HEAL Initiative: Research to Foster an Opioid Use Disorder Treatment System Patients Can Count On

HEAL 计划：促进患者可以信赖的阿片类药物使用障碍治疗系统的研究

• 批准号: 10772818
• 负责人: TAMI L MARK
• 金额: $ 153.98万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10772818
• 关键词: Address; Benchmarking; Buprenorphine; California; Caring; Characteristics; Clinic; Clinical; Cluster randomized trial; Connecticut; County; Disparity; Emergency department visit; Federal Government; Feedback; Fostering; Health; Health Personnel; Health Services; Health system; Helping to End Addiction Long-term; Hospitalization; Individual; International; Knowledge; Literature; Los Angeles; Measurement; Measures; Methadone; Monitor; National Institute of Drug Abuse; Outcome; Outcome Measure; Overdose; Overdose reduction; Patients; Performance; Persons; Pharmaceutical Preparations; Policies; Population; Prevention strategy; Probability; Provider; Psychometrics; Recommendation; Research; Research Personnel; Research Project Grants; Review Literature; Risk Reduction; Substance Use Disorder; System; Testing; Time; Training; Transportation; United States; United States Dept. of Health and Human Services; Universities; Variant; arm; experience; flexibility; improved; improved outcome; medication for opioid use disorder; mortality; opioid mortality; opioid treatment program; opioid use disorder; overdose prevention; overdose risk; patient navigation; patient oriented; peer; premature; programs; randomized, clinical trials; retention rate; social stigma; socioeconomic disadvantage; substance abuse prevention; telehealth; treatment as usual; treatment program; web site

0BPROJECT SUMMARY/ABSTRACT Opioid overdose deaths reached the highest level ever in 2021. Medications to treat opioid use disorder (MOUD) can markedly reduce overdose risks when taken for long enough. More than 650,000 people receive MOUD in Opioid Treatment Programs (OTPs) annually. Unfortunately, on average, less than half of patients stay in opioid use disorder (OUD) treatment for the recommended minimum 1 year of time. OTP retention and outcome quality measures (i.e., “audit and feedback”) may improve treatment retention rates and outcomes. Quality measures can also help monitor the effect of new OTP reimbursement and regulatory policies. Eventually, OTP quality measures could be incorporated into the Federal government’s public facing healthcare provider Compare website. However, research is needed to determine how to most effectively create and disseminate OTP quality measures. The literature on audit and feedback points to three features that influence the probability that measures will result in improved quality: (1) the characteristics of the measures and benchmarks, (2) the knowledge that providers have about how to improve the measures, and (3) the control that providers have over the factors that matter to improve the measure. This study will test approaches for optimizing each of these factors. NIDA RFA-DA-23-046 is supporting multi-project OUD Quality Measurement and Management Research Centers that pair researchers with partner organizations that have an OUD quality measurement and management strategy that research could advance. RTI International, University of California Los Angeles, and Beacon Health Connecticut are the research organizations leading this study. They are partnering with two organizations that need to develop an effective OTP quality measurement and management system: BayMark Health Services and the Los Angeles County Division of Substance Abuse Prevention and Control. The team is implementing three inter-related research projects with the following overall aims: Overall Aim 1. Create and psychometrically test OTP measures of retention, overdose emergency department visits, overdose hospitalizations, and mortality with benchmarks and toolkits describing how OTPs can improve retention. Overall Aim 2. Test the effect of the giving OTPs quality measures and information on how to improve retention (a retention toolkit), with and without quality improvement training, by conducting a clustered randomized trial that assigns OTPs to receive either: (1) retention and outcome measures with the toolkit; or (2) retention and outcome meaures with the toolkit as well as quality improvement (QI) training (i.e., NIATx) (Arm 2), or (3) treatment as usual (Control Arm). Overall Aim 3. Test the effect of aligning OTP-level and LA county population-level OUD measures on retention and outcomes in LA county relative to other counties in California.

0BProject摘要/摘要 阿片类药物过量死亡达到了2021年的最高水平。治疗阿片类药物使用障碍的药物 （MOUD）在服用足够长的时间后可以显着降低过量风险。超过65万人 每年在阿片类药物治疗计划（OTP）中接收moud。不幸的是，平均而言只有不到一半 在建议的至少1年的时间里，患者继续接受阿片类药物使用障碍（OUD）治疗。 OTP 保留和结果质量措施（即“审核和反馈”）可能会提高治疗保留率 和结果。质量措施还可以帮助监测新的OTP报销和监管的效果 政策。最终，可以将OTP质量措施纳入联邦政府的公众 面对医疗保健提供者比较网站。但是，需要研究以确定如何大多数 有效地创建和传播OTP质量度量。有关审计和反馈的文献指向 影响衡量概率的三个特征将提高质量：（1） 措施和基准的特征，（2）提供者对如何的知识 改进措施，以及（3）提供者对改善重要因素的控制 措施。这项研究将测试以优化这些因素的方法。 NIDA RFA-DA-23-046正在支持多项目的OUD质量测量和管理研究 中心将研究人员与具有OUD质量测量的合作伙伴组织配对 研究可能会发展的管理策略。加利福尼亚大学洛杉矶分校RTI国际 康涅狄格州的信标健康组织是领导这项研究的研究组织。他们正在与 两个需要开发有效的OTP质量测量和管理系统的组织： Baymark Health Services和洛杉矶县的滥用药物预防和控制。 该团队正在实施三个相互关联的研究项目，其总体目标是： 总体目的1。创建和心理测试OTP保留量，过量紧急情况 通过基准和工具包的部门访问，过量住院以及死亡率描述 OTP可以改善保留率。 总体目标2。测试给出OTPS质量度量和有关如何改进的信息的影响 保留（保留工具包），有或没有质量改进培训，通过进行集群 分配OTP的随机试验接收：（1）使用该工具包进行保留和结果度量；或者 （2）工具包的保留和结果启动以及质量改进（QI）培训（即NIATX） （ARM 2）或（3）照常治疗（对照组）。 总体目标3。测试对齐OTP级和洛杉矶县人口级别的措施对对齐的影响 相对于加利福尼亚的其他县，洛杉矶县的保留和结果。