Integrated Care for Hepatitis C: Current Uptake & Impact on Future Treatment

丙型肝炎综合护理：目前的采用情况

基本信息

批准号：
10669004
负责人：
Shashi Kapadia
金额：
$ 17.24万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
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：
2019-08-01 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10669004
关键词：
Adoption Affect Area Award Caring Cessation of life Communicable Diseases Complex County Data Data Set Disease Outbreaks Drug user Economics Enabling Factors Enrollment Epidemic Experimental Designs Funding Future Goals Health Health Insurance Health Services Accessibility Health system Healthcare Hepatitis C Hepatitis C Incidence Hepatitis C Therapy Hepatitis C Transmission Improve Access Incidence Individual Injecting drug user Insurance Insurance Coverage Intervention Interview K-Series Research Career Programs Learning Liver diseases Medicaid Medical Medicine Mentored Research Scientist Development Award Mentors Mentorship Methodology Methods Modeling Morbidity - disease rate National Institute of Drug Abuse Natural experiment Needle-Exchange Programs New York Oral Outcome Patients Physicians Policies Policy Maker Policy Research Population Heterogeneity Positioning Attribute Primary Care Provider Public Health Race Regimen Research Research Methodology Research Personnel Review Literature Rotation Rural Service delivery model Service setting Specialist Substance Use Disorder Surveys Syringes System Testing Training United States Viral behavioral health care fragmentation care systems design dynamic system experience experimental analysis hands on research improved injection drug use insight instructor integrated care medical specialist medical specialties models and simulation mortality opioid epidemic opioid use disorder population health prevent primary care provider primary care setting prior authorization programs public health intervention rural area rural setting scale up skills substance use substance use treatment treatment program treatment services trend uptake urban area

项目摘要

PROJECT SUMMARY/ABSTRACT In this proposal for a K01 Mentored Research Scientist Development award, Shashi Kapadia, MD MS proposes a training and research program that will enable him to become an independent physician-researcher focused on policy and systems factors that impact drug user health. Dr. Kapadia is currently an Instructor in Medicine in the Division of Infectious Diseases at Weill Cornell Medicine whose research focuses on hepatitis C (HCV) treatment access for people who inject drugs (PWID). To achieve his long-term goal, Dr. Kapadia will obtain skills in evaluating care delivery models that integrate medical and behavioral health care, particularly the care of substance use disorders. He will learn methodological approaches to policy research that include natural experimental designs and analysis of administrative/claims data, conducting mixed-methods research, and using simulation models to predict the impact of public health interventions. He will achieve these training objectives with a combination of formal coursework, rotations in diverse care settings, mentorship, and hands-on research experience. He will be mentored by Dr. Bruce Schackman (primary), Dr. Yuhua Bao, Dr. David Perlman, Dr. Kristen Marks, and Dr. Erika Martin, as well as a team of expert consultants. Combined, these individuals have expertise in all of the training areas that Dr. Kapadia seeks to develop during this award period. The population health problem that Dr. Kapadia will study during the proposed career development award is the need to improve access to HCV treatment for PWID, with a focus on New York State. Expanded treatment access is needed to prevent long-term morbidity and mortality from liver disease, and can potentially eliminate HCV transmission. Integrating HCV treatment into primary care and substance use treatment settings may help alleviate barriers to expanded treatment. In his proposed research, Dr. Kapadia will use data from New York State Medicaid to study trends in HCV treatment uptake in primary care (Aim 1). He will conduct interviews to contextualize these quantitative findings, and to elicit factors that would further support treatment integration into primary care, substance use treatment, and syringe service programs. (Aim 2). He will then develop a simulation model, based on these findings, to forecast the impact of integrated care models on HCV treatment of PWID in New York State (Aim 3). The proposed research will test whether integrated HCV care is being effectively utilized, describe the barriers to achieving it, and analyze its impact on the health of HCV-infected individuals, especially PWID. It will be relevant to policymakers and public health practitioners. Additionally, the skills that Dr. Kapadia will gain through completion of this mentored research and training plan will enable him to seek future R01 funding and achieve his goal of becoming an independent investigator.

项目摘要/摘要在此提案中，K01指导的研究科学家发展奖，马里兰州Shashi Kapadia 提出了一项培训和研究计划，使他能够成为一名独立的医师研究者专注于影响药物用户健康的政策和系统因素。 Kapadia博士目前是 Weill Cornell Medicine的传染病分裂的医学，其研究重点是乙型肝炎（HCV）注射药物（PWID）的人的治疗访问。为了实现他的长期目标，卡帕迪亚博士将获得评估护理交付模型的技能整合医疗和行为保健，尤其是对药物使用障碍的护理。他会学习的政策研究的方法论方法，包括自然实验设计和分析行政/索赔数据，进行混合方法研究，并使用仿真模型来预测公共卫生干预措施的影响。他将通过正式的结合来实现这些培训目标课程工作，各种护理环境中的轮换，指导和动手研究经验。他会的 Bruce Schackman博士（小学），Yuhua Bao博士，David Perlman博士，Kristen Marks博士和博士指导。埃里卡·马丁（Erika Martin）以及专家顾问团队。这些人结合在一起，都有所有的专业知识 Kapadia博士试图在此奖项期间寻求发展的培训领域。卡帕迪亚博士将在拟议的职业发展期间研究的人口健康问题奖项是需要提高对PWID的HCV治疗的机会，重点是纽约州。扩展需要进行治疗，以防止肝病的长期发病率和死亡率，并且可能有可能消除HCV传输。将HCV治疗纳入初级保健和药物治疗设置可能有助于减轻扩大治疗的障碍。在他提出的研究中，卡帕迪亚博士将使用数据从纽约州医疗补助到研究初级保健中HCV治疗摄取的趋势（AIM 1）。他会的进行访谈以将这些定量发现与之相关，并引起将进一步支持的因素治疗融合到初级保健，药物治疗和注射器服务计划中。（目标2）。他然后将基于这些发现开发模拟模型，以预测综合护理模型的影响关于纽约州PWID的HCV治疗（AIM 3）。拟议的研究将测试是否有效地利用了综合的HCV护理，描述实现它的障碍，并分析其对HCV感染者（尤其是PWID）健康的影响。它将与决策者和公共卫生从业人员有关。此外，卡帕迪亚博士将通过完成这项受过指导的研究和培训计划的完成将使他能够寻求未来的R01 资金并实现成为独立调查员的目标。