Health Systems Node of the NIDA Clinical Trials Network

NIDA 临床试验网络的卫生系统节点

基本信息

批准号：
10644383
负责人：
KATHARINE ANTHONY BRADLEY
金额：
$ 3.42万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
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：
2022-09-01 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10644383
关键词：
Address Adolescent Adult Attention Cannabis Caring Cellular Phone Cessation of life Chronic Clinical Trials Network Collaborations Data Drug Screening Electronic Health Record Evidence based treatment Faculty Faculty Recruitment Family Friends HIV Health Health Care Visit Health system Healthcare Healthcare Systems Helping to End Addiction Long-term Individual Information Systems Infrastructure Leadership Learning Legal Life Mainstreaming Measurement Measures Medical Medicine Methamphetamine use disorder Methods Monitor Morbidity - disease rate National Institute of Drug Abuse Newly Diagnosed Nurses Opiate Addiction Opioid Outcome Patient Outcomes Assessments Patient-Focused Outcomes Patients Persons Population Heterogeneity Population Research Population Study Positioning Attribute Pregnant Women Primary Health Care Provider Psychiatry Public Health Public Health Practice Quality of Care Randomized Controlled Trials Research Research Design Research Institute Research Personnel Rural Community Severities Site Speed Stigmatization Substance Use Disorder Symptoms System Telephone Testing Translating Treatment outcome Underrepresented Minority United States United States National Institutes of Health Vision Work Youth addiction base clinical practice collaborative care comparative effectiveness study disability effective therapy experience illicit drug use implementation research implementation trial improved innovation marijuana use marijuana use disorder medical specialties methamphetamine use mortality multidisciplinary neglect novel novel strategies opioid epidemic opioid misuse opioid overdose point of care pragmatic implementation pragmatic trial public health relevance screening shared decision making social stigma substance use substance use treatment success synthetic opioid treatment response young adult

项目摘要

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction. Substance use (SU) and substance use disorders (SUD) cause extensive morbidity and mortality but have been neglected historically by mainstream health care. The Health Systems Node joined the National Institute on Drug Abuse’s Clinical Trials Network (CTN) in 2015, led by Drs. Campbell, Weisner and Bradley, addiction research leaders in innovative implementation research and pragmatic trials in medical settings. Our node includes 16 Learning Health Systems with national representation and rich population diversity, and represents over 26 million patients. Our faculty are researchers who are embedded in their health systems and committed to cutting-edge addiction research. They bring multidisciplinary expertise in conducting research using innovative methods in different medical settings (e.g. primary care, addiction medicine, OB/GYN, psychiatry, rural communities), and with diverse populations (e.g. under-represented minorities, adolescents, pregnant women, patients with HIV). The node had an outstanding track record in its first 5 years leading 6 multi-site studies, including the CTN’s first entirely electronic health record (EHR)-based pragmatic implementation trial as well as participating in several studies led by other nodes. This renewal application builds upon that success to address the CTN’s objectives over the next 5 years through 3 broad Research Agendas: 1) To test approaches to increasing identification of SU and SUD, and engagement in treatment. For example, we propose a multisite implementation trial to test an innovative approach to implementing cannabis and other drug screening and assessment for SUD; 2) To test new approaches to improve SUD outcomes in medical settings. For example, we propose a point-of-care pragmatic effectiveness trial of telephonic nurse collaborative care and an efficacious smartphone-based SUD treatment, in patients with newly diagnosed SUD; and 3) To develop novel measures and methods for SUD research using EHRs. For example, we propose to validate a 7-item SU severity measure developed by the NIH Roadmap initiative Patient Reported Outcome Measurement Information System (PROMIS) for use in measurement-based care of SUD. These agendas emphasize population-based studies, including pragmatic randomized controlled trials, comparative effectiveness studies, and implementation research, and leverage EHRs. Public Health and Clinical Practice Impact. Over 14.9 million patients with untreated SUD have health care visits annually in the US. If 10% of these patients were identified, engaged and successfully treated, it would translate to 1.5 million patients with resolved SUD each year who otherwise would have gone untreated. The Health Systems Node faculty and infrastructure, in collaboration with the CTN, are uniquely positioned to conduct and disseminate research that advances the integration of SUD treatment into routine medical care, and ultimately to improve patient outcomes and public health.

这项研究是 NIH 帮助消除成瘾长期 (HEAL) 计划的一部分，该计划旨在加快国家阿片类药物公共卫生危机的科学解决方案。 NIH HEAL 计划支持 NIH 的研究，以改善阿片类药物滥用和成瘾的治疗。 SU) 和物质使用障碍 (SUD) 导致广泛的发病率和死亡率，但传统上被主流医疗保健机构忽视。卫生系统节点于 2017 年加入了国家药物滥用研究所的临床试验网络 (CTN)。 2015 年，由 Campbell、Weisner 和 Bradley 博士领导，成瘾我们的节点包括 16 个具有全国代表性和丰富人口多样性的学习健康系统，代表超过 2600 万患者，他们是融入其卫生系统并致力于削减疾病的研究人员。他们利用多学科的专业知识进行研究。不同医疗环境（例如初级保健、成瘾医学、妇产科、精神病学、农村社区）和不同人群（例如代表性不足的少数民族、青少年、孕妇、艾滋病毒患者）的创新方法该节点具有出色的表现。前 5 年领导 6 项多中心研究的记录，包括 CTN 首个完全基于电子健康记录 (EHR) 的实用实施试验以及参与由其他节点领导的多项研究。此更新应用程序建立在通过 3 个广泛的研究议程实现 CTN 未来 5 年目标的成功基础上：1) 测试提高 SU 和 SUD 识别度以及参与度的方法。例如，我们建议进行多地点实施试验，以测试实施大麻和其他药物的创新方法。 SUD 药物筛选和评估；2) 测试改善医疗环境中 SUD 结果的新方法，例如，我们提出了电话护士协作护理和基于智能手机的有效 SUD 治疗的护理点实用有效性试验。 3) 使用 EHR 开发 SUD 研究的新措施和方法例如，我们建议验证 NIH 路线图倡议患者报告结果开发的 7 项 SU 严重程度测量。用于基于测量的 SUD 护理的测量信息系统 (PROMIS)。这些议程强调基于人群的研究，包括实用的随机对照试验、比较有效性研究和实施研究，并利用 EHR 14.9。在美国，每年有 100 万名未经治疗的 SUD 患者接受医疗保健，如果这些患者中的 10% 得到识别、参与并成功治疗，那么每年将有 150 万名 SUD 患者得到解决，否则他们就会去医院就诊。卫生系统节点的教员和基础设施与 CTN 合作，具有独特的优势来开展和传播研究，推动将 SUD 治疗纳入常规医疗护理，并最终改善患者的治疗结果和公共卫生。