• An Innovative Electronic Health Toolkit (Our Whole Lives for Chronic Pain) to Reduce Chronic Pain in Patients With Health Disparities: Open Clinical Trial

      Gardiner, Paula; D'Amico, Salvatore; Luo, Man; Haas, Niina (2020-03-30)
      BACKGROUND: Chronic pain affects millions of Americans. Our Whole Lives, an electronic health (eHealth) toolkit for Chronic Pain (Our Whole Lives for Chronic Pain [OWLCP]), is a mind-body chronic pain management platform that teaches self-management strategies to reduce pain impact and pain medication use. OBJECTIVE: The primary goal of this study was to evaluate the feasibility of OWLCP in reducing pain impact and pain-related outcomes. METHODS: We conducted a pre-post clinical study (2 cohorts) to assess the feasibility of OWLCP usage among low-income patients with chronic pain. Outcome data, collected at baseline and 9 weeks, included Patient-Reported Outcomes Measurement Information System (PROMIS-29), pain self-efficacy, and pain medication use. In the statistical analysis, we used descriptive statistics, logistic regression, linear regression, and qualitative methods. RESULTS: Among the enrolled 43 participants, the average age was 50 years, (39/43) 91% were female, (16/43) 37% were black, and (7/43) 16% were Hispanic. From baseline to follow-up, the PROMIS measures showed a reduction in depression (P=.02), pain interference (P=.003), and average pain impact score (P=.007). Pain self-efficacy increased ((P < .001), whereas opioid use had a 13% reduction (P=.03). CONCLUSIONS: The eHealth chronic pain management platform, OWLCP, is a potential tool to reduce the impact of chronic pain for low-income racially diverse populations.
    • Factors associated with pediatric use of complementary and alternative medicine

      Birdee, Gurjeet S.; Phillips, Russell S.; Davis, Roger B.; Gardiner, Paula (2010-02-01)
      BACKGROUND: Limited data are available on the use of complementary and alternative medicine (CAM) and factors associated with use among the pediatric population in the United States. METHODS: Using the 2007 National Health Interview Survey data among individuals < 18 years of age (n = 9417), we compared CAM users (excluding those using vitamins and minerals) and non-CAM users. Using bivariable and multivariable logistic regression models, we examined independent associations of CAM use with sociodemographic factors, prescription medication use, delays in health care caused by access difficulties, and common medical conditions/symptoms. RESULTS: In an adjusted multivariable logistic model, CAM users were more likely than non-CAM users to be adolescents rather than infants or toddlers (adjusted odds ratio [aOR]: 1.61 [95% confidence interval (CI): 1.11-2.34]); live in the West (aOR: 2.05 [95% CI: 1.62-2.59]), Northeast (aOR: 1.36 [95% CI: 1.02-1.80]), or Midwest (aOR: 1.35 [95% CI: 1.04-1.74]) compared with those in the South; more likely to have a parent with a college education (aOR: 4.33 [95% CI: 2.92-6.42]); and more likely to use prescription medication (aOR: 1.51 [95% CI: 1.19-1.92]). Pediatric CAM users were more likely to have anxiety or stress (aOR: 2.54 [95% CI: 1.89-3.42]), dermatologic conditions (aOR: 1.35 [95% CI: 1.03-1.78]), musculoskeletal conditions (aOR: 1.94 [95% CI: 1.31-2.87]), and sinusitis (aOR: 1.54 [95% CI: 1.11-2.14]). Use of CAM by a parent was strongly associated with the child's use of CAM (aOR: 3.83 [95% CI: 3.04-4.84]). CONCLUSIONS: In 2007, pediatric CAM users were more likely to take prescription medications, have a parent who used CAM, and have chronic conditions such as anxiety or stress, musculoskeletal conditions, dermatologic conditions, or sinusitis. Research is required to guide pediatricians in making recommendations on CAM modalities for children including potential risks and/or benefits and interactions with conventional therapies.