Primary care intervention to reduce prescription opioid overdoses

初级保健干预减少处方阿片类药物过量

基本信息

批准号：
10165792
负责人：
Amy S B Bohnert
金额：
--
依托单位：
VETERANS HEALTH ADMINISTRATION
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2021-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10165792
关键词：
Address Adverse event Afghanistan Alcohol consumption Alcohol or Other Drugs use Attention Behavior Behavior Therapy Behavioral Caring Cessation of life Clinic Cognitive Complement Conflict (Psychology)Controlled Study Data Dose Elements Emergency department visit Ensure Future General Population Health Personnel Healthcare Systems Injury Intervention Iraq Knowledge Location Measures Mediator of activation protein Mental Health Modality Motivation Opioid Opioid Analgesics Outcome Overdose Pain Pain management Pain quality Participant Patient Care Patient Self-Report Patients Personal Satisfaction Pharmaceutical Preparations Pharmacy facility Prescription opioid overdose Preventive Intervention Primary Health Care Provider Public Health Randomized Randomized Controlled Trials Records Reporting Risk Risk Behaviors Risk Reduction Safety Sedation procedure Self Efficacy Services United States Veterans Violence adverse outcome behavior change behavioral health brief intervention care providers chronic pain coping evidence base follow-up health administration improved intervention effect morphine equivalent opioid mortality opioid overdose opioid therapy opioid use overdose prevention overdose risk pill pragmatic trial prescription opioid prevent recruit therapy design treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Reducing opioid pain medication-related adverse outcomes among patients prescribed opioids for pain is critical for ensuring safe and high quality pain care in the Veterans Health Administration (VHA). Overdose is one such adverse outcome; overdose has substantially increased over the past decade and is a highly significant concern for Veterans, VHA care providers, and other stakeholders. A number of VHA initiatives have sought to improve prescribing practices in an effort to address this problem. Concurrent strategies that reduce patient behaviors that increase overdose risk have the potential to complement these efforts, but have not been examined in a controlled study. Primary care is an ideal location for identifying patients prescribed opioids who are at risk for adverse outcomes. Recent initiatives, such as Primary Care Mental Health (PC-MH), have led to the integration of behavioral health providers into primary care and provide the opportunity to deliver behavioral interventions designed specifically to reduce risky opioid use. The purpose of the Prescription Opioid Safety Trial (POST) study is to conduct a randomized controlled trial of a brief intervention to reduce opioid overdose risk behaviors among VHA primary care patients receiving long-term opioid therapy. The intervention blends elements of motivational enhancement interventions for risky substance use and cognitive behavioral pain management interventions. This new intervention will be compared to an equal attention enhanced usual care condition, with both conditions delivered by PC-MH therapists. The study will recruit 450 patients with long-term opioid use who are currently prescribed opioid doses of 50 morphine-equivalent mg/day or greater (an indicator of elevated overdose risk) from primary care clinics at the VA Ann Arbor Healthcare System. The specific aims are: Aim 1) to examine if patients randomly assigned to a brief overdose prevention intervention report reduce

描述（由申请人提供）：减少与阿片类药物相关的阿片类止痛药物相关的不良后果，以确保在退伍军人卫生管理（VHA）中确保安全和高质量的疼痛护理至关重要。用药过量就是这样的不良结果。在过去的十年中，用药过量大大增加，对于退伍军人，VHA护理提供者和其他利益相关者来说，这是一个非常重要的关注点。许多VHA计划试图改善处方实践，以解决此问题。减少患者行为增加过量风险的同时策略有可能补充这些努力，但在一项对照研究中尚未进行检查。初级保健是识别处方患者有不良后果风险的患者的理想场所。最近的举措，例如初级保健心理健康（PC-MH），已导致行为健康提供者将其整合到初级保健中，并提供了提供专门旨在减少风险使用的行为干预措施的机会。处方阿片类药物安全试验（POST）研究的目的是进行短暂干预的随机对照试验，以减少接受长期OOID治疗的VHA初级保健患者中的OID过量风险行为。干预措施将动机增强干预措施的要素融合了风险的药物使用和认知行为疼痛管理干预措施。这种新的干预措施将与同等的注意力增加了常规护理条件进行比较，这两种状况由PC-MH治疗师提供。这项研究将招募450例长期使用阿片类药物的患者，目前处方的阿片类药物剂量为50个吗啡当量的毫克/天或更高的（指标过量风险升高的指标）。具体目的是：目标1）检查患者是否随机分配给简短的过量预防干预报告减少