This administrative supplement is proposed for parent R01, Management of Chronic Low Back Pain in Older Adults Using Auricular Point Acupressure (APA). The purpose of this administrative supplement is to examine the feasibility and preliminary effectiveness of the revised chronic low back pain (cLBP) APA protocol to reduce chronic pain in older adults with Alzheimer's disease and related disorders (ADRD). Our parent R01 proposes the use of APA- a non-invasive, nonpharmacological and self-managed strategy originating from auricular acupuncture in Chinese medicine- as an innovative solution for chronic pain. APA is an acupuncture-like stimulation of the ear that uses small seeds taped to specific ear points instead of needles. APA only requires participants to press on the seeds (to stimulate the specific ear points) three times per day for three minutes each time (nine minutes total per day). This test protocol has consistently provided rapid pain relief (i.e., 1-2 minutes after ear stimulation), which has encouraged patients to continue using APA to self-manage their pain. Our team has established that APA (interventionist- delivered) produces pain relief for cLBP, and has shown that after 4 weeks of APA: (1) patients achieved 51% pain reduction and a 32% improvement in physical function; (2) up to 60% patients took less pain medication; and, (3) changes in peripherally-circulation inflammatory cytokines (IL-1?, IL-2, and IL-6) indicating that APA may reduce inflammation cytokines, leading to sustained pain relief at 1-month follow- up. Based on our APA experiences in ADRD patients, a possible solution to apply APA in ADRD patients is to train caregivers to learn APA so that they can administer APA at home, making APA a sustainable treatment to manage pain for this population. It is feasible to train the caregiver to administer APA based on the PI's pilot study of testing a smartphone application (phone app) to manage cLBP in adults. Therefore, we plan to develop an APA caregiver training program to manage pain in ADRD patients and examine the feasibility and preliminary effectiveness to reduce chronic pain. A waitlist two-group study design will be used: the APA group and the caregiver training (CG-APA) group. In order to remind APA practicing, a phone notification will be sent to caregiver and ADRD patients simultaneously as a reminder for seed pressing.
This administrative supplement is proposed for parent R01: ?Management of Chronic Low Back Pain in Older Adults Using Auricular Point Acupressure (APA) (1R01AG056587-01A1).? The purpose of this administrative supplement is to examine the feasibility and preliminary effectiveness of the revised chronic low back pain APA protocol to reduce chronic pain in older adults with Alzheimer?s disease and related disorders (ADRD).