Combining mindfulness intervention and open-label placebo treatment for chronic pain: a protocol for a feasibility study.

Background: Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), are efficacious mind-body treatments for chronic pain, though their modest effect sizes suggest room for improvement. Notably, recent studies indicate that mindfulness meditation does not engage the endogenous opioid system, which plays an important role in analgesia. Therefore, exploring the combination of a mindfulness-based intervention with a non-opioid treatment that activates this system is warranted.

Choosing well: A narrative review on chronic pain and decision-making.

Chronic pain is one of the most prevalent and costly health conditions in the United States. Previous work has demonstrated that chronic pain impacts cognition and behavior. However, the impact of chronic pain on daily decisions is less well-known.

CYP2D6 Phenotypes and Emergency Department Visits Among Patients Receiving Opioid Treatment.

Importance: Cytochrome P450 2D6 (CYP2D6) bioactivates hydrocodone, tramadol, codeine, and oxycodone to active metabolites that primarily provide analgesic activity. Reduced CYP2D6 activity may be associated with poor pain control.

Objective: To evaluate associations of impaired CYP2D6 activity based on genotype or CYP2D6 inhibitors, alone and together, with analgesic activity of CYP2D6-metabolized opioids among patients with pain.

Over 50 years of research on social disparities in pain and pain treatment: a scoping review of reviews.

Research on social disparities in pain and pain treatment has grown substantially in recent decades, as reflected in a growing number of review articles on these topics. This scoping review of reviews provides a macrolevel overview of scholarship in this area by examining what specific topics and findings have been presented in published reviews. We searched CINAHL, Cochrane Database of Systematic Reviews, Embase, PsycINFO, PubMed, and Web of Science for English-language, peer-reviewed review articles, qualitative or quantitative, that aimed to characterize or explain pain-related differences or inequities across social groups.

Association of initiating CYP2D6-metabolized opioids with risks of adverse outcomes in older adults receiving antidepressants: A retrospective cohort study.

Background: The safety of pharmacokinetic opioid-antidepressant interactions may be affected by the sequence in which the drug is initiated. Previous literature showed that initiation of cytochrome P450 (CYP) 2D6-inhibiting versus CYP2D6-neutral antidepressants concomitantly with existing CYP2D6-metabolized opioids (i.e.

Impact of Propranolol and Psychologically Informed Intervention on Pain Sensitivity: Secondary Analysis from the Biopsychosocial Influence on Shoulder Pain Preclinical Randomized Trial.

Purpose: Measures of pain sensitivity have potential relevance for patient care. We previously identified a subgroup of people at risk for ongoing pain characterized by genetic AND psychological factors. Here, we report planned secondary analyses examining the effect of personalized interventions on pain sensitivity outcomes.

Unrelieved pain and risk of opioid use disorder or overdose in older adults prescribed opioids.

It is unclear to what extent unrelieved pain, the most common motive for prescription opioid misuse, is associated with risks of opioid use disorder (OUD) and opioid overdose (OD) among older adults with prescribed opioids. This retrospective cohort study was conducted among Health and Retirement Study (HRS) participants with linked Medicare claims data between 2006 and 2021. Participants aged 65 years or older with chronic pain who had received at least 1 opioid prescription entered the cohort in an HRS-assessed pain assessment (index) between 2008 and 2020.

Differential DNA methylation profiles of Alzheimer's disease-related genomic pathways in the blood of cognitively-intact individuals with and without high impact chronic pain.

Background: Chronic pain and Alzheimer's disease (AD) are prevalent in older age and their etiologies remain to be understoodand evidence supports potential associations between the two. Both high impact pain and AD have been previously associated with differences in the epigenome. Interactions with the epigenome may serve as a possible underlying mechanism linking high impact pain and AD.

Widespread and prolonged pain may reduce brain clearance capacity only via sleep impairment: Evidence from participants with knee pain.

The brain is key in the pain-sleep relationship, and sleep is needed for glymphatic clearance. However, no studies have examined how pain relates to the glymphatic system (GS). Characterizing the GS alongside sleep quality in well-characterized pain samples is essential for advancing this understanding.

Outcomes of Discontinuing Long-Term Opioid Therapy among Older Cancer Survivors in Long-Term Care Settings.

Objectives: Clinical decisions to continue or discontinue long-term opioid therapy (LTOT; ≥3 months) for older cancer survivors remain challenging due to limited evidence on the risks and benefits of this treatment practice. This study aims to examine the associations of discontinuing LTOT with clinical and opioid-related adverse event (ORAE) outcomes among older cancer survivors residing in long-term care (LTC) settings.

Designs: This retrospective cohort study analyzed data from the 100% Medicare nursing home sample from 2010 to 2021.

Prescription opioid use and cognitive function in older adults with chronic pain: A population-based longitudinal cohort study.

Introduction: Whether prescription opioid exposure, duration, and dose are associated with cognitive function remains inconclusive.

Methods: A longitudinal cohort among 3097 older adults with chronic pain and without dementia was conducted using Health and Retirement Study (HRS) linked to Medicare data from 2006 to 2020. Prescription opioid exposure, cumulative use for ≥ 90 days, and high-dose use (≥ 90 morphine milligram equivalents [MME] daily) were assessed biennially.

The Mediating Role of Physical Function on the Self-Reported Pain and Cognitive Function Association.

Background/objectives: Studies that have investigated the relationship between pain intensity and interference and cognitive function have failed to fully consider the role physical function may play in this relationship. Therefore, the purpose of this study was to examine the mediating role of physical function in the relationship between self-reported pain intensity and interference and cognitive function in middle-to-older aged adults with knee pain.

Methods: Middle-to-older aged participants with knee pain (n = 202) completed the Graded Chronic Pain Scale to assess pain intensity and interference, the Short Performance Physical Battery to assess lower-extremity physical function, and the Montreal Cognitive Assessment to assess global cognitive function.

Development and preliminary testing of a comprehensive Ecological Momentary Assessment of people with chronic pain.

Ecological Momentary Assessment (EMA) is a data collection method to understand people's real-time experience in daily life. To date, no standard instrument exists to measure the pain experience using EMA that provides relevant information for most chronic pain conditions. The goal of this study was to fill this gap by developing a comprehensive EMA pain instrument (cEMAp).

Applying evidence-based cross-disciplinary concepts helps to explain the heterogeneity in pain, function, and biological measures in individuals with knee pain with/at risk of osteoarthritis.

Introduction: Factors contributing to individual differences in knee osteoarthritis remain elusive. Dispositional traits and socioeconomic status are independent predictors of mental and physical health, although significant variability remains. Dispositional traits serve as the biological interface for life experiences.

Association of neighborhood-level disadvantage beyond individual sociodemographic factors in patients with or at risk of knee osteoarthritis.

Objective: Lower socioeconomic status (SES) is a risk factor for poorer pain-related outcomes. Further, the neighborhood environments of disadvantaged communities can create a milieu of increased stress and deprivation that adversely affects pain-related and other health outcomes. Socioenvironmental variables such as the Area Deprivation Index, which ranks neighborhoods based on socioeconomic factors could be used to capture environmental aspects associated with poor pain outcomes.

Household Income Is Associated with Chronic Pain and High-Impact Chronic Pain among Cancer Survivors: A Cross-Sectional Study Using NHIS Data.

Pain is a prevalent issue among cancer patients, yet its link with socioeconomic status has not been thoroughly examined. This study investigated chronic pain (lasting ≥3 months) and high-impact pain (chronic pain limiting activities) among cancer survivors based on household income relative to the federal poverty level (FPL), using data from the National Health Interview Survey (2019-2020). Of the 4585 participants with a history of solid cancers, 1649 (36.

Implementing a pragmatic clinical trial to tailor opioids for chronic pain on behalf of the IGNITE ADOPT PGx investigators.

Chronic pain is a prevalent condition with enormous economic burden. Opioids such as tramadol, codeine, and hydrocodone are commonly used to treat chronic pain; these drugs are activated to more potent opioid receptor agonists by the hepatic CYP2D6 enzyme. Results from clinical studies and mechanistic understandings suggest that CYP2D6-guided therapy will improve pain control and reduce adverse drug events.

Clinical and Adverse Outcomes Associated With Concomitant Use of CYP2D6-Metabolized Opioids With Antidepressants in Older Nursing Home Residents : A Target Trial Emulation Study.

Background: Limited evidence exists on the safety of pharmacokinetic interactions of cytochrome P450 (CYP) 2D6 (CYP2D6)-metabolized opioids with antidepressants among older nursing home (NH) residents.

Objective: To investigate the associations of concomitant use of CYP2D6-metabolized opioids and antidepressants with clinical outcomes and opioid-related adverse events (ORAEs).

Design: Retrospective cohort study using a target trial emulation framework.

Use of CYP2D6 Inhibitors with CYP2D6 Opioids: Association with Emergency Department Visits for Pain.

Hydrocodone, tramadol, codeine, and oxycodone are commonly prescribed opioids that rely on activation by cytochrome P450 2D6 (CYP2D6). CYP2D6 inhibitors can significantly decrease CYP2D6 activity, leading to reduced generation of active metabolites, and impairing pain control. To understand this impact, we assessed emergency department (ED) visits in patients initiating these CYP2D6-dependent opioids while on CYP2D6-inhibitor antidepressants vs.

Identifying barriers and facilitators for using a smartwatch to monitor health among older adults.

Smartwatches are a type of wearable device that enable continuous monitoring of an individual's activities and critical health metrics. As the number of older adults age 65+ continues to grow in the U.S.

A domain-oriented approach to characterizing movement-evoked pain.

Introduction: Movement-evoked pain (MEP) impacts a substantial proportion of US adults living with chronic pain. Evidence suggests that MEP is influenced by numerous biopsychosocial factors and mediated by mechanisms differing from those of spontaneous pain. However, both characteristic and mechanistic knowledge of MEP remain limited, hindering effective diagnosis and treatment.

Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain: intersectional considerations.

Chronic musculoskeletal pain including knee osteoarthritis (OA) is a leading cause of disability worldwide. Previous research indicates ethnic-race groups differ in the pain and functional limitations experienced with knee OA. However, when socioenvironmental factors are included in analyses, group differences in pain and function wane.