Reducing Unused Prescribed Opioids After Cesarean Birth

减少剖腹产后未使用的处方阿片类药物

基本信息

批准号：
10224161
负责人：
Sarah Scheiderich Osmundson
金额：
$ 17.06万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
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：
2019-08-01 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10224161
关键词：
Abdomen Acute Analgesics Anesthesiology Attention Award Biometry Birth Caring Cesarean section Cessation of life Characteristics Clinical Clinical Investigator Clinical Trials Conduct Clinical Trials Custom Development Development Plans Discipline of obstetrics Electronic Health Record Emotional Epidemiology Family Family member Feeling Flushing Foundations Friends Goals Guidelines Gynecology Habits Health system Heroin Hospitals Individual Infant Interdisciplinary Study Interview K-Series Research Career Programs Leadership Legal Location Mental Depression Mentors Methods Minority Mothers National Institute of Drug Abuse Operative Surgical Procedures Opioid Overdose Pain Pain Measurement Pain management Patient Outcomes Assessments Patients Pattern Persons Pharmaceutical Preparations Postoperative Pain Provider Public Health Randomized Clinical Trials Randomized Controlled Trials Readiness Recommendation Reporting Research Research Personnel Research Training Risk Role Safety Scholarship Smoking Testing Time Training United States United States Food and Drug Administration Woman Work base career career development chronic pain clinical decision support clinically significant data tools effectiveness study experience illicit opioid improved innovation instrument multidisciplinary nonmedical use opioid abuse opioid epidemic opioid misuse opioid mortality opioid overdose opioid use overdose death pain outcome pain relief pain score postcesarean section predictive modeling predictive tools prescription opioid programs satisfaction skill acquisition standard care support tools tool treatment as usual trial comparing

项目摘要

PROJECT SUMMARY/ABSTRACT Over the past 15 years, the United States has seen the emergence of an opioid epidemic with drug overdose ranking as the most common cause for accidental death. The rise in drug overdose deaths mirrors the rise in legal opioid prescribing. Unfortunately, most persons using opioids for non-medical purposes obtain them from a family member or friend who was legitimately prescribed opioids. While significant attention has been devoted to prescribing recommendations for individuals with chronic pain and for acute post-surgical pain, much less attention has been given to post-surgical opioid prescribing after hospital discharge. As the most common abdominal surgery in the United States, cesarean birth is the ideal setting to examine methods to reduce unused prescribed opioids. My preliminary work demonstrates that most women have unused opioids after cesarean birth, however a significant proportion of women use all opioids and have unmet pain needs. In addition, current opioid prescribing practices appear to be largely based on prescriber habits rather than patient need. This body of work endeavors to 1) characterize post-discharge opioid use patterns and identify demographic and obstetric variables associated with differential use 2) create and validate a clinical decision support tool that predicts customized post-discharge opioid need and 3) conduct a pilot randomized clinical trial comparing prescribing guided by the CDS tool to standard care to test whether this tool reduces unused opioids without increasing unmet pain after cesarean birth. The overarching objective of this mentored career development experience is to emerge as an independent clinical investigator leading a multidisciplinary research program to improve opioid prescribing after hospital discharge. To accomplish this goal, I will augment my prior research training with advanced coursework and skills development in predictive modeling and conducting clinical trials as well as leadership training focused on opioid prescribing and maternal and infant public health systems. Throughout the award period, the I will work closely with a multidisciplinary team of mentors and advisors—including experts in obstetrics and gynecology, biostatistics, anesthesiology, public health, and epidemiology—to carry out my stated career objectives and specific aims.

项目摘要/摘要在过去的15年中，美国已经看到了阿片类药物流行病的出现排名是意外死亡的最常见原因。不幸的是，大多数使用阿片类药物用于非医学目的的人。合法开处方阿片类药物的家庭成员或炸了。专门针对患有慢性疼痛和急性后手术后疼痛的个体的处方建议出院后，手术后的阿片类药物处方的同时少得多联合会中常见的腹部手术减少未使用的判例式阿片类药物。剖宫产后，妇女的重大建议使用阿片类药物此外，目前的阿片类药物处方习惯似乎是在处方习惯上的低音，而不是。患者需要的工作。人口统计和与差异使用相关的产科变量2）创建和验证临床决策预测定制的分期释放后阿片类药物需要的支持工具工具3）进行试验随机临床试验比较由CD指导的判例板到标准护理以测试工具是否减少未使用的工具阿片类药物在剖宫产后增加未满足的疼痛。发展经验是成为一个独立的临床先生临床领导在出院后开处方的研究计划。在预测建模中增强了我先前的研究培训和高级课程和技能开发并进行临床试验以及领导培训以阿片类药物处方和母体为重点婴儿公共卫生系统。导师和顾问 - 妇产科，生物统计学，麻醉学，公众的魅力。健康和流行病学 - 实现我既定的职业目标和具体目标。