Impact of the COVID-19 pandemic on participants in pragmatic clinical trials for chronic pain: implications for trial outcomes and beyond.

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY Pain Medicine Pub Date : 2024-11-01 DOI:10.1093/pm/pnae060
John J Sellinger, Kathryn Gilstad-Hayden, Christina Lazar, Karen Seal, Natalie Purcell, Diana J Burgess, Steve Martino, Alicia Heapy, Diana Higgins, Marc I Rosen
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Abstract

Objective: The COVID-19 pandemic had profound effects on society, including those living with chronic pain. This study sought to examine pandemic impacts on individuals enrolled in pragmatic clinical trials focused on nonpharmacological treatments for chronic pain.

Methods: We evaluated responses to a questionnaire on COVID-19 impacts that had been administered to participants (n=2024) during study enrollment in 3 pragmatic clinical trials for chronic pain treatment. All trials were part of the National Institutes of Health (NIH)-Department of Veterans Affairs (VA)-Department of Defense (DOD) Pain Management Collaboratory. COVID-19-related impacts on access to health care, mental health, finances, ability to meet basic needs, and social support were assessed.

Results: Pandemic impacts were found in all domains assessed, including access to health care, mental and emotional health, ability to meet basic needs, finances, and social support. Impacts varied by demographic and clinical characteristics. The participants most negatively impacted by the pandemic were younger, Black or Latino, female, more educated, and unemployed and had screened positive for depression. No impact differences were found with regard to alcohol use disorder screenings or a prior history of COVID-19. Higher levels of pain were associated with worse pandemic impacts, and negative impacts declined over time.

Conclusions: Negative impacts of the pandemic on individuals living with chronic pain cut across aspects of life that are also central to effective pain management, including access to health care, social support, and mental and emotional health, with differential impacts found across key demographic and clinical factors. These findings should yield consideration of pandemic impacts in clinical practice and as moderating effects of treatment outcomes in clinical trials conducted during the pandemic.

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COVID-19 大流行对慢性疼痛实用临床试验参与者的影响:对试验结果及其他方面的影响。
目的:COVID-19 大流行对包括慢性疼痛患者在内的社会产生了深远影响。本研究旨在探讨大流行对参加以慢性疼痛非药物治疗为重点的实用临床试验的个人的影响:我们评估了参加 3 项慢性疼痛治疗实用临床试验的参与者(人数为 2024 人)对 COVID-19 影响调查问卷的答复。所有试验都是美国国立卫生研究院(NIH)-退伍军人事务部(VA)-国防部(DOD)疼痛管理合作项目的一部分。评估了 COVID-19 对获得医疗保健、心理健康、财务、满足基本需求的能力和社会支持的影响:结果:大流行对所有评估领域都产生了影响,包括获得医疗保健、精神和情绪健康、满足基本需求的能力、财务状况和社会支持。不同的人口和临床特征造成的影响也不尽相同。受大流行病负面影响最大的参与者年龄较轻、为黑人或拉丁裔、女性、受教育程度较高、失业且抑郁症筛查呈阳性。在酒精使用障碍筛查或 COVID-19 既往史方面没有发现影响差异。疼痛程度越高,大流行带来的影响越严重,而负面影响会随着时间的推移而减少:大流行对慢性疼痛患者的负面影响涉及生活的方方面面,这些方面也是有效控制疼痛的核心,包括获得医疗保健、社会支持以及心理和情感健康。这些发现应有助于在临床实践中考虑大流行病的影响,并在大流行病期间进行的临床试验中考虑其对治疗结果的调节作用。
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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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