Collaborative care interventions for polysubstance use in primary care settings (Co-CARE study)

初级保健机构中针对多种物质使用的协作护理干预措施（Co-CARE 研究）

• 批准号: 10646600
• 负责人: JUDITH FEINBERG
• 金额: $ 20.72万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 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/10646600
• 关键词: Academic Medical Centers; Address; Appalachian Region; Bacterial Infections; Bioinformatics; Caring; Clinical Investigator; Clinical Research; Clinical Trials Network; Communities; Complex; Data; Databases; Electronic Health Record; Ensure; Epidemic; Evidence based practice; Geography; Health Information System; Health Technology; Health system; Incentives; Institution; Intervention; Learning; Life Expectancy; Medicine; Morbidity - disease rate; National Institute of Drug Abuse; Pennsylvania; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Policies; Public Health; Recovery; Research; Research Personnel; Resource-limited setting; Resources; Rural; System; Testing; Underserved Population; Universities; West Virginia; Work; buprenorphine treatment; collaborative care; college; experience; injection drug use; innovation; mobile computing; multi-site trial; multidisciplinary; novel; opioid epidemic; opioid mortality; opioid use disorder; peer; polysubstance use; primary care setting; recruit; relapse risk; smartphone Application; substance misuse; substance use; substance use treatment; 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以下临床研究问题： 起源于阿巴拉契亚中部，这里是当前阿片类药物流行病最严重的地区之一。 全国阿片类药物过量死亡率和相关发病率。 独立、经济紧张以及无法获得药物滥用治疗均导致了 匹兹堡大学（Pitt）、西弗吉尼亚大学（WVU）和宾夕法尼亚大学联手应对这一流行病。 州立医学院 (PSU) 阿巴拉契亚节点将由经验丰富的临床研究人员领导， Jane Liebschutz 博士（皮特）和 Judith Feinberg（西弗吉尼亚大学）将汇聚成功的多位专家。 纪律联合调查员，其中许多人之前曾在其他已建立的节点中拥有 CTN 经验，并且 这些机构被招募来应对区域性药物使用流行病。 附属学术医疗中心覆盖宾夕法尼亚州中部和西部 (PA) 以及整个西弗吉尼亚州 （西弗吉尼亚州）并拥有广泛的生物信息学数据库，其中包含电子健康记录和索赔数据的使用。 利益相关者咨询小组、地区付款人的支持以及与州和地方政策的密切联系 公共卫生官员将确保研究具有相关性和可持续性的可能性很高 研究完成后，该节点的三个目标是：1）进行多站点试验以解决问题。 当前的阿片类药物危机（和其他物质滥用），重点是在 农村和其他服务不足的人群，2) 提出研究来测试现有资源的创新用途 （当地药房、同伴导航员/同伴恢复教练、移动技术、最先进的健康 信息系统）以实施循证实践，将最先进的护理扩展到 资源贫乏地区，无论是农村还是城市，以及 3) 将 CTN 调查结果传播给地区付款者和 该节点将定义本地解决方案来克服这一问题。 服务不足的农村和城市地区障碍的复杂相互作用 我们的资源组合。 CTN 提供的信息将使我们能够对阿片类药物流行病产生重大影响 阿巴拉契亚中部和全国范围内基于节点调查员工作的拟议研究包括：1) 与注射毒品使用相关的严重细菌感染：质量指标和干预（Liebschutz， 2) 药剂师辅助丁丙诺啡治疗（温斯坦利），3) 利用学习成果 卫生系统激励阿片类药物使用障碍的药物辅助康复 (Kraemer)，以及 4) 智能手机应用程序和可穿戴设备复发风险的“早期预警”系统（川崎、 温斯坦利）。

项目成果

Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design.

• DOI: 10.1016/j.dadr.2023.100135
• 发表时间: 2023-03
• 期刊: Drug and alcohol dependence reports
• 作者: Roy, Payel Jhoom;Callaway Kim, Katherine;Suda, Katie;Luo, Jing;Wang, Xiaoming;Olejniczak, Donna;Liebschutz, Jane M
• 通讯作者: Liebschutz, Jane M

Longitudinal study of impact of medication for opioid use disorder on Hamilton Depression Rating Scale.

阿片类药物使用障碍药物对汉密尔顿抑郁评定量表影响的纵向研究。

• DOI: 10.1016/j.jad.2021.10.018
• 发表时间: 2022
• 期刊: Journal of affective disorders
• 影响因子: 6.6
• 作者: Wang,Kesheng;DiChiacchio,Toni;Fang,Wei;Lander,Laura;Feinberg,Judith;Xie,Changchun;Winstanley,ErinL;UbolratPiamjariyakul
• 通讯作者: UbolratPiamjariyakul