Social and behavioral determinants of MOUD utilization and opioid overdose

MOUD 使用和阿片类药物过量的社会和行为决定因素

基本信息

批准号：
10664099
负责人：
Wenjun Li
金额：
$ 75.3万
依托单位：
UNIVERSITY OF MASSACHUSETTS LOWELL
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-01 至 2028-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10664099
关键词：
Accidents Address Adult Age Behavioral Biological Black American Buprenorphine Caring Cessation of life Clinical Communities Data Dose Electronic Health Record Ensure Ethnic Origin Exposure to Food General Population Goals Health High Prevalence Hospitals Housing Individual Legal Machine Learning Major Depressive Disorder Marital Status Mental disorders Methadone Modeling Naltrexone Natural Extract Natural Language Processing Occupations Opioid Outcome Overdose Patients Persons Pharmaceutical Preparations Population Positioning Attribute Race Regression Analysis Research Resources Risk Social Work Stress Structure System Time Transportation United States Department of Veterans Affairs Veterans Veterans Health Administration Violence Washington Woman Work allostatic load behavioral health cohort coping deep learning model demographics electronic health information electronic structure ethnic minority experience food insecurity health determinants health record illicit drug use improved innovation intersectionality male health mindfulness opioid overdose opioid use disorder patient population predictive modeling primary care setting prospective racial minority sex social social health determinants standard care structured data substance use theories unstructured data

项目摘要

Social and behavioral determinants of MOUD utilization and opioid overdose In the US, over 192 people die each day due to opioid overdose (OOD), the leading cause of accidental death among adults. Veterans are especially vulnerable to OOD, experiencing rates double those of non-Veterans, due to their higher prevalence of opioid use disorder (OUD). Medication treatment for OUD (MOUD) is the gold standard treatment for opioid use disorder (OUD). However, in the Veterans Health Administration of the Department of Veterans Affairs (VA) and non-VA hospitals, access to MOUD care is lacking. Compounding poor access, many patients who receive buprenorphine discontinue within 1 year, an indicator of suboptimal treatment retention. Social determinants of health are the conditions in which people are born, live, work, and age. Adverse social determinants of health include job insecurity, housing insecurity, financial insecurity, food insecurity, as well as legal, social/familial, transportation, and violence problems. Together with adverse behavioral health factors such as substance use and mental health disorders (e.g., major depression), adverse social and behavioral determinants of health (SBDH) are associated with poorer health, and concurrent adverse SBDH can have compounding negative health consequences. The overarching goal of this proposal is to understand SBDH, biological variables, clinical settings and clinical factors that impact MOUD access and outcomes and to develop predictive models for MOUD outcomes.

MOUD利用和阿片类药物过量的社会和行为决定因素在美国，由于阿片类药物过量（OOD），每天有192多人死亡，这是意外死亡的主要原因在成年人中。退伍军人尤其容易受到OOD的攻击，经历了非退伍军人的比率两倍，由于它们较高的阿片类药物使用障碍（OUD）的患病率。 OUD（MOUD）的药物治疗是黄金阿片类药物使用障碍（OUD）的标准治疗方法。但是，在退伍军人卫生管理中退伍军人事务部（VA）和非VA医院，缺乏获得MOUD护理的机会。复合通道不佳，许多在1年内停止丁丙诺啡的患者，这是次优的指标保留治疗。健康的决定因素是人们出生，生活，工作和年龄的条件。不利的社交健康的决定因素包括工作不安全感，住房不安全感，财务不安全，粮食不安全以及法律，社会/家庭，运输和暴力问题。与不利的行为健康因素一起例如药物使用和心理健康障碍（例如重度抑郁症），不利的社会和行为健康的决定因素（SBDH）与健康差有关，并发不良SBDH可以更复杂的负面健康后果。该提议的总体目标是了解SBDH，影响MOUD访问和结果的生物变量，临床环境和临床因素以及为MOUD结果开发预测模型。