PROJECT SUMMARY/ABSTRACT Chronic pain is one of the most common conditions treated in the primary care setting, with chronic low back pain (cLBP) costing over 30 billion dollars a year; yet treatment remains unsatisfactory for many patients. Chronic pain is commonly defined by anatomic location; however, the underlying mechanisms of chronic pain conditions may be more closely related to the central sensitization of pain processing with significant overlap existing among chronic pain syndromes. The term Chronic Overlapping Pain Conditions (COPCs) refers to commonly coexisting or co-prevalent idiopathic pain conditions, and cLBP is one of the conditions identified as a COPC. Other examples include fibromyalgia and chronic migraine. It is estimated that among people with chronic low back pain, two-thirds have additional COPCs. Although COPCs are common, risk factors and protective mechanisms are not well characterized. This study will use a tool called the Chronic Overlapping Pain Conditions screener to identify people with COPCs among participants enrolled in the OPTIMUM study (Optimizing Pain Treatment in Medical settings Using Mindfulness). The first aim of this study is to measure the prevalence and risks factors associated with Chronic Overlapping Pain Conditions in our study sample. The second aim is to identify how the response to the OPTIMUM intervention differs between people with isolated cLBP and those with additional COPCs. The third aim is to explore the experiences of study participants with COPCs from historically marginalized populations. The OPTIMUM study is a pragmatic clinical trial of mindfulness-based stress reduction (MBSR) adapted to address chronic pain and delivered via telemedicine in a primary care setting as group medical visits. The OPTIMUM study is recruiting people with cLBP from three primary care health settings that together provide for a racially and ethnically diverse study population. Given the “real life” setting of the OPTIMUM study, we expect findings to be highly relevant across multiple primary care settings including urban and rural safety net organizations. Additional findings regarding the prevalence and demographics of COPCs, the response of participants with COPCs to the OPTIMUM intervention, and the interviews with people with COPCs from historically marginalized populations, will advance knowledge about the characteristics and potential treatments for COPCs.

PROJECT NARRATIVE This project will describe the prevalence of Chronic Overlapping Pain Conditions among people with Chronic Low Back Pain enrolled in the OPTIMUM study, which includes Mindfulness Meditation taught as online group medical visits versus usual medical care. In addition to evaluating the effect of the mindfulness group visits, we will interview historically marginalized study participants to learn more about their experiences and priorities living with multiple chronic pain conditions.