Improving Treatment Strategies for Prescription Opioid Use Disorder- Resubmission

改善处方阿片类药物使用障碍的治疗策略 - 重新提交

• 批准号: 9788400
• 负责人: Patricia B Wright
• 金额: $ 18.9万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9788400
• 关键词: 12 year old; Accounting; Address; Aftercare; Age; American; Attitude; Behavior; Buprenorphine; Caring; Cessation of life; Clinical Trials; Consent; Data; Development; Disease; Drug Metabolic Detoxication; Economics; Enrollment; Epidemic; Ethnography; Evidence based intervention; Expenditure; Funding; Goals; Health; Individual; Interview; Knowledge; Longitudinal Studies; Modeling; National Institute of Drug Abuse; Opioid Antagonist; Opioid agonist; Opioid user; Outcome; Outpatients; Participant; Perception; Persons; Pharmaceutical Preparations; Population; Population Heterogeneity; Prescription drug overdose; Process; Public Health; Qualitative Methods; Race; Randomized; Randomized Controlled Trials; Recovery; Relapse; Rural; Time; Treatment outcome; United States; Withdrawal Symptom; Work; base; cohort; contextual factors; control trial; cost; disease transmission; effective therapy; evidence base; experience; follow-up; help-seeking behavior; implementation strategy; improved; improved outcome; innovation; medication-assisted treatment; opioid abuse; opioid epidemic; opioid use; opioid use disorder; overdose death; patient oriented; preference; prescription opioid; prescription opioid abuse; prevent; reduced substance use; rural area; social; socioeconomics; treatment program; treatment strategy; urban area

PROJECT SUMMARY There is critical need for more effective treatment strategies to address the public health crisis that exists due to the dramatic rise in prescription opioid (PO) use disorder and the underutilization of evidence- based medication-assisted treatments (MAT). The rise of opioid use in the rural South, where opioid abuse rates are highest, is alarming. Elucidation of factors that promote seeking and sustaining MAT in this population is imperative in order to improvement treatment implementation and outcomes. The aims of this project are to: (1) identify key decision factors for seeking MAT from the perspective of persons with PO use disorder entering outpatient PO treatment in a rural Southern state; (2) identify key decision factors among persons with PO use disorder enrolled in outpatient MAT for continuing/discontinuing with opioid agonist or antagonist treatment after completing detoxification; and (3) to identify and characterize individual- and contextual-level factors contributing to successful detoxification and treatment outcomes among a cohort of persons seeking MAT for PO use disorder at 16-week follow-up. To accomplish this, we will conduct a 16 week focused ethnographic study that includes in-depth qualitative interviews with 30 treatment-seeking individuals with PO use disorder who are enrolled in an ongoing clinical trial (R01DA039088) that seeks to improve treatment, retention and outcomes for PO use disorder. Given the current dearth of information regarding treatment-seeking for PO use disorder among rural PO users, qualitative methods will allow us to develop an in-depth, detailed analysis of the complexities surrounding this important decision. Findings from this study will increase our understanding of the related personal, social, and treatment-related issues that influence treatment decisions among rural PO users. These data will be invaluable as we move from understanding treatment-seeking to developing evidence-based interventions that are acceptable, promoting retention, to rural persons with PO use disorder, as they will be based on their perspectives and tailored to their needs and preferences.

项目摘要 至关重要的需要更有效的治疗策略来解决存在的公共卫生危机 由于处方阿片类药物（PO）使用障碍的急剧上升，证据不足 - 基于药物辅助治疗（MAT）。南部农村地区使用阿片类药物的兴起，阿片类药物 滥用率最高，令人震惊。阐明促进寻求和维持垫子的因素 为了改善治疗的实施和结果，这种人群必须进行。目的 该项目的内容是：（1）确定从人的角度寻找垫子的关键决策因素 随着PO使用障碍，在南部农村国家进入门诊PO治疗； （2）确定关键决定 在门诊垫中加入/中断的门诊垫的患者中的因素 完成排毒后阿片类药物或拮抗剂治疗； （3）识别和表征 个人和上下文级别的因素有助于成功排毒和治疗结果 在16周的随访中寻求垫子使用垫的人群中。为此， 我们将进行16周以16周的民族志研究，其中包括与 30个寻求治疗的人患有PO使用障碍的人正在进行一项正在进行的临床试验 （R01DA039088）试图改善使用障碍的治疗，保留和结果。鉴于 当前有关农村PO用户中寻求治疗疾病的寻求治疗障碍的信息， 定性方法将使我们能够对周围的复杂性进行深入，详细的分析 这个重要的决定。这项研究的结果将增加我们对相关个人的理解 社会和治疗相关的问题，影响农村PO使用者的治疗决策。这些数据 当我们从了解寻求治疗转向发展基于证据的时候，将是无价的 可以接受的干预措施促进保留率，向患有PO使用障碍的农村人 基于他们的观点，并根据他们的需求和偏好量身定制。