MIRHIQL Resource Center for Improving Quality of Life with Chronic Pain (MRC)

MIRHIQL 改善慢性疼痛生活质量资源中心 (MRC)

• 批准号: 10705887
• 负责人: MEREDITH C. B. ADAMS
• 金额: $ 597.81万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705887
• 关键词: Address; Advisory Committees; Affect; Behavior; Benefits and Risks; Caring; Categories; Clinical; Clinical Research; Common Data Element; Communities; Complex; Consensus; Data; Data Analyses; Data Collection; Diagnostic; Ecosystem; Elements; Environmental Risk Factor; Expert Opinion; Foundations; Goals; Health Personnel; Health Policy; Individual; Infrastructure; Institution; Intervention; Interview; Knowledge; Link; Measures; Medicine; Mission; Opioid; Outcome; Outcomes Research; Pain; Patients; Pattern; Persons; Phenotype; Policies; Privatization; Process; Provider; Public Health; Quality of life; Research; Resources; Risk Assessment; Societies; System; Testing; Translating; Treatment outcome; United States National Institutes of Health; Validation; Vulnerable Populations; Work; chronic pain; chronic painful condition; clinical care; clinical center; clinical practice; clinically relevant; cohort; data harmonization; data sharing; disorder prevention; eHealth; electronic health data; experience; functional status; health care delivery; health data; health equity promotion; improved; innovation; opioid abuse; opioid misuse; opioid therapy; opioid use; opioid use disorder; patient oriented; personalized care; personalized medicine; prescription opioid; process evaluation; research study; screening; social health determinants; support network; support tools; systematic review; timeline; tool; tool development; treatment adherence; trial comparing; usability

Project Summary Despite acknowledging the challenges of long-term opioid use (LTOT) in clinical and research studies, there is no consensus on clinically defining opioid misuse. In clinical practice, screening and risk/benefit calculations remain difficult because while opioid use can be problematic, it may be beneficial in certain subpopulations. The combination of variables that could be used clinically to assess the risk of harms versus quality of life for people on LTOT has not been established. It may be possible to decrease some of the tension between prescribers and patients if clinical providers have a working clinical definition and improved ways of assessing whether a patient is a candidate for LTOT. The MIRHIQL Resource Center's (MRC) long-term goal is to understand how chronic pain (CP) and related factors influence the progression of LTOT behaviors. The objective of MRC center is to create a research community that connects the MIRHIQL network to IMPOWR research centers and larger HEAL network to translate findings while developing a key opioid misuse and LTOT infrastructure. We hypothesize that defining opioid misuse and the LTOT benefit/risk framework will require integrated patient-centered clinical approaches that address the systemic issues affecting healthcare delivery and the patient-provider interaction, leading to a fundamental shift in how healthcare providers and the public are educated. These goals will be achieved through the following specific aims: (1) the MRC will harmonize data collection and common data elements for the MIRHIQL network, providing coordinated support for network activities while connecting to the IMPOWR Network and larger HEAL Ecosystem via our IMPOWR CC, (2) The MRC will clinically define opioid misuse with associated risks/benefits using an interconnected strategy including multi-society expert Delphi, qualitative interviewing of prescribers and people with lived pain experience, and phenotyping and validating cohort definitions in electronic health and administrative claims data, and (3) The MRC will perform analytical and clinical validation of screening and benefit/risk tools for LTOT and definition of opioid misuse in a cohort trial comparing different combinations of relevant OM variables. Usability (system/provider input) and user experience (provider/patient input) will evaluated for clinical utility in real-world clinical settings. These aims will provide a coordinated integration of systematic review, qualitative interviewing, EHR and claims data, and expert Delphi Taskforce to identify and test candidate variables for a clinical definition of opioid misuse and develop screening and risk/benefit tools for clinical care. The proposed research is innovative because we will be able to leverage the large-scale claims (CMS and private payer) and EHR data to build a framework for LTOT care on a rapid timeline. These results will support future research but will also have direct clinical impact, aligning with NIH HEAL's mission.

项目概要 尽管承认长期阿片类药物使用（LTOT）在临床和研究中面临的挑战，但 关于阿片类药物滥用的临床定义尚未达成共识。在临床实践中，筛查和风险/效益计算 仍然很困难，因为虽然阿片类药物的使用可能存在问题，但它可能对某些亚人群有益。 可在临床上用于评估伤害风险与生活质量的变量组合 LTOT 上的人员尚未建立。或许可以减少一些之间的紧张关系 处方者和患者，如果临床提供者有有效的临床定义和改进的评估方法 患者是否适合 LTOT。 MIRHIQL 资源中心 (MRC) 的长期目标是 了解慢性疼痛 (CP) 和相关因素如何影响 LTOT 行为的进展。这 MRC 中心的目标是创建一个将 MIRHIQL 网络连接到 IMPOWR 的研究社区 研究中心和更大的 HEAL 网络转化研究结果，同时开发关键的阿片类药物滥用和 LTOT 基础设施。我们假设定义阿片类药物滥用和 LTOT 效益/风险框架将 需要以患者为中心的综合临床方法来解决影响医疗保健的系统性问题 交付和患者与提供者的互动，导致医疗保健提供者和患者的方式发生根本性转变 公众受到教育。这些目标将通过以下具体目标来实现：（1）MRC将 协调 MIRHIQL 网络的数据收集和通用数据元素，提供协调支持 用于网络活动，同时通过我们的 IMPOWR 连接到 IMPOWR 网络和更大的 HEAL 生态系统 CC，(2) MRC 将使用相互关联的方法在临床上定义阿片类药物滥用及其相关风险/益处 策略包括多社会专家 Delphi、对处方者和患有生活疼痛的人进行定性访谈 电子健康和行政索赔中的经验、表型和验证队列定义 (3) MRC 将针对筛查和获益/风险工具进行分析和临床验证 比较相关 OM 的不同组合的队列试验中的 LTOT 和阿片类药物滥用的定义 变量。将评估可用性（系统/提供商输入）和用户体验（提供商/患者输入） 在现实临床环境中的临床实用性。这些目标将提供系统性的协调整合 审查、定性访谈、EHR 和索赔数据以及德尔福专家工作组来识别和测试 阿片类药物滥用临床定义的候选变量，并开发筛查和风险/效益工具 临床护理。拟议的研究具有创新性，因为我们将能够利用大规模的索赔 （CMS 和私人付款人）和 EHR 数据，用于快速构建 LTOT 护理框架。这些结果 将支持未来的研究，但也将产生直接的临床影响，与 NIH HEAL 的使命保持一致。