Reducing Drug-Related Mortality Using Predictive Analytics: A Randomized, Statewide, Community Intervention Trial

使用预测分析降低药物相关死亡率：一项随机、全州范围的社区干预试验

基本信息

批准号：
10173211
负责人：
Magdalena Cerda
金额：
$ 16.85万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-30 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10173211
关键词：
2019-nCoV Accident and Emergency department Acute Admission activity Adverse effects Affect Alcohol or Other Drugs use Buprenorphine COVID-19 COVID-19 pandemic Cause of Death Cessation of life Cities Communities Country Data Data Set Data Sources Diagnosis Disasters Disease Outbreaks Distress Emergency department visit Emergency medical service Environment Epidemic Evidence based treatment Fentanyl Future Harm Reduction Health Health Services Health system Home environment Hospitalization Impact evaluation Infection Infrastructure Interruption Intervention Intervention Community Trial Measures Medicaid Methadone Naloxone National Institute of Drug Abuse Needle-Exchange Programs Neighborhoods Outcome Overdose Parents Pharmaceutical Preparations Pharmacy facility Policies Positioning Attribute Predictive Analytics Public Health Randomized Records Recovery Reporting Research Research Personnel Resources Rhode Island Risk Running Series Services Social Work Stress Sum System Time United States Work addiction adverse outcome base burden of illness coronavirus disease design ethnic minority population evidence base experience grasp health care delivery high risk improved insight interest methadone treatment minority communities mortality novel opioid use disorder overdose death overdose prevention overdose risk pandemic disease parent grant prescription opioid prevent prevention service racial and ethnic response synthetic opioid tool treatment program treatment services trend

项目摘要

The COVID-19 pandemic is colliding with the ongoing drug overdose epidemic, a public health crisis that has taken over 750,000 lives in the United States over the past two decades. The pandemic and associated policy responses will have lasting impacts of the lives of people at risk for overdose. Moreover, the immediate effects of the pandemic on access to overdose prevention and treatment resources, as well as fatal and nonfatal overdose rates, are in need of urgent study. This research will determine how policies enacted as a result of the COVID-19 pandemic response have affected both access to overdose prevention and treatment resources, as well as rates of fatal and non-fatal overdoses in the community. The effect of acute changes on COVID-19 related diagnoses, hospitalizations, and deaths on subsequent spikes in fatal and nonfatal overdose, particularly in racial/ethnic and economically distressed communities, will also be examined. Documenting these impacts will provide important insights into the types of health service measures that need to be put in place during future disasters to avoid escalation of drug overdose risk. The study will take place in Rhode Island, a state with the 4th highest COVID-10 diagnosis rate and the 7th highest COVIDassociated mortality rates in the nation (as of May 18th, 2020). In Aim 1, we will determine how policies enacted as part of the state’s COVID-19 pandemic response have influenced both access to and utilization of harm reduction resources (e.g., naloxone) and engagement in substance use treatment, as well as rates of fatal and non-fatal overdoses. In Aim 2, we hypothesize that various measures of COVID-19 disease burden (e.g., diagnosis rates, hospitalizations) will predict subsequent spikes in fatal and non-fatal overdose, and that these spikes will be particularly pronounced in economically distressed and racial/ethnic minority communities. This work will help build an urgently needed evidence base to determine how best to effectively manage the adverse effects of COVID-19 on the overdose epidemic, and to support addiction-related health and social service systems during unanticipated public health crises in the future.

COVID-19 大流行与持续存在的药物过量流行相互冲突，这是一场公共卫生危机，过去二十年里，这场大流行病夺走了美国超过 75 万人的生命。政策应对措施将对面临用药过量风险的人们的生活产生持久影响。大流行病对获得过量预防和治疗资源的影响，以及致命和这项研究将确定如何制定政策。 COVID-19 大流行应对措施的结果影响了药物过量预防和治疗的获得资源以及社区致命和非致命用药过量的发生率。随后致命和非致命病例激增后与 COVID-19 相关的诊断、住院治疗和死亡还将审查用药过量问题，特别是在种族/族裔和经济困难社区中。记录这些影响将为了解哪些类型的卫生服务措施提供重要见解该研究将在未来发生灾难时采取措施，以避免药物过量风险升级。罗德岛州，该州的新冠肺炎 (COVID-10) 诊断率排名第四，与新冠肺炎 (COVID-10) 相关的确诊率排名第七全国死亡率（截至 2020 年 5 月 18 日）在目标 1 中，我们将确定政策如何实施。作为该州 COVID-19 大流行应对措施的一部分而制定的措施影响了对减少危害资源（例如纳洛酮）和参与药物滥用治疗，以及吸毒率在目标 2 中，我们了解了 COVID-19 疾病负担的各种衡量标准。（例如诊断率、住院率）将预测随后致命和非致命用药过量的高峰，并且这些激增在经济困难和少数种族/族裔中尤其明显这项工作将有助于建立一个迫切需要的证据库，以确定如何最好地有效地开展工作。管理 COVID-19 对药物过量流行的不利影响，并支持与成瘾相关的健康和社会服务系统以应对未来不可预见的公共卫生危机。