A tailored, peer-delivered intervention to reduce recurring opioid overdoses

量身定制的、同行提供的干预措施，以减少反复出现的阿片类药物过量

基本信息

批准号：
9352799
负责人：
T John WINHUSEN
金额：
$ 26.52万
依托单位：
UNIVERSITY OF CINCINNATI
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-15 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9352799
关键词：
Acute Certification Cessation of life Clinical Trials Competence Control Groups Effectiveness Emergency Care Emergency department visit Enrollment Epidemic Evidence based intervention Factor Analysis Feedback Fright Future Hour Individual Intervention Knowledge Mediation Mediator of activation protein Methods Modeling Morbidity - disease rate Naloxone Opioid Overdose Participant Patients Persons Persuasive Communication Pharmaceutical Preparations Preparation Preventive Intervention Publishing Randomized Recruitment Activity Recurrence Reporting Risk Risk Factors Risk Reduction Secondary Prevention Self Efficacy Structure Surveys Telephone Testing Time Training United States base computer program cost design disability experience medication-assisted treatment multimodality opioid use opioid use disorder peer pilot trial prevent public health relevance satisfaction

项目摘要

DESCRIPTION (provided by applicant): In recent years, the United States has experienced a growing opioid-use epidemic accompanied by a dramatic rise in opioid-overdose (OOD). Individuals experiencing a non-fatal OOD are at heightened risk for future OODs. A recent study revealed that patients with repeated OODs accounted for 15% of all OOD ED visits, and were more likely to be hospitalized. Although naloxone can reverse an acute overdose, there is no guarantee the medication will be available in time. The only completely effective method of preventing subsequent OOD is successful treatment of the underlying opioid use disorder (OUD). Despite this, there are no published interventions to facilitate treatment entry for patient experiencing a non-fatal OOD. To fill this gap, we created the Tailored Telephone Intervention delivered by Peers to Prevent Recurring Opioid Overdoses (TTIP-PRO), a secondary prevention intervention for individuals with OUD and a recent OOD designed to: 1) encourage patients to initiate medication assisted treatment (MAT) and 2) increase knowledge about OOD risk reduction. To maximize effectiveness, TTIP-PRO was designed based on principles from the elaboration likelihood model (ELM) of persuasion. Based on the ELM, TTIP-PRO is patient-tailored, provides empirically-based information in a multimodal format, and is delivered by a Peer Interventionist - a person who has been abstinent from illicit opioids for at least a year, is enrolled in MAT, and has personal experience with OOD. To minimize cost and implementation barriers, TTIP-PRO is provided remotely and consists of: 1) a 30-minute telephone call during which the Peer Interventionist engages the individual in an open discussion about MAT and provides tailored feedback based on the individual's OOD risk factors and knowledge about OOD and MAT; 2) a mailing with materials to reinforce the patient's knowledge of his/her personal risk factors, review how to appropriately respond to an OOD, re-emphasize the benefits of MAT, and remind the participant where he/she can obtain treatment. Because the TTIP-PRO computer program generates tailored feedback and guides the Peer Interventionist through intervention delivery, TTIP-PRO training and certification can be accomplished in 4 hours. Our initial study evaluating the acceptability of TTIP-PRO revealed a high degree of satisfaction with TTIP-PRO for both Peer Interventionists and participants and a significant increase in the participants' knowledge about OOD and MAT. The specific aims of this project are to: 1) Finalize the Peer Interventionist training materials by creating training files and evaluating the inter-rater reliability of TTIP-PRO's competence assessment (Stage IA); and 2) Conduct pilot testing in preparation for a full-scale clinical trial (Stage IB). Exploratory aims ae to: E1) Test the validity of two assessments developed for TTIP-PRO; E2) Test our conceptual model of TTIP-PRO's mechanisms of change.

描述（由申请人提供）：近年来，美国阿片类药物使用日益流行，同时阿片类药物过量 (OOD) 急剧增加，经历非致命 OOD 的个人未来面临 OOD 呼吸风险。最近的一项研究显示，重复 OOD 的患者占所有 OOD 急诊就诊的患者的 15%，并且更有可能住院治疗。及时预防后续 OOD 的唯一完全有效的方法是成功治疗潜在的阿片类药物使用障碍 (OUD)，但目前还没有公布的干预措施可以帮助经历非致命性 OOD 的患者进入治疗。，我们创建了由同行提供的定制电话干预措施，以防止复发性阿片类药物过量 (TTIP-PRO)，这是针对 OUD 患者的二级预防干预措施，以及最近的 OOD 旨在：1) 鼓励患者开始药物辅助治疗(MAT) 和 2) 增加有关 OOD 风险降低的知识，TTIP-PRO 是根据说服的详细可能性模型 (ELM) 的原理设计的，TTIP-PRO 是针对患者量身定制的。以多模式形式提供基于经验的信息，并由同伴干预员提供 - 戒除非法阿片类药物至少一年的人已注册 MAT，并拥有 OOD 个人经验。为了最大限度地减少成本和实施障碍，TTIP-PRO 是远程提供的，包括：1) 30 分钟的电话通话，在此期间，同伴干预员与个人进行有关 MAT 的公开讨论。并根据个人的 OOD 风险因素以及 OOD 和 MAT 知识提供量身定制的反馈 2) 邮寄材料以加强患者对其个人风险因素的了解，回顾如何适当应对OOD，再次强调 MAT 的好处，并提醒参与者他/她可以在哪里获得治疗，因为 TTIP-PRO 计算机程序会生成量身定制的反馈并指导同伴干预员进行干预，因此可以完成 TTIP-PRO 培训和认证。我们评估 TTIP-PRO 可接受性的初步研究显示，同伴干预者和参与者对 TTIP-PRO 高度满意，并且参与者对 OOD 和 MAT 的了解显着增加。该项目的具体目标是：1) 通过创建培训文件并评估 TTIP-PRO 能力评估的评估者间可靠性（阶段 IA），最终确定同伴干预培训材料；2) 进行试点测试，为全面评估做好准备； -规模临床试验（阶段 IB）。探索性目的是：E1）测试为 TTIP-PRO 开发的两项评估的有效性；E2）测试我们的 TTIP-PRO 变化机制的概念模型。