Race, age, and gender influences among clusters of african american and white patients with chronic pain

2004 ◽  
Vol 5 (3) ◽  
pp. 171-182 ◽  
Author(s):  
C Green
2018 ◽  
Vol 18 (4) ◽  
pp. 645-656 ◽  
Author(s):  
Marion K. Slack ◽  
Ramon Chavez ◽  
Daniel Trinh ◽  
Daniel Vergel de Dios ◽  
Jeannie Lee

AbstractBackground and aimsAcute pain is differentiated from chronic pain by its sudden onset and short duration; in contrast, chronic pain is characterized by a duration of at least several months, typically considered longer than normal healing time. Despite differences in definition, there is little information on how types of self-management strategies or outcomes differ when pain is chronic rather than acute. Additionally, age and gender are thought to be related to types of strategies used and outcomes. However, strategies used and outcomes can be influenced by level of education, socioeconomic status, occupation, and access to the health care system, which can confound associations to type of pain, age or gender. The purpose of this study was to examine the association of strategies used for pain self-management and outcomes with type of pain, acute or chronic, age, or gender in a socioeconomically homogenous population, pharmacists.MethodsPharmacists with acute or chronic pain and a valid email completed an on-line questionnaire on demographic characteristics, pain characteristics, pharmacological and non-pharmacological strategies for managing pain, and outcomes (e.g. pain intensity). Univariate analysis was conducted by stratifying on type of pain (acute or chronic), then stratifying on gender (men vs. women) and age (younger vs. older). Thea priorialpha level was 0.05.ResultsA total of 366 pharmacists completed the questionnaire, 212 with acute pain (average age=44±12.1; 36% men) and 154 with chronic pain (average age=53±14.0; 48% men). The chronic pain group reported substantially higher levels of pain before treatment, level of post-treatment pain, level of pain at which sleep was possible, and goal pain levels (effect sizes [ES’s]=0.37–0.61). The chronic pain group were substantially more likely to use prescription non-steroidal anti-inflammatory medications (NSAIDS), opioids, and non-prescription pain relievers (ES’s=0.29–0.80), and non-medical strategies (ES’s=0.56–0.77). Participants with chronic pain also were less confident (ES=0.54) and less satisfied (ES=0.52). In contrast, there were no differences within either the acute or chronic pain groups related to gender and outcomes. In the acute pain group, there also were no gender differences related to management strategies. However, younger age in the acute pain group was associated with use of herbal remedies and use of rest. Within the chronic pain group, men were more likely to use NSAIDS and women more likely to use hot/cold packs or massage while older participants were more likely to use massage. Variability in post-treatment level of pain and percent relief was high in all groups (coefficient of variation=25%–100%).ConclusionsThe differences between acute and chronic pain were substantial and included differences in demographic characteristics, pain characteristics, management strategies used, and outcomes. In contrast, few associations between age and gender with either management strategies or outcomes were identified, although the variability was high.ImplicationsWhen managing or researching pain management, acute pain should be differentiated from chronic pain. Because of the substantial variability within the gender and age groups, an individual approach to pain management irrespective of age and gender may be most useful.


1998 ◽  
Vol 21 (11) ◽  
pp. 2455-2458 ◽  
Author(s):  
KATERINA HNATKOVA ◽  
JOHAN E.P. WAKTARE ◽  
FRANCIS D. MURGATROYD ◽  
XIAHOUA GUO ◽  
A. JOHN CAMM ◽  
...  

2003 ◽  
Vol 6 (3) ◽  
pp. 284-285
Author(s):  
L Oderda ◽  
B Stockdale ◽  
GM Oderda ◽  
G Donaldson ◽  
M Ashburn ◽  
...  

2017 ◽  
Vol 1 (S1) ◽  
pp. 7-7
Author(s):  
Tim D Klepp ◽  
Primavera Spagnolo ◽  
Pei-Hong Shen ◽  
Nancy Diazgranados ◽  
Colin Hodgkinson ◽  
...  

OBJECTIVES/SPECIFIC AIMS: The preliminary analysis sought to retrospectively characterize the role of hypocretin receptor 2 (HCRTR2) in the development and prognosis of AD along with associated behavioral measures including smoking, self-reported drinking history, and neuroticism. Given the results in this study along with the paucity of information regarding the functional significance of rs2653349, we intend to comprehensively characterize HCRTR2 using haplotype analyses. We will then identify relationships between our haplotype analysis and IV alcohol self-administration using the Computer-Assisted Infusion System, and phenotypes identified in a sleep study. Furthermore, we aim at identifying functional loci in the hypocretin/orexin system by investigating differential allele expression in the orexin receptors in hippocampus tissue obtained from postmortem human brains. METHODS/STUDY POPULATION: This study examined 1569 European American and African American individuals between 18 and 65 years old, 922 of whom with a current diagnosis of AD. Participants were genotyped for HCRTR2 rs2653349 and ancestry was determined via a genome-wide panel of ancestry informative markers. AD was diagnosed using the Structured Clinical Interviews for DSM-IV (SCID-IV) for psychiatric disorders and recent alcohol use was assessed by 90-day Timeline Follow-back (TLFB) interviews. Smoking was assessed using the Fagerström Test for Nicotine Dependence and neuroticism was measured using the NEO Personality Inventory. RESULTS/ANTICIPATED RESULTS: In European Americans, a significant difference was found in current AD diagnosis between AX carriers and GG carriers (z=−2.390, p=0.017). This relationship remained significant in a logistic regression model controlled for age and gender (R2=0.269, p=0.015). TLFB drinking measures were compared based on the median values to correct for the ceiling effect resulting from the assessment covering the past 90 days. Total drinks (U=8.280, p=0.004), number of drinking days (U=6.983, p=0.008), and average drinks per days (U=7.221, p=0.007) were all noted to significantly differ between the two allele groups among Caucasians. The associations between rs2653349 and total drinks (R2=0.115, p=0.023) and heavy drinking days (R2=0.190, p=0.015) remained significant in linear regressions controlled for age and gender. Furthermore, Caucasian AX carriers had a higher median number of drinking days relative to GG homozygotes among current AD positive subjects (U=6.937, p=0.012) and a lower median number of drinking days among current AD negative subjects (U=4.430, p=0.035). Among Caucasian AD negative subjects, there was a significantly greater frequency of smokers (χ2=3.550, p=0.046). In African American participants, there were no significant differences in AD diagnosis and in measures of AD severity by genotype. African American males diagnosed with current AD had higher rates of smoking in the AX group (χ2=4.969, p=0.017). No significant associations were found between rs2653349 and neuroticism in any of the cohorts analyzed in this sample. DISCUSSION/SIGNIFICANCE OF IMPACT: The results suggest that, among Caucasians, AX carriers have an increased risk to develop AD independently of their age and gender. In addition, among individuals with a diagnosis of AD, AX carriers reported a greater number of drinking days, as measured by the TLFB, suggesting that this polymorphism also exerts an effect on the severity of the disease. This effect on increased alcohol consumption was absent in Caucasian AX carriers without current AD diagnosis. In future analysis, we will explore how different genetic profiles in HCRTR2, and also HCRTR1, may alter the orexin signaling pathway and how such alterations may predispose patients to develop AD and exacerbate AD once it develops.


1996 ◽  
Vol 93 (3) ◽  
pp. 168-171 ◽  
Author(s):  
N. A. Buckley ◽  
A. H. Dawson ◽  
I. M. Whyte ◽  
P. Hazell ◽  
A. Meza ◽  
...  

2008 ◽  
Vol 12 (2) ◽  
pp. 221-227 ◽  
Author(s):  
Keith E. Whitfield ◽  
Christopher L. Edwards ◽  
Dwayne Brandon ◽  
Camela McDougald

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