Appalachian Node

阿巴拉契亚节点

• 批准号: 10359849
• 负责人: JANE M LIEBSCHUTZ
• 金额: $ 101.54万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-15 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10359849
• 关键词: Academic Medical Centers; Address; Appalachian Region; Area; Bacterial Infections; Bioinformatics; Caring; Clinical; Clinical Investigator; Clinical Research; Clinical Sciences; Clinical Trials Network; Coal; Coal Mining; Collaborations; Communities; Complex; County; Data; Databases; Discipline; Distress; Economics; Electronic Health Record; Employment Opportunities; Endocarditis; Ensure; Environmental Risk Factor; Epidemic; Evidence based practice; Family; Geography; HIV; Health; Health Information System; Health Policy; Health Technology; Health system; Healthcare; Healthcare Systems; Helping to End Addiction Long-term; Hepatitis B; Hepatitis C; Incentives; Industry; Infrastructure; Institutes; Institution; Insurance Carriers; Integrated Health Care Systems; Intervention; Kentucky; Leadership; Learning; Life Expectancy; Long-Term Care; Manuals; Medical; Medicine; Morbidity - disease rate; National Institute of Drug Abuse; Neonatal Abstinence Syndrome; Ohio; Opiate Addiction; Opioid; Overdose; Patients; Pennsylvania; Persons; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Plant Roots; Play; Policies; Professional Education; Protocols documentation; Provider; Public Health; Publications; Records; Recovery; Research; Research Personnel; Resource-limited setting; Resources; Risk; Risk Factors; Role; Rural; Series; Site; System; Tennessee; Testing; Training Programs; Translational Research; Transportation; Underserved Population; Unemployment; United States National Institutes of Health; Universities; West Virginia; Work; addiction; base; buprenorphine treatment; chronic pain; college; evidence base; experience; healing; improved; injection drug use; innovation; mobile computing; mortality; multi-site trial; multidisciplinary; novel; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; opioid use disorder; outreach; overdose death; peer; practice-based research network; programs; recruit; relapse risk; response; rural area; rural counties; rurality; smartphone Application; social; social exclusion; substance misuse; substance use; substance use treatment; syndemic; treatment program; underserved rural area; urban area; wearable device

Abstract: The Appalachian Node of NIDA Clinical Trials Network (CTN) will address clinical research questions that arise from Central Appalachia, an epicenter of the current opioid epidemic. It has among the highest rates of opioid overdose deaths and related morbidities in the nation. Its rural geography, culture of independence, strained economy and lack of access to substance use treatment have all contributed to the epidemic. Joining together University of Pittsburgh (Pitt), West Virginia University (WVU) and Penn State College of Medicine (PSU), the Appalachian Node will be led by experienced clinical investigators, Drs. Jane Liebschutz (Pitt) and Judith Feinberg (WVU). The node will bring together successful multi-disciplinary co-investigators, many of whom had prior CTN experience in other established nodes and who have been recruited to these institutions to respond to the regional substance use epidemic. The affiliated academic medical centers cover central and western Pennsylvania (PA) and all of West Virginia (WV) and have extensive bioinformatics databases with electronic health record and claims data. Use of a Stakeholder Advisory Group, support from regional payors, and close ties with state and local policy and public health officials will ensure that research has relevance and a high likelihood of sustainability after study completion. The three aims of the node are to: 1) conduct multisite trials that will address the current opioid crisis (and other substance misuse), with an emphasis on conducting studies among rural and other underserved populations, 2) propose studies to test innovative uses of existing resources (local pharmacies, peer navigators/peer recovery coaches, mobile technology, state-of-the-art health information systems) to implement evidence-based practices that will extend state-of-the-art care into resource-poor regions, both rural and urban, and 3) disseminate CTN findings to regional payers and policymakers, practitioners, and the community. The node will define local solutions to overcome the complex interplay of barriers in underserved rural and urban areas. The combination of our resources and those provided by the CTN will enable us to make a significant impact on the opioid epidemic in central Appalachia and nationally. Proposed studies built on work of node investigators include: 1) Serious Bacterial Infections Related to Injection Drug Use: Quality Metrics and Intervention (Liebschutz, Pollini), 2) Pharmacist-Assisted Buprenorphine Treatment (Winstanley), 3) Leveraging the Learning Health System to Incentivize Medication-Assisted Recovery for Opioid Use Disorder (Kraemer), and 4) An “Early Warning” System for Relapse Risk with Smartphone Apps and Wearable Devices (Kawasaki, Winstanley).

抽象的： NIDA临床试验网络（CTN）的阿巴拉契亚节点将解决临床研究问题 来自阿巴拉契亚市中心，当前的绿核酸流行病的中心。它具有最高的元素率 过量的死亡人数和相关的病毒。它粗糙的地理，独立文化，紧张 经济和缺乏吸引药物治疗的机会都导致了这种流行病。一起加入 匹兹堡大学（皮特），西弗吉尼亚大学（WVU）和宾夕法尼亚州立医学院（PSU）， 阿巴拉契亚节点将由经验丰富的临床研究者Drs领导。简·利布斯（Pitt）和朱迪思（Judith） Feinberg（WVU）。该节点将使成功的多学科共同研究人员聚集在一起，其中许多人都有 以前在其他已建立的节点并已招募这些机构以回应的CTN经验 对区域物质的使用流行。会员学术医疗中心涵盖了中央和西方 宾夕法尼亚州（宾夕法尼亚州）和整个西弗吉尼亚州（WV），并具有广泛的生物信息学数据库 健康记录和索赔数据。使用利益相关者咨询小组，区域付款人的支持以及关闭 与州和地方政策以及公共卫生官员的联系将确保研究具有相关性和高度 研究完成后可持续性的可能性。节点的三个目标是：1）进行多站点试验 这将解决当前的阿片类药物危机（以及其他滥用物质），重点是进行研究 在粗糙和其他服务不足的人群中，2）提案研究以测试现有资源的创新用途 （当地药房，同行导航员/同行恢复教练，移动技术，最先进的健康信息 系统）实施基于证据的实践，以将最新的护理扩展到资源贫乏的地区， 粗糙和城市，以及3）向区域付款人和政策制定者，从业者和 社区。该节点将定义局部解决方案，以克服服务欠佳的障碍的复杂相互作用 农村和城市地区。我们的资源和CTN提供的资源的结合将使我们能够做到 对阿巴拉契亚中部和全国的阿片类药物流行的重大影响。拟议的研究基于工作 节点调查人员包括：1）与注射药物使用有关的严重细菌感染：质量指标和 干预（Liebschutz，Pollini），2）药剂师协助的丁丙诺啡治疗（Winstanley），3） 学习卫生系统激励通过药物辅助恢复阿片类药物使用障碍（KRAEMER）， 4）一种“预警”系统，用于使用智能手机应用程序和可穿戴设备（川崎， 温斯坦利）。