The Ohio Valley Node of the Clinical Trials Network

临床试验网络俄亥俄谷节点

• 批准号: 10652032
• 负责人: T John WINHUSEN
• 金额: $ 37.9万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10652032
• 关键词: Age; Buprenorphine; Caring; Categories; Characteristics; Clinical Trials Network; Code; Cross-Over Studies; Data; Data Set; Diagnosis; Drug usage; Electronic Health Record; Goals; ICD-9; Inpatients; International Classification of Diseases; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); Length; Link; Measures; Methadone; Modeling; Naloxone; Naltrexone; Ohio; Outcome; Outcome Measure; Outpatients; Output; Overdose reduction; Patients; Pharmaceutical Preparations; Pharmacy facility; Probability; Psychiatric Diagnosis; Public Health; Race; Relapse; Retrospective cohort; Social Security Number; Specific qualifier value; Time; United States; Veterans; Veterans Health Administration; Weight; base; cohort; cost; data repository; data warehouse; design; digital repositories; health care service; improved; indexing; individual patient; insight; interest; military veteran; mortality; opioid mortality; opioid use disorder; primary outcome; secondary outcome; systems of equations; treatment effect; vector

PUBLIC HEALTH ABSTRACT Medications for Opioid Use Disorder (MOUD), such as methadone, buprenorphine (with or without naloxone), and extended-release naltrexone, have been shown to reduce overdoses and drug use. However, MOUD retention is essential to attaining these outcomes. Unfortunately, only 50% or less of patients remain on MOUD 6 months after initiating treatment, a minimum standard established by the National Quality Forum. One possible approach to improving retention would be using patient characteristics to select the MOUD with which patients are most likely to be successful. This study will utilize VHA data sets to identify patient characteristics associated with improved MOUD retention by MOUD type as well as patient characteristics associated with successful MOUD discontinuation without relapse. We will use a retrospective cohort design using the International Classification of Disease, 9th and 10th edition (ICD-9/10-CM) codes to operationalize OUD since the years of data used for this study cross over the time of ICD-10 implementation (2015). Aim 1 is to identify patient characteristics associated with MOUD retention and opioid overdose death by MOUD type. Our primary outcome for Aim 1 will be a binary measure of retention defined as continuous coverage with the type of MOUD the patient originally initiated for 180 days after the index date without a 28- day gap in treatment. Secondary outcome measures will include (1) a binary measure of retention similar to the primary outcome but over the 365 days after the index date and (2) opioid overdose death in the 365 days after the index date using the VHA Mortality Data Repository. Aim 2 is to quantify the association between probability of relapse after MOUD discontinuation and both length of MOUD therapy and patient characteristics. The outcome for Aim 2 will be discontinuation with vs. without relapse.

公共卫生摘要 阿片类药物使用障碍（MOUD）的药物，例如美沙酮，丁丙诺啡（有或 没有纳洛酮）和延长释放纳曲酮，已被证明可减少过量药物 和吸毒。但是，MOUD保留对于获得这些结果至关重要。 不幸的是，在开始治疗后6个月，只有50％或更少的患者留在MOUD上 国家质量论坛建立的最低标准。一种可能的方法 提高保留率将使用患者特征来选择moud 患者最有可能成功。这项研究将利用VHA数据集识别患者 与MOUD类型和患者改善的MOUD保留相关的特征 与成功停产无复发相关的特征。我们将使用一个 回顾性队列设计使用国际疾病分类，第9和第10版 （ICD-9/10-cm）自本研究的数据交叉以来的数年以来，要运行OUD的代码 在ICD-10实施期间（2015年）。目标1是确定患者特征 与MOUD类型的MOUD保留和阿片类药物过量死亡有关。我们的主要 AIM 1的结果将是保留的二进制量度，定义为连续覆盖范围 MOUD的类型最初在指数日期后180天发起的患者没有28-- 治疗中的一日差距。次要结果指标将包括（1） 保留与主要结果相似，但在索引日期后的365天和（2） 阿片类药物过量死亡在指数日期使用VHA死亡率数据后的365天内死亡 存储库。 AIM 2是量化MOUD后复发概率之间的关联 停用以及MOUD治疗的长度和患者特征。结果 AIM 2将以与无复发的方式中断。