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老年人的慢性疼痛与疼痛管理:方案与初步结果

Chronic Pain and Pain Management in Older Adults: Protocol and Pilot Results.

作者信息

LaRowe Lisa R, Miaskowski Christine, Miller Angela, Mayfield Andrea, Keefe Francis J, Smith Alexander K, Cooper Bruce A, Wei Lee-Jen, Ritchie Christine S

出版信息

Nurs Res. 2024;73(1):81-88. doi: 10.1097/NNR.0000000000000683.

Abstract

BACKGROUND

Chronic pain occurs in 30% of older adults. This prevalence rate is expected to increase, given the growth in the older adult population and the associated growth of chronic conditions contributing to pain. No population-based studies have provided detailed, longitudinal information on the experience of chronic pain in older adults; the pharmacological and nonpharmacological strategies that older adults use to manage their chronic pain; and the effect of chronic pain on patient-reported outcomes.

OBJECTIVES

This article aims to describe the protocol for a population-based, longitudinal study focused on understanding the experience of chronic pain in older adults. The objectives are to determine the prevalence and characteristics of chronic pain; identify the pharmacological and nonpharmacological pain treatments used; evaluate for longitudinal differences in biopsychosocial factors; and examine how pain types and pain trajectories affect important patient-reported outcomes. Also included are the results of a pilot study.

METHODS

A population-based sample of approximately 1,888 older adults will be recruited from the National Opinion Research Center at the University of Chicago's AmeriSpeak Panel to complete surveys at three waves: enrollment (Wave 1), 6 months (Wave 2), and 12 months (Wave 3). To determine the feasibility, a pilot test of the enrollment survey was conducted among 123 older adults.

RESULTS

In the pilot study, older adults with chronic pain reported a range of pain conditions, with osteoarthritis being the most common. Participants reported an array of pharmacological and nonpharmacological pain strategies. Compared to participants without chronic pain, those with chronic pain reported lower physical and cognitive function and poorer quality of life. Data collection for the primary, longitudinal study is ongoing.

DISCUSSION

This project will be the first longitudinal population-based study to examine the experience and overall effect of chronic pain in older adults. Pilot study results provide evidence of the feasibility of study methods. Ultimately, this work will inform the development of tailored interventions for older patients targeted to decrease pain and improve function and quality of life.

摘要

背景

30%的老年人患有慢性疼痛。鉴于老年人口的增长以及导致疼痛的慢性病的相应增加,这一患病率预计还会上升。尚无基于人群的研究提供关于老年人慢性疼痛经历、老年人用于管理慢性疼痛的药物和非药物策略,以及慢性疼痛对患者报告结局的影响的详细纵向信息。

目的

本文旨在描述一项基于人群的纵向研究方案,重点是了解老年人慢性疼痛的经历。目标是确定慢性疼痛的患病率和特征;识别所使用的药物和非药物疼痛治疗方法;评估生物心理社会因素的纵向差异;并研究疼痛类型和疼痛轨迹如何影响重要的患者报告结局。还包括一项试点研究的结果。

方法

将从芝加哥大学全国民意研究中心的美国民意调查小组中招募约1888名老年人作为基于人群的样本,分三个阶段完成调查:入组(第1阶段)、6个月(第2阶段)和12个月(第3阶段)。为确定可行性,在123名老年人中对入组调查进行了试点测试。

结果

在试点研究中,患有慢性疼痛的老年人报告了一系列疼痛状况,其中骨关节炎最为常见。参与者报告了一系列药物和非药物疼痛策略。与没有慢性疼痛的参与者相比,患有慢性疼痛的参与者报告身体和认知功能较低,生活质量较差。主要纵向研究的数据收集正在进行中。

讨论

该项目将是第一项基于人群的纵向研究,以检查老年人慢性疼痛的经历和总体影响。试点研究结果提供了研究方法可行性的证据。最终,这项工作将为针对老年患者的量身定制干预措施的开发提供信息,以减轻疼痛、改善功能和生活质量。

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