Patients decline buprenorphine from the emergency department CTN:0107 add on

患者拒绝从急诊科使用丁丙诺啡 CTN:0107 添加

• 批准号: 10666250
• 负责人: KATHLEEN T. BRADY
• 金额: $ 27.58万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10666250
• 关键词: Accident and Emergency department; Address; Buprenorphine; Consolidated Framework for Implementation Research; Country; Data; Dimensions; Emergency Department patient; Emergency Medicine; Evidence based treatment; Foundations; Funding; Harm Reduction; Individual; Instruction; Intervention; Interview; Knowledge; Length; Life; Medical; Minority; Modification; Opioid; Overdose; Overdose reduction; Pathway interactions; Patients; Pharmaceutical Preparations; Placebos; Principal Investigator; Provider; Public Health; Quality of Care; Recovery; Research; Research Design; Savings; Science; Social Functioning; South Carolina; Structure; Survey Methodology; Time; United States Dept. of Health and Human Services; acute care; addiction; buprenorphine treatment; comparative effectiveness study; craving; implementation science; improved; mortality; opioid epidemic; opioid use; opioid use disorder; patient engagement; patient-level barriers; peer; programs; therapy design; therapy development; uptake; user centered design

Program Director/Principal Investigator (Last, First, Middle): Brady, Kathleen T PROJECT SUMMARY (See instructions): Why do patients decline buprenorphine from the emergency department?: Add-on study to CTN-0107 Emergency department-initiated buprenorphine (EDIB) successfully doubles retention in treatment at 30 days when compared to referral alone. Additionally, there are significant benefits to treatment with buprenorphine and other medications for opioid use disorder (MOUD) including significant reductions in overdose and all-cause mortality, better retention compared to placebo or no medication increased length of time in recovery, decreased opioid use, decreased craving, and improved social functioning. Emergency departments (EDs) are well-suited to engage patients in buprenorphine treatment, resulting in significantly improved ED quality of care and increased access to this life-saving treatment. Unfortunately, only a minority of patients eligible and offered EDIB receive it. The specific objective of this proposal is to systematically evaluate reasons why EDIB-eligible patients with OUD decline EDIB. This study will be a qualitative study utilizing semi-structured interviews with ED medical providers, ED staff, and patients who are deemed eligible for EDIB to evaluate provider/staff-level and patient-level barriers and facilitators to EDIB acceptance among eligible patients. This knowledge is imperative to public health efforts addressing the opioid epidemic, as results can be used to improve harm reduction interventions by addressing critical gaps for ED patients with OUD. This proposal would be the first to examine why a minority of patients eligible for EDIB accept it when it is available and recommended. This study will provide an important initial step in better understanding reasons for declining EDIB and informing intervention design and implementation to increase EDIB uptake. This study can be completed rapidly and has potential to positively impact the thousands of patients with OUD seen in EDs across the country. Our team of experts in addiction science, survey methods, qualitative data, implementation science and emergency medicine are uniquely qualified to carry out this proposal. RELEVANCE (See instructions): The proposed research will provide the foundation to address systematic problems with ED-initiated buprenorphine programs, which will in turn improve patient engagement in evidenced-based treatments.

项目总监/首席研究员（最后、第一、中间）：Brady, Kathleen T 项目摘要（参见说明）： 为什么患者在紧急情况下拒绝使用丁丙诺啡 部门？：CTN-0107 的附加研究 急诊科发起的丁丙诺啡 (EDIB) 成功地将治疗保留率提高了一倍 与单独转诊相比，需要 30 天。此外，治疗有显着的好处 丁丙诺啡和其他治疗阿片类药物使用障碍 (MOUD) 的药物，包括显着减少 用药过量和全因死亡率，与安慰剂或不用药相比，保留效果更好，寿命更长 恢复时间、减少阿片类药物的使用、减少渴望并改善社会功能。紧急情况 科室 (ED) 非常适合让患者接受丁丙诺啡治疗，从而显着 提高了急诊科的护理质量并增加了获得这种救命治疗的机会。不幸的是，只有一个 少数符合资格并提供 EDIB 的患者会接受该治疗。 该提案的具体目标是系统地评估符合 EDIB 资格的患者的原因 随着OUD下降EDIB。这项研究将是一项利用 ED 半结构化访谈的定性研究 被认为有资格 EDIB 评估提供者/工作人员级别的医疗提供者、急诊室工作人员和患者 合格患者接受 EDIB 的患者层面障碍和促进因素。这些知识是 应对阿片类药物流行病的公共卫生工作势在必行，因为结果可用于改善危害 通过解决 ED 患者 OUD 的关键差距来减少干预措施。 该提案将首次探讨为什么少数符合 EDIB 资格的患者会接受它 可用并推荐。这项研究将为更好地理解提供重要的第一步 EDIB 下降的原因，并为干预设计和实施提供信息，以提高 EDIB 的采用率。 这项研究可以快速完成，并有可能对数千名患有此病的患者产生积极影响 OUD 出现在全国各地的 ED 中。我们的专家团队在成瘾科学、调查方法、 定性数据、实施科学和急诊医学具有独特的资格来实现这一目标 提议。 相关性（参见说明）： 拟议的研究将为解决 ED 发起的系统性问题提供基础 丁丙诺啡计划，这反过来将提高患者对循证治疗的参与度。