Project Description
Development of a Health tool to assess the Impact of Opioids in Older Adults
Over one-third of
Americans >65 years of age experience chronic pain. However, a paucity of
research exists on the optimal pharmacologic approaches to manage chronic pain
in the older adult and on the impact of opioids on pain control, cognition and
physical functioning. Recent guidelines have recommended judicious use of
opioids for the management of moderate to severe pain in this population.
Unfortunately, we have very little knowledge about the risks and benefits of
implementing this recommendation in vulnerable older adults. It has been
difficult to gauge the true benefits and harms of opioid use among older adults
in prior studies because they often rely on cross-sectional assessments and
retroactive reporting of symptom burden. Many assessment strategies to
date have failed to fully capture the day-to-day experience of older adults
using opioids to treat chronic pain, including temporal variation in symptom
relief and adverse effects on cognitive and physical functioning. Therefore, we
propose to develop and pilot a mobile Health (mHealth) based monitoring tool
that in addition to assessing symptoms, measures in-the-moment cognitive and
physical performance. This preliminary data will provide the foundation for a
definitive study on the impact of opioids on pain control, cognitive and
physical performance in older adults.
Bio
Christine Ritchie, MD, MSPH, FACP is the Harris Fishbon Distinguished Professor in Clinical Translational Research and Aging at the University of California San Francisco (UCSF). She is a board certified geriatrician and palliative care physician with long-standing experience in clinical care delivery and advanced illness research. Dr. Ritchie’s research focuses on quality of life and health care issues surrounding multimorbidity. She is studying the impact of symptom burden on health care utilization in individuals with multiple chronic conditions. She is also evaluating how technology can be used to support patients and families with serious illness in their transition from the hospital to home. At UCSF, Dr. Ritchie is creating an implementation science infrastructure for the care of those with serious illness and is facilitating the growth of clinical programs and research that focus on quality of life and health care delivery models for those with chronic serious illness and multimorbidity. She is developing national quality of care metrics and a national database to evaluate quality of house calls care for home-limited patients and their families.
Email: Christine.Ritchie@ucsf.edu