MIRHIQL Resource Center for Improving Quality of Life with Chronic Pain (MRC)

MIRHIQL 改善慢性疼痛生活质量资源中心 (MRC)

基本信息

批准号：
10705887
负责人：
MEREDITH C. B. ADAMS
金额：
$ 597.81万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
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：
2023-08-15 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10705887
关键词：
Address Advisory Committees Affect Behavior Benefits and Risks Caring Categories Clinical Clinical Research Common Data Element Communities Complex Consensus Data Data Analyses Data Collection Diagnostic Ecosystem Elements Environmental Risk Factor Expert Opinion Foundations Goals Health Personnel Health Policy Individual Infrastructure Institution Intervention Interview Knowledge Link Measures Medicine Mission Opioid Outcome Outcomes Research Pain Patients Pattern Persons Phenotype Policies Privatization Process Provider Public Health Quality of life Research Resources Risk Assessment Societies System Testing Translating Treatment outcome United States National Institutes of Health Validation Vulnerable Populations Work chronic pain chronic painful condition clinical care clinical center clinical practice clinically relevant cohort data harmonization data sharing disorder prevention eHealth electronic health data experience functional status health care delivery health data health equity promotion improved innovation opioid abuse opioid misuse opioid therapy opioid use opioid use disorder patient oriented personalized care personalized medicine prescription opioid process evaluation research study screening social health determinants support network support tools systematic review timeline tool tool development treatment adherence trial comparing usability

Address Advisory Committees Affect Behavior Benefits and Risks Caring Categories Clinical Clinical Research Common Data Element Communities Complex Consensus Data Data Analyses Data Collection Diagnostic Ecosystem Elements Environmental Risk Factor Expert Opinion Foundations Goals Health Personnel Health Policy Individual Infrastructure Institution Intervention Interview Knowledge Link Measures Medicine Mission Opioid Outcome Outcomes Research Pain Patients Pattern Persons Phenotype Policies Privatization Process Provider Public Health Quality of life Research Resources Risk Assessment Societies System Testing Translating Treatment outcome United States National Institutes of Health Validation Vulnerable Populations Work chronic pain chronic painful condition clinical care clinical center clinical practice clinically relevant cohort data harmonization data sharing disorder prevention eHealth electronic health data experience functional status health care delivery health data health equity promotion improved innovation opioid abuse opioid misuse opioid therapy opioid use opioid use disorder patient oriented personalized care personalized medicine prescription opioid process evaluation research study screening social health determinants support network support tools systematic review timeline tool tool development treatment adherence trial comparing usability

展开

项目摘要

Project Summary Despite acknowledging the challenges of long-term opioid use (LTOT) in clinical and research studies, there is no consensus on clinically defining opioid misuse. In clinical practice, screening and risk/benefit calculations remain difficult because while opioid use can be problematic, it may be beneficial in certain subpopulations. The combination of variables that could be used clinically to assess the risk of harms versus quality of life for people on LTOT has not been established. It may be possible to decrease some of the tension between prescribers and patients if clinical providers have a working clinical definition and improved ways of assessing whether a patient is a candidate for LTOT. The MIRHIQL Resource Center's (MRC) long-term goal is to understand how chronic pain (CP) and related factors influence the progression of LTOT behaviors. The objective of MRC center is to create a research community that connects the MIRHIQL network to IMPOWR research centers and larger HEAL network to translate findings while developing a key opioid misuse and LTOT infrastructure. We hypothesize that defining opioid misuse and the LTOT benefit/risk framework will require integrated patient-centered clinical approaches that address the systemic issues affecting healthcare delivery and the patient-provider interaction, leading to a fundamental shift in how healthcare providers and the public are educated. These goals will be achieved through the following specific aims: (1) the MRC will harmonize data collection and common data elements for the MIRHIQL network, providing coordinated support for network activities while connecting to the IMPOWR Network and larger HEAL Ecosystem via our IMPOWR CC, (2) The MRC will clinically define opioid misuse with associated risks/benefits using an interconnected strategy including multi-society expert Delphi, qualitative interviewing of prescribers and people with lived pain experience, and phenotyping and validating cohort definitions in electronic health and administrative claims data, and (3) The MRC will perform analytical and clinical validation of screening and benefit/risk tools for LTOT and definition of opioid misuse in a cohort trial comparing different combinations of relevant OM variables. Usability (system/provider input) and user experience (provider/patient input) will evaluated for clinical utility in real-world clinical settings. These aims will provide a coordinated integration of systematic review, qualitative interviewing, EHR and claims data, and expert Delphi Taskforce to identify and test candidate variables for a clinical definition of opioid misuse and develop screening and risk/benefit tools for clinical care. The proposed research is innovative because we will be able to leverage the large-scale claims (CMS and private payer) and EHR data to build a framework for LTOT care on a rapid timeline. These results will support future research but will also have direct clinical impact, aligning with NIH HEAL's mission.

项目摘要尽管承认临床和研究中长期使用阿片类药物（LTOT）的挑战，但仍有对临床定义阿片类药物滥用没有共识。在临床实践中，筛查和风险/福利计算保持困难，因为尽管使用阿片类药物可能会出现问题，但它可能对某些亚群有益。可以在临床上使用变量的组合来评估危害风险与生活质量的风险 LTOT上的人尚未建立。可能会减少之间的某些张力处方者和患者如果临床提供者具有工作的临床定义，并改进了评估方法患者是否是LTOT的候选人。 Mirhiql资源中心（MRC）的长期目标是了解慢性疼痛（CP）和相关因素如何影响LTOT行为的发展。这 MRC中心的目的是建立一个将MirhiQl网络连接到Impowr的研究社区研究中心和更大的治疗网络，以在开发关键阿片类药物滥用和 LTOT基础架构。我们假设定义阿片类药物滥用和LTOT福利/风险框架将需要以患者为中心的综合临床方法来解决影响医疗保健的系统问题交付和患者提供者的互动，导致医疗保健提供者和公众受过教育。这些目标将通过以下特定目的实现：（1）MRC将协调MirhiQL网络的数据收集和共同数据元素，提供协调支持通过我们的Impowr连接到Impowr网络和更大的治疗生态系统的网络活动 CC，（2）MRC将使用互连包括多社会专家Delphi在内的策略，处方者的定性访谈和生命痛苦的人经验，表型和验证电子健康和行政主张中的队列定义数据，（3）MRC将对筛查的分析和临床验证以及利益/风险工具在比较相关OM的不同组合的队列试验中，LTOT和阿片类药物滥用的定义变量。将评估可用性（系统/提供商输入）和用户体验（提供者/患者输入）现实世界中临床环境中的临床实用性。这些目标将提供系统的协调整合审查，定性访谈，EHR和索赔数据以及专家Delphi工作组以识别和测试候选变量，用于滥用阿片类药物的临床定义，并开发筛查和风险/利益工具临床护理。拟议的研究具有创新性，因为我们将能够利用大规模主张（CMS和私人付款人）和EHR数据，以在快速时间表上建立LTOT护理框架。这些结果将支持未来的研究，但也将产生直接的临床影响，与NIH Heal的使命保持一致。