Virtual MOUD Treatment: Virtual Point-of-Care Toxicology Testing to Accompany Virtual Medication Assisted Treatment for Opioid Use Disorder
虚拟 MOUD 治疗:虚拟护理点毒理学测试伴随阿片类药物使用障碍的虚拟药物辅助治疗
基本信息
- 批准号:10316571
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-03-01 至 2023-08-31
- 项目状态:已结题
- 来源:
- 关键词:AbstinenceAddressAmericanBehavior TherapyBuprenorphineCaringCharacteristicsClinicalComputerized Medical RecordConnecticutConsolidated Framework for Implementation ResearchDataData AnalysesData CollectionDiagnostic Reagent KitsDocumentationDrug PrescriptionsDrug usageEducationFeedbackFutureGoalsHealthcare SystemsHybridsInstitutionInterventionInterviewLaboratoriesLeadershipLiquid substanceMassachusettsMedical RecordsMedicineMethodologyMethodsModalityOpioidOralOutcomeOutpatientsPatient SchedulesPatient-Centered CarePatient-Focused OutcomesPatientsPersonsPharmaceutical PreparationsPhasePoliciesPrivacyProceduresProcessProviderPublishingRandomizedRandomized Clinical TrialsReadingRegulationResearchResourcesSalivaSamplingSecureSelf AdministrationServicesSiteSocietiesSpecific qualifier valueStigmatizationStructureSubstance Use DisorderTelephoneTest ResultTestingTimeToxicologyTravelUnited States Department of Veterans AffairsUrineVeteransVisitVisualizationaddictionarmbasecontingency managementdesigndrug of abusedrug testingeffectiveness evaluationhealth service useimprovedinnovationmedication-assisted treatmentmeetingsmulti-site trialnovelopioid use disorderpandemic diseasepilot trialpoint of carepoint of care testingrandomized effectiveness trialrandomized trialscale upself testingsocial stigmasubstance usetesting uptaketrenduptakeusabilityuser centered designvirtualvirtual deliveryvirtual healthcare
项目摘要
Background. Medication treatment of Opioid Use Disorder (MOUD) saves lives and is increasingly delivered
virtually. Currently, 60% of VA outpatient addiction treatment occurs over video. The pandemic accelerated this
trend, but it will be sustained through multiple VA policies. However, toxicology testing, a major component of
MOUD care, currently requires in-person visits. A process for virtual point-of-care toxicology testing is needed.
Significance. In current virtual MOUD care, toxicology testing is either not completed or requires in-person
urine testing, which is inconvenient and stigmatizing. A process for virtual point-of-care testing, which mitigates
these barriers, will be developed through this research. Such as process will be more acceptable, facilitate
patient-centered care, and decrease stigma, improving MOUD utilization and patient outcomes. This research
will directly address VA stated goals to “Improve MOUD implementation” and “Understand how to address
stigma.”
Innovation. MOUD care, which incorporates (1) virtual toxicology testing, (2) patient self-testing at the point-of-
care, and (3) oral-fluid test kits, is entirely novel. There has been no research on virtual point-of-care toxicology
testing among Veterans. In addition, virtual toxicology testing will advance other innovative addiction
treatments such as virtual contingency management.
Specific Aims. This research will develop a Virtual Point-of-Care Toxicology Testing Process for VA. AIM 1
(Pre-Pilot) will design and iteratively modify a Virtual Toxicology Testing Process, which uses oral fluid test kits.
AIM 2 (Pilot Trial) will evaluate the feasibility, acceptability, and proximal effects of the process by evaluating
provider and patient testing uptake, qualitative feedback, and health service use. AIM 3 (Scale-up) will (1)
prepare a Virtual Point-of-Care Toxicology Testing Toolkit and (2) operationalize testing for a future multi-site
randomized trial.
Methodology. Mixed-methods will be used to develop and evaluate the testing process, which will use an oral-
fluid test for common drugs of abuse. Patients will self-administer the test during virtual MOUD visits and
assess results with providers. In the pre-pilot phase, stakeholder groups of VA-wide clinical/laboratory leaders,
providers, and patients will design and iteratively modify the process. In the pilot phase, a single-arm mixed-
methods pilot trial will evaluate the process among patients and providers at two VA facilities. Feasibility will be
evaluated by examining process uptake. Acceptability will be evaluated through semi-structured interviews with
patients and providers based on Consolidated Framework for Implementation Research (CFIR) constructs.
Health service use will be evaluated by analyzing data on patient characteristics, test utilization, and treatment
contacts extracted from the electronic medical record. In the scale-up phase, the Virtual Point-of-Care
Toxicology Testing Process will be summarized in a toolkit for VA-wide distribution. The toolkit will (1) identify
tests meeting VA requirements; (2) develop education materials; (3) specify procedures for administering and
analyzing tests; and (4) specify additional activities such as confirming results, ordering tests, and documenting
results.
Next Steps/Implementation. The Virtual Point-of-Care Toxicology Testing Toolkit will be disseminated using
current VA addictions informational and didactic resources and venues. The toolkit will be operationalized for a
future multisite, randomized hybrid trial evaluating the effectiveness of virtual toxicology testing compared to
testing as usual.
背景:阿片类药物使用障碍 (MOUD) 的药物治疗可以挽救生命,并且越来越多地实施
事实上,目前,退伍军人事务部 60% 的门诊毒瘾治疗都是通过视频进行的。
趋势,但它将通过多项 VA 政策得以维持。然而,毒理学测试是其中的一个主要组成部分。
MOUD 护理目前需要亲自就诊,需要虚拟现场毒理学测试流程。
意义 在当前的虚拟 MOUD 护理中,毒理学测试要么尚未完成,要么需要亲自进行。
尿液检测,这是一种不方便且具有侮辱性的虚拟即时检测过程,可以减轻这种情况。
这些障碍,将通过这项研究制定,这样的过程将更容易被接受、促进。
以患者为中心的护理,减少耻辱感,提高 MOUD 的利用率和患者的治疗效果。
将直接实现 VA 既定目标“改进 MOUD 实施”和“了解如何解决
柱头。”
MOUD 护理,其中包括 (1) 虚拟毒理学测试,(2) 患者现场自我测试。
护理和(3)口腔液体检测试剂盒是完全新颖的。目前还没有关于虚拟护理点毒理学的研究。
此外,虚拟毒理学测试将促进其他创新成瘾。
虚拟应急管理等治疗方法。
具体目标 本研究将为 VA 开发虚拟护理点毒理学测试流程。
(预试点)将设计并迭代修改虚拟毒理学测试流程,该流程使用口腔液测试套件。
AIM 2(试点试验)将通过评估该过程的可行性、可接受性和近期效果
提供者和患者的测试采用率、定性反馈和卫生服务使用将 (1)。
准备虚拟护理点毒理学测试工具包并 (2) 为未来的多站点实施测试
随机试验。
将使用混合方法来开发和评估测试过程,该过程将使用口头测试。
常见滥用药物的液体测试 患者将在虚拟 MOUD 就诊期间自行进行测试。
在预试点阶段,VA 范围内的临床/实验室领导者的利益相关者团体将与提供者一起评估结果。
在试验阶段,提供者和患者将设计并迭代修改该过程。
试点试验将评估两个 VA 机构的患者和提供者之间的流程。
通过检查流程采用情况来评估可接受性将通过半结构化访谈来评估。
基于实施研究综合框架 (CFIR) 构建的患者和提供者。
将通过分析患者特征、测试利用率和治疗数据来评估卫生服务的使用情况
从电子病历中提取的联系人 在扩展阶段,虚拟护理点。
毒理学测试过程将总结在一个工具包中,以便在 VA 范围内分发。该工具包将 (1) 确定。
满足 VA 要求的测试;(2) 制定教育材料;(3) 指定实施和管理程序
分析测试;(4) 指定其他活动,例如确认结果、订购测试和记录
结果。
后续步骤/实施将使用以下方式传播虚拟护理点毒理学测试工具包。
当前 VA 成瘾信息和教学资源和场所该工具包将投入使用。
未来的多中心、随机混合试验评估虚拟毒理学测试与传统毒理学测试相比的有效性
像往常一样进行测试。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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{{ truncateString('ERIC HERMES', 18)}}的其他基金
Path To Better Sleep + Virtual Coaching: The Effectiveness and Implementation of Internet-Based Self-Management Program for Insomnia in a Regional Healthcare System
更好的睡眠虚拟辅导之路:区域医疗系统中基于互联网的失眠自我管理计划的有效性和实施
- 批准号:
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- 资助金额:
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实施和评估基于计算机的心理健康干预措施
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实施和评估基于计算机的心理健康干预措施
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实施和评估基于计算机的心理健康干预措施
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10194470 - 财政年份:2016
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实施和评估基于计算机的心理健康干预措施
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Implementing and Evaluating Computer-Based Interventions for Mental Health
实施和评估基于计算机的心理健康干预措施
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