# Guiding Aging Long-Term Opioid Therapy Users Into Safer Use Patterns

> **NIH NIH P30** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2022 · $432,655

## Abstract

ABSTRACT
Patients on long-term opioid therapy are aging and now face magnified risk of harm with continued high-dose
opioid use. These increased risks are due to age-related changes in drug metabolism, multi-morbidity, and
polypharmacy. The dominant approach to mitigate these risks is to screen for aberrant patient opioid
behaviors, with assessments like the Current Opioid Misuse Measure (COMM), so that clinicians can pre-empt
misuse early through review of contractual opioid agreements or by lowering patient dosages. By focusing on
opioid misuse alone, this strategy encourages forced opioid tapering that is associated with opioid overdose
and mental health crisis. Many persons have mental health, trauma-related or polysubstance use disorders
that need to be addressed. Directing clinician attention to the comorbid conditions associated with opioid
misuse may promote safer and more effective care. Such an approach provides a broader understanding of
the pain experience and may help address the reasons why patients use or misuse opioids. The specific aims
are: (1) to develop a simple experimental approach for the collection of clinical pain data and for assessing,
preventing, and managing pain in later life through the electronic health record; and (2) to assess the
comparative effectiveness of PainTracker, a set of questions that targets a broad range of problems associated
with pain, in a randomized controlled trial. Using the electronic health record, patient portal, and
patient-reported outcome capabilities, we will develop programming logic for a randomized experimentation
platform wherein two or more versions of pain surveys may be delivered to patients (Aim 1). We will use this
system to evaluate PainTracker, delivered to half of the sample (2,579 patients). The primary outcome is
patient referral rate to non-opioid care (e.g., mental and behavioral health care, antidepressant prescribing,
physical therapy, and sleep medicine). Secondary outcomes will include prescription quantities for opioids,
non-opioid pain medications, benzodiazepines and antidepressants. Assuming 2,579 patients per condition,
there is an 80% chance to detect differences between groups that have a 25% vs 29% referral rate,
assuming a significance level of 0.05 and a two-sided test. Each Chronic Opioid Use Registry participant
that meets the inclusion criteria will: (i) be assigned to one of two conditions involving patient surveys (Pain
Tracker + COMM or COMM alone1); (ii) be prompted 3 times to complete the survey; and (iii) receive a
score also delivered to their physician's inbox in Epic®. This supplemental proposal is in response to NOT-
AG-22-005 which seeks applications that "improv[e] the understanding of mechanisms underlying pain
experience with aging". It aims to improve the health of persons with pain on long-term opioid therapy by
identifying appropriate assessments to better address their pain experience and problems in their lives.

## Key facts

- **NIH application ID:** 10615508
- **Project number:** 3P30AG024968-20S1
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** JASON N. DOCTOR
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $432,655
- **Award type:** 3
- **Project period:** 2004-09-30 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10615508

## Citation

> US National Institutes of Health, RePORTER application 10615508, Guiding Aging Long-Term Opioid Therapy Users Into Safer Use Patterns (3P30AG024968-20S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10615508. Licensed CC0.

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