HEAL Initiative: Research to Foster an Opioid Use Disorder Treatment System Patients Can Count On

HEAL 计划：促进患者可以信赖的阿片类药物使用障碍治疗系统的研究

• 批准号: 10772818
• 负责人: TAMI L MARK
• 金额: $ 153.98万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10772818
• 关键词: Address; Benchmarking; Buprenorphine; California; Caring; Characteristics; Clinic; Clinical; Cluster randomized trial; Connecticut; County; Disparity; Emergency department visit; Federal Government; Feedback; Fostering; Health; Health Personnel; Health Services; Health system; Helping to End Addiction Long-term; Hospitalization; Individual; International; Knowledge; Literature; Los Angeles; Measurement; Measures; Methadone; Monitor; National Institute of Drug Abuse; Outcome; Outcome Measure; Overdose; Overdose reduction; Patients; Performance; Persons; Pharmaceutical Preparations; Policies; Population; Prevention strategy; Probability; Provider; Psychometrics; Recommendation; Research; Research Personnel; Research Project Grants; Review Literature; Risk Reduction; Substance Use Disorder; System; Testing; Time; Training; Transportation; United States; United States Dept. of Health and Human Services; Universities; Variant; arm; experience; flexibility; improved; improved outcome; medication for opioid use disorder; mortality; opioid mortality; opioid treatment program; opioid use disorder; overdose prevention; overdose risk; patient navigation; patient oriented; peer; premature; programs; randomized, clinical trials; retention rate; social stigma; socioeconomic disadvantage; substance abuse prevention; telehealth; treatment as usual; treatment program; web site

0BPROJECT SUMMARY/ABSTRACT Opioid overdose deaths reached the highest level ever in 2021. Medications to treat opioid use disorder (MOUD) can markedly reduce overdose risks when taken for long enough. More than 650,000 people receive MOUD in Opioid Treatment Programs (OTPs) annually. Unfortunately, on average, less than half of patients stay in opioid use disorder (OUD) treatment for the recommended minimum 1 year of time. OTP retention and outcome quality measures (i.e., “audit and feedback”) may improve treatment retention rates and outcomes. Quality measures can also help monitor the effect of new OTP reimbursement and regulatory policies. Eventually, OTP quality measures could be incorporated into the Federal government’s public facing healthcare provider Compare website. However, research is needed to determine how to most effectively create and disseminate OTP quality measures. The literature on audit and feedback points to three features that influence the probability that measures will result in improved quality: (1) the characteristics of the measures and benchmarks, (2) the knowledge that providers have about how to improve the measures, and (3) the control that providers have over the factors that matter to improve the measure. This study will test approaches for optimizing each of these factors. NIDA RFA-DA-23-046 is supporting multi-project OUD Quality Measurement and Management Research Centers that pair researchers with partner organizations that have an OUD quality measurement and management strategy that research could advance. RTI International, University of California Los Angeles, and Beacon Health Connecticut are the research organizations leading this study. They are partnering with two organizations that need to develop an effective OTP quality measurement and management system: BayMark Health Services and the Los Angeles County Division of Substance Abuse Prevention and Control. The team is implementing three inter-related research projects with the following overall aims: Overall Aim 1. Create and psychometrically test OTP measures of retention, overdose emergency department visits, overdose hospitalizations, and mortality with benchmarks and toolkits describing how OTPs can improve retention. Overall Aim 2. Test the effect of the giving OTPs quality measures and information on how to improve retention (a retention toolkit), with and without quality improvement training, by conducting a clustered randomized trial that assigns OTPs to receive either: (1) retention and outcome measures with the toolkit; or (2) retention and outcome meaures with the toolkit as well as quality improvement (QI) training (i.e., NIATx) (Arm 2), or (3) treatment as usual (Control Arm). Overall Aim 3. Test the effect of aligning OTP-level and LA county population-level OUD measures on retention and outcomes in LA county relative to other counties in California.

0B项目概要/摘要 2021 年阿片类药物过量死亡人数达到有史以来最高水平。治疗阿片类药物使用障碍的药物 （MOUD）如果长期服用，可以显着降低超过 650,000 人的用药过量风险。 不幸的是，每年接受阿片类药物治疗计划 (OTP) 的 MOUD 的人数不到一半。 患者接受阿片类药物使用障碍 (OUD) 治疗的时间建议至少为 1 年。 保留和结果质量措施（即“审核和反馈”）可以提高治疗保留率 质量措施还可以帮助监控新 OTP 报销和监管的效果。 最终，OTP 质量措施可以纳入联邦政府的公共政策中。 然而，需要研究来确定如何最有效地做到这一点。 有效地创建和传播 OTP 质量措施 有关审核和反馈的文献指出。 影响措施提高质量概率的三个特征：(1) 措施和基准的特征，(2) 提供者拥有的关于如何 改进措施，以及 (3) 提供商对改进措施的重要因素的控制 这项研究将测试优化每个因素的方法。 NIDA RFA-DA-23-046 支持多项目 OUD 质量测量和管理研究 将研究人员与具有 OUD 质量衡量标准的合作伙伴组织配对的中心 研究可以推进的管理策略，RTI International，加州大学洛杉矶分校， 和 Beacon Health Connecticut 是领导这项研究的研究组织。 需要开发有效的 OTP 质量测量和管理系统的两个组织： BayMark 健康服务中心和洛杉矶县药物滥用预防和控制部门。 该团队正在实施三个相互关联的研究项目，总体目标如下： 总体目标 1. 创建并进行心理测量测试保留、过量紧急情况的 OTP 措施 科室就诊、服药过量住院和死亡率，并提供描述如何影响的基准和工具包 OTP 可以提高保留率。 总体目标 2. 测试提供 OTP 质量措施的效果以及如何改进的信息 保留（保留工具包），有或没有质量改进培训，通过进行集群 分配 OTP 接受以下任一项的随机试验：(1) 使用工具包进行保留和结果测量；或 (2) 使用工具包进行保留和结果测量以及质量改进 (QI) 培训（即 NIATx） （第 2 组）或 (3) 照常治疗（对照组）。 总体目标 3. 测试协调 OTP 级别和洛杉矶县人口级别 OUD 措施对 与加利福尼亚州其他县相比，洛杉矶县的保留率和结果。