Population-Based Analyses of Healthcare Utilization and Outcomes in Users of Medical Marijuana

基于人群的医用大麻使用者医疗保健利用和结果分析

基本信息

批准号：
10666578
负责人：
Teresa Jo Hudson
金额：
$ 40.73万
依托单位：
UNIV OF ARKANSAS FOR MED SCIS
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-30 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10666578
关键词：
Accident and Emergency department Accidental Injury Accidents Admission activity Adverse event Affect Ambulatory Care American Anxiety Arkansas Behavioral Benefits and Risks Benzodiazepines COVID-19 impact Cannabis Cannabis policy Cessation of life Characteristics Clinical Clinical Decision Support Systems Consensus Consumption Data Data Sources Databases Diagnosis Dose Drug Prescriptions Eligibility Determination Emergency department visit Engineering Epilepsy Future Geography Glaucoma Goals Guidelines Health Health Policy Healthcare Healthcare Systems Hospital Departments Individual Intervention Investigation Knowledge Legal Link Marijuana Measures Medical Medical Informatics Medical Marijuana Medical Records Medicine Mental Health Mental disorders Motor Multiple Sclerosis Opioid Opioid Rotation Outcome Outcome Study Overdose Patients Persons Pharmaceutical Preparations Physicians Police Policies Policy Maker Population Population Research Post-Traumatic Stress Disorders Qualifying Recreation Registries Research Source Substance abuse problem Suicide THC concentration Ulcerative Colitis United States National Academy of Sciences Vehicle crash Vital Statistics adverse outcome chronic pain clinical care cohort cost cost outcomes health care service utilization health data innovation inpatient service insurance claims interest marijuana use marijuana user mortality opioid epidemic opioid use pharmacologic population based population health practice setting public health research reduce symptoms response socioeconomics symposium vehicular accident

项目摘要

PROJECT SUMMARY Limited scientific consensus exists on the clinical, healthcare system, financial, or societal impact of legalization of medical marijuana (MMJ) in states. The swift changes in state policies regarding MMJ use, combined with the current national opioid epidemic, creates an impending need to better understand the clinical, pharmacological, and behavioral impact of MMJ. The state of Arkansas approved MMJ use in 2016 by individuals with select conditions, and dispensaries opened in May 2019. Unique data assets available through the Arkansas Healthcare Transparency Initiative and the Arkansas Health Data Initiative (HDI) consist of individually linked but de-identified mandatory all-payer claims, vital statistics, hospital and emergency department (ED) discharge, and state police motor vehicular crash data, along with data on individuals who qualify for MMJ use. This will be the first population-level analysis that measures clinical and adverse events in a population of MMJ users and non-users through three specific aims: Specific Aim 1: Describe demographic, geographic, socioeconomic, and clinical characteristics; healthcare utilization, adverse events (new mental health diagnoses, substance abuse/overdose, suicide, accidental injury, or MVA accidents); and opioid and benzodiazepine use among three groups: 1) individuals eligible for MMJ in Arkansas who do not obtain an MMJ card (non-cardholders) , 2) individuals who are eligible and obtain a MMJ card but do not purchase MMJ (cardholders), and 3) those who are eligible, obtain a card, and purchase MMJ (consumers). Specific Aim 2: Compare 12-month pre- and post-healthcare use and costs (inpatient and outpatient care, ED visits, and prescription medications), and adverse events between consumers and non-cardholders. As a sub-aim, we will evaluate changes in opioid and benzodiazepine utilization after commencing a course of MMJ therapy. Specific Aim 3: Examine the impact of COVID-19 on MMJ cardholder requests, MMJ purchases, healthcare use, and adverse events. This project brings together five data sources to examine the impact of MMJ on Arkansans. This includes the Arkansas All Payer Claims Database (APCD), the MMJ registry, vital statistics files, and data documenting emergency department visits and MVAs. These data are linkable at the person level which allows person-level analyses or healthcare utilization and outcomes. This will be the first population-level analysis that measures clinical and adverse events in a population of MMJ users and non-users. Results of this research will help fill the gap in scientific knowledge by determining whether MMJ use has benefits (e.g, decreased healthcare use and cost, substitution opioids and benzodiazepines) while producing no additional harm (e.g., new mental health diagnosis, MVAs) and thus inform future MMJ policy.

项目概要关于临床、医疗保健系统、财务或社会影响的科学共识有限各州医用大麻（MMJ）合法化。关于 MMJ 使用的国家政策的迅速变化，结合当前全国阿片类药物流行，迫切需要更好地了解 MMJ 的临床、药理学和行为影响。阿肯色州于 2016 年批准使用 MMJ 有特定条件的个人以及 2019 年 5 月开业的药房。独特的数据资产可通过阿肯色州医疗保健透明度倡议和阿肯色州健康数据倡议 (HDI) 包括单独链接但去识别化的强制性全付款人索赔、生命统计、医院和紧急情况部门 (ED) 出院和州警察机动车辆事故数据，以及有关个人的数据符合 MMJ 使用资格。这将是第一个衡量临床和不良事件的人群水平分析通过三个具体目标吸引 MMJ 用户和非用户群体：具体目标 1：描述人口、地理、社会经济和临床特征；卫生保健利用、不良事件（新的心理健康诊断、药物滥用/过量、自杀、意外受伤或 MVA 事故）；三类人群中阿片类药物和苯二氮卓类药物的使用情况：1) 符合条件的个人对于阿肯色州未获得 MMJ 卡的 MMJ（非持卡人），2) 符合资格的个人并获得MMJ卡但不购买MMJ（持卡人），并且3）符合资格的人，获得卡，并购买MMJ（消费者）。具体目标 2：比较 12 个月的医疗保健前后使用情况和成本（住院和门诊护理、急诊科就诊和处方药）以及消费者和非持卡人之间的不良事件。作为一个子目标，我们将评估开始一个疗程后阿片类药物和苯二氮卓类药物利用的变化 MMJ疗法。具体目标 3：检查 COVID-19 对 MMJ 持卡人请求、MMJ 购买、医疗保健的影响使用和不良事件。该项目汇集了五个数据源，以研究 MMJ 对阿肯色人的影响。这包括阿肯色州所有付款人索赔数据库 (APCD)、MMJ 注册表、生命统计文件和数据记录急诊科就诊和 MVA。这些数据可在人员级别链接，从而允许人员级别分析或医疗保健利用和结果。这将是第一个衡量人口水平的分析 MMJ 用户和非用户群体中的临床和不良事件。这项研究的结果将通过确定 MMJ 的使用是否有帮助填补科学知识的空白。生产时的好处（例如，减少医疗保健使用和成本、替代阿片类药物和苯二氮卓类药物）没有额外的伤害（例如，新的心理健康诊断，MVAs），从而为未来的 MMJ 政策提供信息。