Prediction of Return to Opioid Use During Immediate Community Reintegration

在立即重新融入社区期间恢复阿片类药物使用的预测

• 批准号: 10711730
• 负责人: Nicole Holland Weiss
• 金额: $ 26.01万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10711730
• 关键词: Biometry; Centers of Research Excellence; Community Integration; Coupled; Data; Ecological momentary assessment; Environmental Monitoring; Galvanic Skin Response; Health; Hour; Individual; Inpatients; Life; Methods; Opioid; Overdose; Persons; Physiology; Post-Traumatic Stress Disorders; Research; Risk; Severities; Symptoms; Testing; Time; Work; community reintegration; contextual factors; evidence base; heart rate variability; high risk; innovation; opioid use; opioid use disorder; prevent; preventive intervention; return to use; tool; wearable sensor technology

PROJECT SUMMARY/ABSTRACT Nearly 400,000 people with an opioid use disorder (OUD) receive OUD treatment each year, or 19.7% of all people with an OUD. Community reintegration following residential OUD treatment is a critically vulnerable time, with most inpatients returning to use within 30 days. Given the extremely brief window of opportunity for prevention intervention, evaluating time-sensitive proximal predictors of return to opioid use during community reintegration is essential. Risk for return to use fluctuates substantially-even within timescales of hours-with some people displaying higher variability than others. Identifying predictors of return to opioid use thus requires methods that can track return to use closely over time, rather than relying on retrospective or cross-sectional assessments. Ecological monitoring tools can accurately record severity and variability of return to opioid use in daily life, proximally to when they occur. Yet, application of this work during the extremely high-risk period of community reintegration is scarce. The proposed study will assess time-varying, longitudinal changes in posttraumatic stress disorder (PTSD) symptoms on risk for return to opioid use during community reintegration. Further, the influence of physiology (heart rate variability [HRV] and electrodermal response [EDA]) on risk for return to opioid use-including when coupled with PTSD symptoms-will be explored. These findings will inform evidence-based tools to prevent and/or delay return to opioid use during community integration. This study advances research by using ecological momentary assessment (EMA) and a wearable biosensor (Empatica) to test proximal relations between PTSD symptoms and return to opioid use-and the influence of physiology-in the 30 days immediately following residential OUD treatment (N=150). EMA and biometrics capture data frequently (or, for the Empatica E4, continuously), naturalistically, and in near real-time, allowing for explication of within-person, proximal relations, as well as contextual factors underlying risk. Aim 1 determines the influence of PTSD on return to opioid use during immediate community reintegration of OUD inpatients. Aim 2 evaluates the utility of passively collected physiology to detect return to opioid use during immediate community reintegration of OUD inpatients. The proposed research fills important gaps regarding time-sensitive proximal predictors of return to opioid use during the high-risk and understudied period of community reintegration. This work is important, timely, and innovative. Developing evidence-based tools to prevent and delay return to opioid use during community reintegration has important implications for the health of individuals in our nation.

项目 摘要/摘要 每年有近 400,000 名阿片类药物使用障碍 (OUD) 患者接受 OUD 治疗，占总人数的 19.7% 所有拥有 OUD 的人。住院 OUD 治疗后重新融入社区是一个极其脆弱的问题 时间，大多数住院患者在 30 天内恢复使用。鉴于机会之窗极其短暂 预防干预，评估社区期间恢复阿片类药物使用的时间敏感的近端预测因素 重返社会至关重要。恢复使用的风险波动很大——即使在几个小时的时间范围内—— 人们表现出比其他人更高的变异性。因此，确定阿片类药物重新使用的预测因素需要 可以随着时间的推移密切跟踪恢复使用的方法，而不是依赖于回顾性或横截面 评估。生态监测工具可以准确记录阿片类药物使用回归的严重程度和变异性 日常生活，接近它们发生的时间。然而，这项工作在极高风险时期的应用 重新融入社区的情况很少。拟议的研究将评估随时间变化的纵向变化 创伤后应激障碍（PTSD）症状与重返社区期间重新使用阿片类药物的风险相关。 此外，生理学（心率变异性 [HRV] 和皮肤电反应 [EDA]）对风险的影响 将探讨恢复阿片类药物的使用（包括在伴有创伤后应激障碍症状时）。这些发现将告知 在社区融合期间防止和/或延迟重新使用阿片类药物的基于证据的工具。 这项研究通过使用生态瞬时评估（EMA）和可穿戴生物传感器来推进研究 （Empatica）测试 PTSD 症状与恢复使用阿片类药物之间的近端关系以及影响 生理学 - 住院 OUD 治疗后 30 天内（N=150）。 EMA 和生物识别捕获 频繁地（或者，对于 Empatica E4，连续地）、自然地、近乎实时地获取数据，从而允许 解释人与人之间的密切关系以及潜在风险的背景因素。目标 1 决定 PTSD 对 OUD 住院患者立即重新融入社区期间恢复使用阿片类药物的影响。目标2 评估被动收集的生理学检测返回阿片类药物的效用 在 OUD 住院患者立即重新融入社区期间使用。 拟议的研究填补了有关返回阿片类药物的时间敏感近端预测因素的重要空白 在重新融入社区的高风险和研究不足的时期使用。这项工作重要、及时、 创新的。开发基于证据的工具来预防和延迟社区期间恢复使用阿片类药物 重返社会对我们国家个人的健康具有重要影响。