Advancing Treatment Outcomes for Pregnant Women with Opioid Use Disorder

改善患有阿片类药物使用障碍的孕妇的治疗效果

• 批准号: 10594948
• 负责人: Ashley A Leech
• 金额: $ 17.23万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10594948
• 关键词: Address; Advisory Committees; Affect; Age; Award; Birth; Budgets; Buprenorphine; Calibration; Career Mobility; Caring; Characteristics; Child; Clinical; Clinical Trials; Consumption; Cost Effectiveness Analysis; Decision Analysis; Decision Making; Doctor of Philosophy; Drug Withdrawal Symptoms; Environment; Expenditure; Exposure to; Family; Frequencies; Funding; Future; Geography; Goals; Grant; Guidelines; Health; Health Benefit; Health Care Sector; Health Policy; Health Resources; Health Services; Health Services Accessibility; Health system; Healthcare; Healthcare Systems; Hospitalization; Implant; Improve Access; Infant; Infant Health; Injectable; Intervention; Leeches; Link; Maternal Exposure; Maternal Health; Maternal and Child Health; Mathematical Model Simulation; Measures; Medical; Mentors; Mentorship; Methadone; Methodology; Methods; Modeling; Naltrexone; Neonatal; Neonatal Abstinence Syndrome; Operations Research; Opioid; Opioid agonist; Outcome; Patients; Pattern; Personal Satisfaction; Pharmacotherapy; Policies; Policy Maker; Population; Pregnancy; Pregnant Women; Prenatal care; Process; Provider; Public Health; Quality of life; Recommendation; Recovery; Relapse; Reproducibility; Research; Research Personnel; Research Priority; Resources; Risk; Risk Reduction; Science; Scientist; Syndrome; Techniques; Training; Treatment outcome; Uncertainty; Universities; Withdrawal; Woman; addiction; care delivery; career; clinical practice; cost; evidence base; evidence based guidelines; fetal; follow-up; health care delivery; health care service utilization; health related quality of life; improved; in utero; infant outcome; marginalization; maternal outcome; medical schools; models and simulation; mortality; opioid agonist therapy; opioid use; opioid use disorder; opioid withdrawal; optimal treatments; overdose risk; professor; reproductive; side effect; treatment optimization; treatment strategy

PROJECT SUMMARY/ABSTRACT Ashley A. Leech, PhD, MS is an Assistant Professor in the Department of Health Policy at the Vanderbilt University School of Medicine. As a health decision scientist and health services researcher, Dr. Leech seeks to identify and improve the delivery of high-value health services to address the specialized needs of reproductive age and pregnant women in the US. This training grant will support her career goal of becoming a leading investigator who specializes in decision science methodology to empirically inform decision making on health services and resource priorities for marginalized women and their children in the US. Specifically, by evaluating real-world tradeoffs associated with treatment strategies and assessing the value of conducting further research to reduce decision uncertainty and optimize treatment benefits, she aims to provide a strong evidence base to improve the care for pregnant women afflicted by addiction. Opioid use disorder in pregnancy has more than quadrupled in the last two decades, resulting in adverse pregnancy and birth outcomes and a subsequent rise in healthcare utilization. Furthermore, access to treatment for pregnant women remains limited and varies geographically and across treatment strategies and care settings. High-value care for opioid use disorder in pregnancy requires methodologically rigorous studies that measure both the value of existing and new interventions and analyze the effects of resource constraints on decision making. To address these gaps, Aim 1 of the proposed research assesses the value of all available treatment options for pregnant women with opioid use disorder and quantifies the value of obtaining more research to guide future treatment and management decisions for these patients. Aim 2 takes this analysis a step further by incorporating resource constraints into the model to optimize care processes and delivery amid an environment with multiple barriers to timely and appropriate access to treatment. Results from these aims will collectively inform clinical practice, resource prioritization, and important policy decisions that can improve the availability of services for this population. During the award period, Dr. Leech will gain additional methodological expertise in advanced calibration, value of information analysis, and optimization methods for decision making, while also becoming well-informed in the clinical and policy space to improve the management and care for pregnant women and children affected by opioid use. Her mentoring and advisory team are nationally recognized clinicians, methodologists, and health policy experts who will provide the critical mentorship necessary to advance her career in the fields of addiction, decision science, and maternal and child health. This award will enable Dr. Leech to become a leading and independently funded research investigator.

项目摘要/摘要 Ashley A. Leech，博士，MS是范德比尔特卫生政策系的助理教授 大学医学院。作为健康决策科学家和健康服务研究人员，Leech博士寻求 识别和改善高价值卫生服务的交付，以满足 美国的生殖年龄和孕妇。这项培训赠款将支持她成为一个职业目标 领先的研究者专门从事决策科学方法论，以实证为决策提供有关决策 在美国，边缘化妇女及其子女的卫生服务和资源优先事项。具体来说，由 评估与治疗策略相关的现实世界权衡并评估进行的价值 她的进一步研究以减少决策不确定性并优化治疗益处，她的目标是提供强大的 改善成瘾困扰的孕妇护理的证据基础。 在过去的二十年中，怀孕的阿片类药物使用障碍已超过三倍，导致不利 怀孕和出生结果以及随后的医疗保健利用率增加。此外，访问 孕妇的治疗仍然有限，并且在地理位置以及各种治疗策略上有所不同， 护理设置。高价值护理阿片类药物使用障碍的怀孕需要方法严格的研究 该衡量现有干预措施和新干预措施的价值并分析资源约束的影响 关于决策。为了解决这些差距，拟议研究的目标1评估了所有人的价值 阿片类药物使用障碍孕妇的可用治疗选择，并量化获得的价值 更多研究以指导这些患者的未来治疗和管理决策。 AIM 2接受这个 通过将资源约束纳入模型以优化护理过程和 在具有多个障碍的环境中交付，可及时且适当地获得治疗。结果 这些目标将共同为临床实践，资源优先级和重要的政策决定提供信息 可以提高该人群的服务可用性。 在奖励期间，Leech博士将获得高级校准的其他方法论专业知识 信息分析和决策的优化方法，同时也变得良好 改善影响孕妇和儿童的管理和护理的临床和政策空间 通过阿片类药物使用。她的指导和咨询团队是全国认可的临床医生，方法学家，以及 卫生政策专家将提供必要的关键指导，以促进她在该领域的职业生涯 成瘾，决策科学以及母亲和儿童健康。该奖项将使Leech博士成为 领导和独立资助的研究调查员。