Characteristics and outcomes for hospitalized patients with methamphetamine and opioid co-use: Identifying opportunities for hospital-based addiction services tailored to co-use

甲基苯丙胺和阿片类药物同时使用的住院患者的特征和结果：确定针对共同使用的医院成瘾服务的机会

• 批准号: 10677138
• 负责人: Riley Shearer
• 金额: $ 4.08万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677138
• 关键词: Accounting; Address; Administrator; Admission activity; Advocacy; Age; Ambulatory Care; Automobile Driving; Cessation of life; Characteristics; Clinical; Clinical Medicine; Communication; Communities; Community Hospitals; Complex; Consult; Consultations; Cox Proportional Hazards Models; Data; Death Certificates; Death Rate; Development; Educational process of instructing; Effectiveness; Electronic Health Record; Ethnic Origin; Evaluation; Fellowship; Frontline worker; Funding; Future; Gender; Goals; Health; Health Services Accessibility; Health Services Research; Hospital Mortality; Hospitalization; Hospitals; Individual; Inpatients; Insurance Coverage; Intervention; Interview; Lead; Length of Stay; Link; Location; Logistics; Medicine; Methamphetamine; Methods; National Research Service Awards; Nurses; Opioid; Outcome; Overdose; Patient Care; Patients; Pattern; Pharmaceutical Preparations; Physicians; Provider; Race; Readiness; Research; Research Methodology; Research Personnel; Resources; Risk Reduction; Sampling; Services; Shapes; Social Workers; Structure; Substance Use Disorder; Surveys; Time; Training; United States; Work; addiction; comorbidity; demographics; design; experience; hospital readmission; improved; individualized medicine; medication for opioid use disorder; methamphetamine use; mortality; opioid use; overdose death; polysubstance use; prevent; programs; readmission rates; readmission risk; response; skills; social stigma; sociodemographics; substance use; treatment services

PROJECT SUMMARY/ABSTRACT Drug overdose deaths continue to rise in the United States, accounting for over 100,000 deaths in 2021 alone. Methamphetamine and opioid co-use are largely fueling the most recent increase in mortality. In addition, co- use associated hospital admissions increased more than five-fold between 2003 and 2015. Previous research and hospital-based addiction services for substance use have focused on opioid use alone. These addiction medicine services have increased rates of medication for opioid use disorder and improved patient linkage to continuing outpatient treatment. As a result, hospital length of stay and readmission rates have decreased. However, past research indicates individuals with co-use have different sociodemographic and health profiles and are less likely to receive medication for opioid use disorder than individuals who use opioids alone. There is limited evidence of how existing hospital-based addiction services effect patients who co-use methamphetamine and opioids or how these services could be tailored to better treat hospitalized patients with co-use. The overall objective of this Kirschstein-NRSA F30 fellowship is to generate evidence that can guide the eventual development, implementation, and evaluation of hospital addiction medicine treatment services tailored to co-use. The specific aims of this proposal are: 1) to characterize patient demographics and hospitalization characteristics associated with co-use from a nationally representative sample of inpatient hospitalizations, 2) to quantify the risk of re-admission and mortality following hospital discharge, by substance use profile, and whether differences vary by the receipt of hospital-based addiction services and 3) to identify barriers and facilitators to providing hospital-based addiction services tailored for patients with co-use. The proposed mixed methods project is based on a sequential explanatory approach. It includes training in both quantitative (Aims 1 & 2) and qualitative (Aim 3) research methodologies. Through this work and a thoughtfully designed training plan, the trainee will achieve the following goals: 1) develop health services research expertise, 2) advance the substance use research field as it relates to polysubstance use, 3) integrate research, clinical, and advocacy activities in the field of addiction medicine. This supports his long-term goal of bridging health services research and clinical medicine to support patients with substance use disorders as a physician-researcher.

项目概要/摘要 美国因药物过量死亡人数持续上升，仅 2021 年就有超过 10 万人死亡。 甲基苯丙胺和阿片类药物的共同使用在很大程度上加剧了最近死亡率的上升。此外，共同 2003 年至 2015 年间，与使用相关的住院人数增加了五倍多。 先前的研究和基于医院的药物成瘾服务仅关注阿片类药物的使用。 这些成瘾药物服务提高了阿片类药物使用障碍的用药率，并改善了 患者与持续门诊治疗的联系。因此，住院时间和再入院率 已减少。然而，过去的研究表明，共同使用的个体具有不同的社会人口特征 和健康状况，并且与使用阿片类药物的人相比，接受阿片类药物使用障碍药物治疗的可能性较小 仅阿片类药物。现有的医院成瘾服务如何影响以下患者的证据有限 共同使用甲基苯丙胺和阿片类药物或如何调整这些服务以更好地治疗住院患者 患者共同使用。 Kirschstein-NRSA F30 奖学金的总体目标是生成可以指导的证据 医院成瘾药物治疗服务的最终开发、实施和评估 专为共同使用而定制。该提案的具体目标是：1）描述患者人口统计特征和 来自全国代表性住院患者样本的与共同使用相关的住院特征 住院治疗，2) 按物质量化出院后再次入院和死亡的风险 使用概况，以及差异是否因接受医院成瘾服务而有所不同，以及 3) 识别 为共同吸毒患者提供医院成瘾服务的障碍和促进因素。 所提出的混合方法项目基于顺序解释方法。它包括以下方面的培训 定量（目标 1 和 2）和定性（目标 3）研究方法。通过这项工作和 经过精心设计的培训计划，学员将实现以下目标： 1）发展健康服务 研究专业知识，2) 推进与多物质使用相关的物质使用研究领域，3) 整合 成瘾医学领域的研究、临床和宣传活动。这支持了他的长期目标 将卫生服务研究和临床医学联系起来，为患有药物滥用障碍的患者提供支持 医师研究员。