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

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

展开

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大流行与正在进行的药物过量流行病相撞，这是一种公共卫生危机在过去的二十年中，在美国夺走了75万多人的生命。大流行和相关政策回应将对有过量用药风险的人们的生命产生持久的影响。而且，直接大流行对获得过量药物预防和治疗资源的影响以及致命的影响非致命过量率需要紧急研究。这项研究将决定政策如何作为一个共同19的大流行反应的结果都影响了预防过量和治疗的机会社区中的资源以及致命和非致命性过量的发生率。急性变化对 COVID-19相关诊断，住院和随后致命和非致命性峰值的死亡服用过量，特别是在种族/种族和经济苦恼的社区中，也将被检查。记录这些影响将为卫生服务措施的类型提供重要的见解在将来的灾难中需要进行到位，以避免药物过量风险的升级。该研究将接受位于罗德岛州的位置，该州的诊断率是第四高的州，共同诊断率是第七高的州全国的死亡率（截至2020年5月18日）。在AIM 1中，我们将确定政策如何作为该州共同19-19的大流行反应的一部分制定的已影响和利用减少损害资源（例如纳洛酮）和在药物使用治疗中的参与以及致命和非致命性过量。在AIM 2中，我们假设Covid-19疾病伯恩的各种度量（例如，诊断率，住院率）将预测致命和非致命过量的随后峰值，并且在经济困扰和种族/族裔少数民族中，这些尖峰将特别明显社区。这项工作将有助于建立急需的证据基础，以确定如何最好地有效管理Covid-19对过量流行的不良影响，并支持与成瘾有关的健康未来意料之外的公共卫生危机期间的社会服务系统。