# Addressing Opioid Use Disorder in Older Adults through Primary Care Innovation (OUD-PCI)

> **NIH AHRQ R18** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2021 · $826,202

## Abstract

ABSTRACT
The Agency for Healthcare Research and Quality and other agencies are exploring specific aspects of opioid
and pain management among older adults seen in primary care settings. Those over 65 years old or suffering
from conditions that cause pain that significantly limits their functioning (e.g., physical, mental or psychological
disabilities) are at considerably higher risk for adverse effects of opioid medications. Chronic pain in these
individuals may have multiple causes and can manifest through multiple types of pain. Non-cancer chronic pain
may interact with multiple health conditions in a more complex manner. The pharmacodynamics and
pharmacology of opioids may be altered significantly at an older age due to physiological changes and
polypharmacy (resulting in drug-drug interactions and more adverse effects) becomes a much greater
challenge. Furthermore, the same patients may experience decreased autonomy, self-efficacy, resilience, and
social support, while the healthcare system may struggle to effectively and safely coordinate their increasingly
complex care. These synergistic risk factors converge on the ability of patients and their primary care doctors
to optimize the management of chronic pain, requiring more carefully designed and innovative healthcare
approaches. Most current pain management interventions have been developed for a typically younger
population that may more frequently demonstrate opioid abuse, while few programs or resources are available
that are tailored to adults who are older or at higher risk. These individuals are more likely to be harmed by
opioids that they receive in the course of regular clinical therapy. Therefore, addressing the specific needs and
health challenges of these populations through innovation and careful tailoring of existing pain management
strategies is urgently needed. Based on these considerations, our team designed a multi-faceted, person-
centered and scalable chronic pain management program to be implemented in Oklahoma primary care
practices that is systematically tailored to older adults and those with functional disabilities or increased social
risk. Our innovative approach is anchored in best practices and resources that we have developed in past
studies. Our proposed initiative will help primary care practices optimize pain management approaches in older
adults through an integrated and trans-disciplinary application of advances in multi-modal pain management,
pain-mechanism-based pharmacotherapy, personalized and goal-oriented care that focuses on functional
capacity, implementation science, evidence-based quality improvement methodology, and community-engaged
design.

## Key facts

- **NIH application ID:** 10246916
- **Project number:** 5R18HS027913-02
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Steven Alan Crawford
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $826,202
- **Award type:** 5
- **Project period:** 2020-09-30 → 2023-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246916

## Citation

> US National Institutes of Health, RePORTER application 10246916, Addressing Opioid Use Disorder in Older Adults through Primary Care Innovation (OUD-PCI) (5R18HS027913-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10246916. Licensed CC0.

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