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

• 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
• 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

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。