Troy Christopher Dildine

All Publications

• Is a career in science still viable for emerging scholars in pain and health equity? Pain Dildine, T. C. 2025; 166 (5): 1214

  View details for DOI 10.1097/j.pain.0000000000003602

  View details for PubMedID 40237776

• Not a 'DEI hire'. Science (New York, N.Y.) Dildine, T. C. 2025; 388 (6744): 330

  View details for DOI 10.1126/science.ady1733

  View details for PubMedID 40245134

• Beyond pain intensity: Validating single-item pain bothersomeness measures. The journal of pain Edwards, K. A., You, D. S., Lannon, E. W., Dildine, T. C., Darnall, B. D., Mackey, S. C. 2025; 31: 105395

  Abstract

  Chronic pain is a complex and multifaceted health condition, rendering pain intensity alone insufficient for comprehensively understanding the impact of pain. Pain bothersomeness scales have been developed to measure pain's impact on life, however lack adequate validation. Our study examines the validity of two single-item measures (5-point and 11-point response scales) for pain bothersomeness. We collected data from 633 treatment-seeking adults with mixed-etiology chronic pain. Pearson correlations were conducted to examine the relationships between each pain bothersomeness item and 20 general and pain-related functioning measures. ANOVAs examined the ability of pain bothersomeness scores to discriminate between eight groupings based on general and pain-related functioning. Linear regressions analyzed pain bothersomeness as a predictor of 14 measures of general and pain-related functioning three months later. Both pain bothersomeness items correlated significantly with 19 functioning measures and discriminated between eight groupings. Controlling for covariates, both items were consistently predictive of worse pain interference (Total adj r² =.34), pain catastrophizing (Total adj r² =.21-.22), depression (Total adj r² =.25-.26), and satisfaction with social roles (Total adj r² =.13-.16) three months later. Both single-item pain bothersomeness items demonstrated consistent concurrent, discriminant, and predictive validity. These low-burden assessments provide valuable information about patient functioning in clinical settings, suggesting their utility in improving chronic pain care. PERSPECTIVE: Both single-item pain bothersomeness measures demonstrated consistent concurrent and discriminant validity. Both items predicted worse pain interference, pain catastrophizing, depression, and social functioning 3-months later.

  View details for DOI 10.1016/j.jpain.2025.105395

  View details for PubMedID 40228688

• Zoom-Delivered Empowered Relief for Chronic Pain: Observational Longitudinal Pilot Study Exploring Feasibility and Pain-Related Outcomes in Patients on Long-Term Opioids. JMIR formative research Edwards, K. A., Dildine, T. C., You, D. S., Herrick, A. M., Darnall, B. D., Mackey, S. C., Ziadni, M. S. 2025; 9: e68292

  Abstract

  Patients with chronic pain on long-term opioid therapy often face barriers to accessing effective nonpharmacological treatments, including the burden of multiple sessions, lack of trained clinicians, and travel time. Empowered Relief (ER), a 2-hour, single-session pain relief skills class, can improve pain and quality of life among patients with chronic pain when delivered in person or virtually.This study examined the impact of Zoom-delivered ER among people with chronic pain on long-term opioid therapy. We assessed (1) the feasibility and acceptability of Zoom-delivered ER; (2) changes in pain and opioid use outcomes at 3 and 6 months after treatment; and (3) daily associations among pain, opioid dose, and the Pain Catastrophizing Scale (PCS) before and after treatment.During the early COVID-19 pandemic, we conducted an uncontrolled pilot study of a Zoom-delivered ER among 60 adults (n=45, 76% female participants; n=52, 88% White participants) experiencing chronic pain who were receiving daily prescribed opioids (≥10 morphine-equivalent daily dose). Participants completed assessments at enrollment, before class, after class, 3 months after treatment, and 6 months after treatment. Furthermore, participants completed 2 daily assessment periods (spanning 14 consecutive days) before and after the class. We used a multilevel modeling approach to examine (1) the raw changes in PCS, average pain intensity, pain interference, and self-reported opioid dose at 3 and 6 months after treatment and (2) daily-level changes in average pain intensity and opioid dose before and after the class.Of the 60 participants enrolled, 41 (68%) attended the class and 24 (59% of the 41 class attendees) reported satisfaction with the Zoom-delivered class. PCS score was significantly reduced at 3 months (β=-3.49, P=.01; Cohen d=0.35) and 6 months after treatment (β=-3.61, P=.01; Cohen d=0.37), and pain intensity was significantly reduced at 3 months (β=-0.56, P=.01; Cohen d=0.39) compared to enrollment. There were no significant reductions in pain interference or opioid dose. Across daily assessments, higher daily pain catastrophizing was associated with worse daily pain (β=.42, P<.001) and higher self-reported opioid use (β=3.14, P<.001); daily pain intensity significantly reduced after the class (β=-.50, P<.001). People taking prescribed opioids as needed trended toward decreasing their daily opioid use after the class (β=-9.31, P=.02), although this result did not survive correction for multiplicity.Improvements to future Zoom-delivered ER iterations are needed to improve feasibility and acceptability among people with chronic pain and daily prescribed opioid use. Despite this, findings show a promising preliminary impact of the intervention on pain outcomes. A larger randomized controlled trial of Zoom-delivered ER among this patient population is currently under way.

  View details for DOI 10.2196/68292

  View details for PubMedID 40068160

• PROGRESS: A Patient-centered Engagement Infrastructure and Multi-level Approach to Enrich Diversity, Equity, and Inclusion in a National Randomized Online Behavioral Pain Treatment Study. The journal of pain Clifton, J., Adair, E., Cheung, M., Torres, C., Andrews, W., Dorsonne, B., Hailu, A. Y., Heggan, E., Miefert, J., Riazi, G., Dildine, T. C., Spears, S., Greer-Smith, R., Pun, T., Williams, N., Perez, L., King, H. P., Ziadni, M. S., Mackey, S., Darnall, B. D. 2024: 104718

  Abstract

  Twenty percent of individuals experience chronic pain worldwide posing significant challenges to those living with it. Pain research is crucial for developing and characterizing effective strategies to reduce the burden of chronic pain. Traditional research approaches often yield homogeneous study samples that poorly generalize and have unknown applicability across diverse patient populations. The Pain Relief with Online Groups that Empower Skills-based Symptom Reduction (PROGRESS) study aims to address disparities in pain research engagement and patient outcomes through the intentional inclusion of people with varied backgrounds and experiences of pain, and through a multilevel design informed by diverse stakeholder recommendations. The composition of three advisory boards (Patient Engagement and Diversity Board, Local Patient Advisory Board, and the National Patient Advisory Panel) prioritized diversity in patient/expert advisor background, geographic location, race, and ethnicity. Our engagement approach aligns with the Foundational Expectations for Partnerships in Research by Patient-Centered Outcomes Research Institute (PCORI), which emphasizes diverse representation, early and ongoing engagement, dedicated funds for advisor compensation, collaborative decision making, meaningful participation, and continuous assessment. The first 24 months of study advisor engagement has yielded multiple recruitment strategies resulting in a study population enriched with a breadth of identities within PROGRESS (e.g., inclusive patient-facing materials). Lessons learned underscore the importance of investing time in building patient and stakeholder relationships, trust, and embracing diverse viewpoints amongst the study team. PROGRESS demonstrates the potential of diverse patient-centered engagement to support evidence-based outcomes and practices that are more inclusive, equitable, and representative of the broader population. PERSPECTIVE: The PROGRESS study demonstrates how diverse patient engagement and inclusive advisory boards enhance research outcomes. By aligning with PCORI standards and employing innovative recruitment strategies, it highlights the vital role of stakeholder relationships and diverse perspectives. Key lessons learned emphasize adaptive strategies and continuous feedback for advancing equitable pain research.

  View details for DOI 10.1016/j.jpain.2024.104718

  View details for PubMedID 39454847

• Assessing Differences in Healthcare Discrimination as a Function of High Impact Chronic Pain and Opioid Use Dildine, T. C., Lannon, E., Mackey, S., You, D. S. CHURCHILL LIVINGSTONE. 2024: 37

  View details for Web of Science ID 001282167300167

• CONSIDERING SOCIOCULTURAL BIASES IN CHRONIC PAIN TREATMENT AND PAIN OUTCOMES Dildine, T., Edwards, K. A., Lannon, E., Darnall, B., Mackey, S. C. OXFORD UNIV PRESS INC. 2024: S127

  View details for Web of Science ID 001271352800255

• PROFILES OF CHRONIC PAIN STIGMA AND THEIR ASSOCIATION WITH HEALTH OUTCOMES Edwards, K. A., You, D. S., Mackey, S. C., Darnall, B. OXFORD UNIV PRESS INC. 2024: S127

  View details for Web of Science ID 001271352800254

• THE PAIN SIG PRESENTS: HEALTH DISPARITIES IN CHRONIC PAIN: CHARACTERIZING THE ROLE OF STIGMA, SOCIOCULTURAL, AND NEIGHBORHOOD FACTORS Edwards, K. A., Dildine, T., Spector, A. L. OXFORD UNIV PRESS INC. 2024: S126

  View details for Web of Science ID 001271352800253

• Trends in patient representation in low back pain pharmacological randomized clinical trials, 2011-2020: A systematic review. The journal of pain Jiang, T. E., Edwards, K. A., Dildine, T. C., You, D. S., Nguyen, T., Pascual, A. P., Falasinnu, T. 2024

  Abstract

  Low back pain (LBP) significantly affects global health, with associated detrimental outcomes such as physical impairment, emotional distress, and exacerbated mental health symptoms. This study evaluated the representation of marginalized groups, including racialized, gender minority, pregnant/lactating, and elderly individuals in randomized controlled trials (RCTs) for pharmacological interventions treating LBP from 2011 to 2020. We searched Embase, MEDLINE, and CINAHL in December 2021, and 139 studies were eligible. Most trials (n = 113, 81%) reported participant sex; however, no study collected data on sexual and gender minorities, and the majority (n = 99, 71%) excluded pregnant/lactating individuals. Most trials (n = 105, 76%) reported no data on participant race or ethnicity. We limited within-country analyses of race and ethnicity to US-based trials because US-based trials were more likely to report race and/or ethnicity (48%) compared to non-US-based trials (8%). Black participants were the only racialized group whose composition were comparable to US Census estimates. About half (n = 73, 53%) of all trials had an upper age limit for eligibility (range: 40-85 years old) and 24% (n = 33) excluded adults aged > 65 years. Our findings confirm that trials for pharmacological LBP interventions underreport demographic data, and the trials that include this data have unrepresentative samples. There is an urgent need for more inclusive and representative patient samples to ensure generalizability and equitable benefits. Standardizing demographic data reporting and integrating community-based participatory research methods can help foster inclusive research practices. This review was registered with PROSPERO, ID 296017. PERSPECTIVE: This systematic review investigates patient representation in pharmacological-based clinical trials for low back pain, the most prevalent pain condition worldwide. Improvements in reporting demographic data and recruiting diverse participant populations-across different racialized, gender and sexual minority, and age groups- will help clinical research generalizability and provide equitable benefits. DATA AVAILABILITY: Please contact Tiffany Jiang (tjiang8@stanford.edu) for requests for extraction tool and extracted data.

  View details for DOI 10.1016/j.jpain.2023.12.013

  View details for PubMedID 38185211

• The Impact Of Single-Session Behavioral Pain Management Class On Next Day Pain Intensity And Opioid Use Among People With Chronic Pain Taking Prescribed Daily Opioids: A Daily Dairy Study Edwards, K., Dildine, T., Herrick, A., You, D. S., Darnall, B., Ziadni, M. S. CHURCHILL LIVINGSTONE. 2023: 96-97

  View details for Web of Science ID 000995432100257