Abstract Title Improving Chronic Pain Management among Older Adults through Primary Care Innovation – A Patient-Centered Goal Approach Background Opioid-related deaths among Oklahomans aged 65 and older increased by 61%, from 7.4 to 11.9 deaths per 100,000 between 2017-2019 and 2020-2022. To improve non-cancer chronic pain and opioid management among older adults, the Oklahoma Primary Healthcare Improvement Cooperative implemented a multi-faceted, person-centered, scalable chronic pain management program in 31 Oklahoma primary care practices from January 2022 to September 2023, using a 3-stage, modified stepped-wedge design (Reducing Inappropriate Opioid Use in Seniors in Oklahoma (RISE-OK) Study). As part of the quality improvement intervention, participants set personalized goals related to chronic pain management, and goal achievement was measured as a secondary outcome. This study aimed to assess how effectively older adults involved in a primary care–based intervention achieve their personalized pain management goals to improve chronic pain and reduce opioid use. Methods Of the 270 enrolled participants (≥ 60 years), 267 set goals for pain management. Participants were asked how chronic pain impacted their daily lives and what they hoped to achieve with pain management. Participants also identified barriers to achieving their goals and created action plans to address these barriers. Two investigators independently qualitatively coded participant goals, barriers, and action plans, categorizing them into themes; any differences in coding were resolved through group consensus. Most participants rated their goal attainment between 3 and 12 months, depending on their wave, using a 3-category scale. Results Participants had an average age of 70 years, were 62% female, and 81% white, non-Hispanic. Most primary care practices (57%) were small, with 1-5 clinicians, and located in rural communities (53%). Participant goals prioritized physical activity (36%), obtaining a specific health care service (12%), doing recreational activities (e.g., travel, hobbies, attending events) (12%), controlling other symptoms (e.g., fatigue, constipation, insomnia) (9%), and reducing medications (7%). Other goals included performing self-care activities (6%), continuing to work (5%), and socializing with family/friends (3%). 24% of participants attained their goals as expected, 22% attained their goals better than expected, and 53% did not attain their goals. Conclusion Older adults set diverse personalized goals for chronic pain management, prioritized mobility and meaningful life activities, and nearly half met their goals. Implementing patient-centered goal setting in chronic pain care encourages clinicians to align treatment recommendations with what matters most to patients, potentially improving adherence to care and functional and quality of life outcomes for older adults with chronic pain.