School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Bruyère Research Institute, Ottawa, Ontario, Canada.
J Am Geriatr Soc. 2019 Mar;67(3):603-608. doi: 10.1111/jgs.15684. Epub 2018 Dec 8.
BACKGROUND/OBJECTIVES: The burden of low back pain (LBP) is high, especially for older adults who experience a higher number of years living with a disability. However, this population is not being well represented in clinical trials (CTs). This study analyzed the International Clinical Trial Registry Platform (ICTRP) database from the World Health Organization to verify the future trend in the participation of older adults in registered CTs on LBP.
We performed a cross-sectional review of the ICTRP searching for prospective protocols planning interventions for LBP with registration dates from January 2015 through November 2018. From the protocols of the eligible studies, we extracted those planning to include older adults.
A total of 167 protocols for CTs for LBP were planning to recruit participants older than 65 years. However, only five registries (2.99%; pooled sample = 169 participants) were designed to target participants specifically older than 65 years. The exclusion of older participants was not justified and imposed through an arbitrary upper-age limit in 93.6% of the protocols. Most of the protocols are from single-center studies, and a greater number are planned to be carried out in developed regions. Higher interest was in pharmacologic interventions, devices/technology, and physical rehabilitation.
Older adults with LBP will continue to be underinvestigated in CTs for LBP in the near future. In general, ongoing trials are small, planned in developed regions, and proposing pharmacologic interventions to deal with LBP. J Am Geriatr Soc 67:603-608, 2019.
背景/目的:腰痛(LBP)的负担很高,尤其是对于经历更多残疾年限的老年人。然而,这一人群在临床试验(CT)中并未得到很好的代表。本研究分析了世界卫生组织的国际临床试验注册平台(ICTRP)数据库,以验证老年人参与 LBP 注册 CT 的未来趋势。
我们对 ICTRP 进行了横断面回顾,搜索了 2015 年 1 月至 2018 年 11 月期间注册的针对 LBP 的前瞻性方案。从合格研究的方案中,我们提取了那些计划纳入老年人的方案。
共有 167 项针对 LBP 的 CT 方案计划招募年龄大于 65 岁的参与者。然而,只有 5 项注册(2.99%;汇总样本=169 名参与者)专门针对年龄大于 65 岁的参与者设计。排除老年参与者是不合理的,并且在 93.6%的方案中通过任意上限年龄来实施。大多数方案是单中心研究,并且更多的方案计划在发达地区进行。对药物干预、设备/技术和物理康复的兴趣更高。
在不久的将来,LBP 的老年参与者将继续在 LBP 的 CT 中受到研究不足。一般来说,正在进行的试验规模较小,计划在发达地区进行,并且提出了药物干预来处理 LBP。美国老年医学会杂志 67:603-608, 2019。