The impact of Adverse Childhood Experiences on sensory thresholds in adults living with Multimorbidity And chronic Pain; a feasibility study (the ACE-MAP study)
Multimorbidity and chronic pain
The primary aim of the ACE-MAP study is to assess the feasibility and acceptability of the proposed study procedures. The secondary aim is to generate preliminary data to understand the impact of ACEs on QST and CPM parameters in people with multimorbidity and/or chronic pain. Potential participants will be provided with a participant information sheet by email or post (depending on participant preference) before attending their assessment session. They will be given at least 24 hours to consider their participation and will have the opportunity to ask questions (via email or telephone) before the session. Written informed consent will be obtained at the start of the assessment session, before the completion of any study assessments. Next, participants will be asked to complete a series of questionnaires on: • Demographics, including year of birth, sex assigned at birth, ethnicity, recruitment stream, Scottish Index of Multiple Deprivation (SMID), level of education, employment status, and household income; • Health behaviours, using the General Practice Physical Activity Questionnaire (GPPAQ) and the World Health Organization’s Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST); • Long-term conditions; • Chronic pain, using the CAPE pain questionnaire (in the final stages of development); • Adverse childhood experiences, using the CAPE ACE questionnaire (in the final stages of development); • Medication. Next will be the completion of physical measurements: • Weight; • Height; • Quantitative sensory testing (QST) on each hand, including thermal thresholds, mechanical thresholds, vibration thresholds, pressure-pain thresholds, stimulus-response function, and wind-up ratio; • Conditioned pain modulation (CPM) using the dominant hand for the test stimulus (heat pain threshold and pressure pain threshold) and the non-dominant hand for the conditioning stimulus (cold water bath at 10 C). Finally, participants will be asked to complete a questionna
Four groups of participants aged ≥18 years old are eligible for recruitment: 1. Chronic pain with multimorbidity 1.1. Has ≥1 of the LTCs listed below 1.2. Has a diagnosis of chronic pain AND/OR has had persistent or recurring pain lasting >3 months 2. Chronic pain without multimorbidity 2.1. Has a diagnosis of chronic pain AND/OR has had persistent or recurring pain lasting >3 months 3. Multimorbidity without chronic pain 3.1 Has ≥2 of the LTCs listed below 4. Healthy volunteer controls List of long-term conditions (LTCs): Cardiovascular disease: stroke, coronary artery disease, heart failure, peripheral artery disease, heart valve disorders, arrhythmia, venous thromboembolic disease, aneurysm, hypertension (treated and untreated). Metabolic and endocrine disease: diabetes, Addison’s disease, cystic fibrosis, thyroid disorders. Respiratory disease: chronic obstructive pulmonary disease, asthma, bronchiectasis. Neurological disease: Parkinson’s disease, epilepsy, multiple sclerosis, paralysis, transient ischaemic attack, peripheral neuropathy. Cancer: solid organ cancers, haematological cancers, metastatic cancers, melanoma, benign cerebral tumours that cause disability. Mental and behavioural disorder: dementia, schizophrenia, depression, anxiety, bipolar disorder, drug or alcohol misuse, eating disorder, autism, post-traumatic stress disorder. Musculoskeletal disease: connective tissue disease, osteoarthritis, long-term musculoskeletal problems due to injury, osteoporosis, gout. Digestive disease: chronic liver disease, inflammatory bowel disease, chronic pancreatic disease, peptic ulcer. Urogenital disorder: chronic kidney disease, end-stage kidney disease, endometriosis, chronic urinary tract infection. Haematological disorder: anaemia (including pernicious anaemia and sickle cell anaemia). Eye disease: vision impairment that cannot be corrected. Ear disease: a hearing impairment that cannot be corrected, Meniere’s disease. Infectious disease: hu
1. Unable to read or speak English to a sufficient standard to complete questionnaires or to follow instructions for sensory tests, 2. Lacks the capacity to consent to participate in the study 3. Chronic pain without multimorbidity: Has ≥1 of the LTCs 4. Multimorbidity without chronic pain: Has a diagnosis of chronic pain AND/OR has had persistent or recurring pain lasting >3 months 5. Controls: Has ≥2 of the LTCs; A diagnosis of chronic pain AND/OR has had persistent or recurring pain lasting >3 months