Using Default Opioid Prescription Settings to Limit Excessive Opioid Prescribing to Adolescents and Young Adults

使用默认阿片类药物处方设置来限制青少年和年轻人的过量阿片类药物处方

基本信息

批准号：
9923615
负责人：
Kao-Ping Chua
金额：
$ 19.66万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
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：
2019-05-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9923615
关键词：
Address Adenoidal structure Adenoidectomy Adolescent and Young Adult Award Behavior Behavior Therapy Blue Cross Blue Shield Characteristics Child Clinical Data Decision Making Development Plans Doctor of Philosophy Dose Electronic Health Record Ensure Environment Excision Future Goals Grant Health Policy Health Services Heterogeneity Institutes Institution Insurance Carriers Interruption Intervention Interview Medicaid Mentors Mentorship Methods Michigan Mission National Institute of Drug Abuse Operative Surgical Procedures Opioid Otolaryngologist Pain management Patient Outcomes Assessments Patients Pattern Physicians Pilot Projects Population Postoperative Period Private Hospitals Procedures Provider Regulation Reporting Research Research Methodology Research Personnel Risk Sampling Structure Surveys System Time Series Analysis Tonsil Tonsillectomy Training Universities Vulnerable Populations age group aged base career development clinical practice cost design experience implementation research individual patient insight intervention effect meetings opioid misuse opioid use pediatrician prescription opioid prescription opioid misuse prevent substance misuse success therapy design young adult

项目摘要

PROJECT SUMMARY / ABSTRACT Candidate: Kao-Ping Chua, MD, PhD, is a general pediatrician and health services researcher who aims to become a national leader in appropriate opioid prescribing to children and young adults. Research Context: Adolescents and young adults collectively have the highest rates of prescription opioid misuse of any age group, and leftover opioids from prior prescriptions are a key driver of this misuse. Therefore, it is crucial to ensure that quantities in opioid prescriptions match the needs of adolescents and young adults. This proposal will pilot an electronic health record-based intervention using default opioid prescription settings to limit excessive opioid prescribing to adolescents and young adults undergoing tonsillectomy and/or adenoidectomy (removal of the tonsils and/or adenoids), which are common surgeries associated with high rates and quantities of opioid prescribing. In the pilot study, the default settings will be informed by data on baseline patient-reported post-operative opioid consumption, thereby increasing the likelihood that these settings reflect patient need. Specific Aims: 1) To pilot a behavioral intervention using default opioid prescription settings among adolescents and young adults undergoing tonsillectomy and/or adenoidectomy at the University of Michigan; 2) To refine the intervention for future research by assessing providers’ experiences with the default settings; and 3) To identify additional high-priority procedures and conditions for default setting interventions. Research Plan: Dr. Chua will design and implement an intervention using default opioid prescription settings for adolescents and young adults undergoing tonsillectomy and/or adenoidectomy at the University of Michigan. Dr. Chua will use an interrupted time series analysis to evaluate the effect of the intervention on the dosing of the initial post-operative opioid prescription and patient-reported outcomes, and will additionally interview providers to assess their experiences with the intervention. To determine additional potential targets for future default setting interventions in an R01 grant, Dr. Chua will analyze claims from adolescents and young adults insured by Blue Cross Blue Shield of Michigan and Michigan Medicaid to identify other procedures and conditions with high rates and quantities of opioid prescribing. Career Development Plan: Dr. Chua will develop expertise in 1) Qualitative and mixed methods research; 2) Implementation research; and 3) Opioid prescribing and substance misuse. His career development will be supported by close mentorship, advanced coursework, and research meetings/seminars. Environment: The University of Michigan offers the ideal environment for Dr. Chua to pursue this training, with the outstanding guidance of well-established mentors and interdisciplinary institutes dedicated to his success.

项目摘要 /摘要候选人：Kao-Ping Chua，医学博士，博士是一名普通儿科和卫生服务研究人员成为针对儿童和年轻人的适当阿片类药物处方的国家领导者。研究环境：青少年和年轻人统称的处方OID率最高滥用任何年龄段的人和先前处方中剩下的阿片类药物是这种滥用的关键驱动力。因此，至关重要的是要确保阿片类药物处方中的数量与青少年和年轻人。该提案将使用默认的Ooid进行基于电子健康记录的干预措施处方设置以限制对正在接受的青少年和年轻人的过多阿片类药物处方扁桃体切除术和/或腺样体切除术（去除扁桃体和/或腺样体），这是常见的手术与高率和数量的阿片类药物处方有关。在试点研究中，默认设置将是由基线患者报告的术后阿片类药物消耗的数据获悉，从而增加了这些设置反映了患者需求的可能性。具体目的：1）使用默认的阿片类药物处方设置进行行为干预密歇根大学接受扁桃体切除术和/或腺样切除术的青少年和年轻人； 2）通过评估提供商在默认设置中的经验来完善未来研究的干预措施；和 3）确定默认设置干预措施的其他高优先级过程和条件。研究计划：Chua博士将使用默认的阿片类药物处方设置设计和实施干预措施对于青少年和年轻人接受扁桃体切除术和/或腺样体切除术密歇根州。 Chua博士将使用中断的时间序列分析来评估干预对剂量的初始术后阿片类药物处方和患者报告的结果，并将采访提供者评估他们在干预方面的经验。确定其他潜在目标对于R01赠款中的将来的默认设置干预措施，Chua博士将分析青少年和密歇根州和密歇根州医疗补助的Blue Cross Blue Shield保险的年轻人以识别其他较高的阿片类药物处方的程序和条件。职业发展计划：Chua博士将在1）定性和混合方法研究中发展专业知识； 2）实施研究； 3）阿片类药物处方和滥用物质。他的职业发展将是在近距离精神训练，高级课程和研究会议/研讨会的支持下。环境：密歇根大学为Chua博士提供了这项培训的理想环境，并公认的导师和跨学科机构的杰出指导致力于他的成功。