomere length as a biomarker to examine MM’s long-term effects on biological aging in older adults. Further, while contributing to the differentiated response to MM, individual differences (e.g., sex, baseline pain phenotyping, expectancy) have not been adequately explored in prior research. To address these gaps, we propose the first prospective cohort study that innovatively combines technology-based ecological momentary assessments (EMA) and in- person visits over 12 months to obtain both subjective and objective data on MM’s effects. The main goals of this project are to 1) determine MM’s short- and long-term effects on pain, physical, emotional, and cognitive functioning, and quality of life in older adults, and 2) identify MM product characteristics and patient subgroups associated with improved outcomes or side effects. To accomplish these goals, we will recruit and follow 440 older adults (³ 50 years, 50% male) with chronic pain as some initiate MM (n=330) and other do not (n=110). Subjective and objective data will be collected at in-person visits (baseline & 12 months) and via smartphone- and sensor-based measurement bursts at 1, 3, 6, and 9 months. The specific aims are: 1) Determine whether MM use leads to short-term changes in pain intensity level, physical and emotional functioning measured in real-time; 2) Determine whether MM use leads to longer-term changes over 12 months, including pain intensity, emotional, physical, and cognitive functioning, health-related quality of life, and telomere length; and 3) Among those initiating MM, examine which MM product characteristics (i.e., THC:CBD ratio, administration route, dose) predict more improvements in outcomes defined in Aims 1&2 or more side effects, and whether individual differences (e.g., sex, baseline pain phenotyping, expectancy) moderate the relationship. With multisource data collected in real-time and over 12 months, our results will contribute to the greatly needed scientific evidence on: 1) whether MM can reduce pain and improve physical/emotional functioning in short term among older adults; 2) whether effects of MM last for 12 months and demonstrate quality of life improvements or cognitive changes; 3) whether health benefits and consequences differ by MM product type; and 4) which subgroups of patients may benefit more from MM use.

抽象的老年人是该国医用大麻 (MM) 使用者中快速增长的一部分，患有慢性病疼痛是最常见的使用原因，迫切需要系统地检查 MM 的短期和长期治疗。对核心结果的长期影响，包括疼痛强度、身体、情绪和认知功能，以及整体生活质量，并跟踪其对老年人的副作用（NOT-DA-20-014）。技术提供了测量 MM 使用及其体内结果的独特机会，但尚未得到应用此外，我们的研究表明，端粒长度（细胞衰老的衡量标准）是重要的。与慢性疼痛阶段呈负相关，但没有研究使用端粒长度作为生物标志物进一步研究 MM 对老年人生物衰老的长期影响，同时促进衰老。对 MM 的差异化反应、个体差异（例如性别、基线疼痛表型、预期）为了解决这些差距，我们提出了第一个前瞻性研究。队列研究创新地将基于技术的生态瞬时评估（EMA）和in- 人员访问超过 12 个月，以获得有关 MM 影响的主观和客观数据。该项目的目的是 1) 确定 MM 对疼痛、身体、情绪和认知的短期和长期影响老年人的功能和生活质量，2) 确定 MM 产品特征和患者亚组第 440 章患有慢性疼痛的老年人（3 50 岁，50% 男性），其中一些人开始 MM (n=330)，而其他人则没有 (n=110)。主观和客观数据将通过亲自访问（基线和 12 个月）以及通过智能手机收集 - 以及第 1、3、6 和 9 个月时基于传感器的测量突发具体目标是： 1) 确定是否。 MM 的使用会导致疼痛强度水平、身体和情绪功能的短期变化实时；2) 确定 MM 的使用是否会导致 12 个月内的长期变化，包括疼痛强度、情绪、身体和认知功能、健康相关的生活质量以及端粒长度； 3) 在那些发起 MM 的人中，检查哪些 MM 产品特征（即 THC:CBD 比例、给药）途径、剂量）预测目标 1 和 2 中定义的结果有更多改善或更多副作用，以及是否个体差异（例如性别、基线疼痛表型、预期）调节了这种关系。通过超过 12 个月实时收集的多源数据，我们的结果将有助于满足急需的需求科学证据表明：1) MM 是否可以减轻疼痛并改善身体/情绪功能老年人中的足月；2) MM 的影响是否持续 12 个月并表现出生活质量改善或认知变化；3) 健康益处和后果是否因 MM 产品类型而异； 4) 哪些亚组患者可能从 MM 的使用中获益更多。