Assessing the Contribution of Alcohol and Psychotropic Medication Use to Upward US Injury and Poisoning Trends

评估酒精和精神药物的使用对美国伤害和中毒趋势上升的贡献

• 批准号: 10023139
• 负责人: Jacob T Borodovsky
• 金额: $ 2.83万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-02 至 2021-01-03
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10023139
• 关键词: Accident and Emergency department; Accidents; Acute; Admission activity; Adult; Affect; Age; Alcohol consumption; Alcohols; Americas; Behavior; Benzodiazepines; Central Nervous System Depressants; Classification; Data; Data Files; Data Set; Development; Drug Prescriptions; Drug usage; Elderly; Epidemiologic Methods; Epidemiology; Event; Expenditure; Fellowship; Female; Frequencies; Goals; Grant; Health; Health Expenditures; Health Policy; Health Surveys; Health behavior; High Prevalence; Incidence; Individual; Injury; Knowledge; Learning; Life Expectancy; Link; Liver diseases; Measures; Medical; Mentors; Methodology; Modeling; Morbidity - disease rate; National Health Interview Survey; Nature; Opioid; Outcome; Pattern; Persons; Pharmaceutical Preparations; Pharmacoepidemiology; Physiological; Play; Poisoning; Policy Research; Population; Prevalence; Public Health; Reading; Recommendation; Research; Research Project Grants; Risk; Risk Factors; Role; Sex Differences; Sleep; Subgroup; Suicide; Surveys; Time; Time trend; Training; Translating; Woman; advanced analytics; adverse drug reaction; age related; aging population; alcohol effect; alcohol epidemiology; alcohol measurement; alcohol misuse; alcohol poisoning; alcohol risk; alcohol-related death; alcohol-related injury; analytical method; binge drinking; career; clinically relevant; combat; demographics; design; drinking; epidemiology study; experience; health assessment; high risk; high risk drinking; male; middle age; mortality; non-opioid analgesic; opioid epidemic; prescription opioid; programs; public policy on alcohol; research study; responsible research conduct; sedative; sex; skills; statistics; trend; trend analysis; young adult

PROJECT SUMMARY The fellowship applicant's long-term goal is to build an academic alcohol and drug epidemiology research program that (1) clarifies the causes and consequences of population-level patterns of alcohol and drug use and (2) generates results that can be translated into public health policy recommendations. The mutually reinforcing training plan and research study in this proposal are designed to help the applicant take the necessary methodological and professional steps towards his goal. Project rationale and objectives: In recent years, mortality due to injury, poisoning, suicide, and liver disease increased substantially and contributed to a decline in U.S. life expectancy. Alcohol and prescription medication use have been identified as key contributors, but the nature and scope of this contribution require further clarification in order to create effective solutions. Risky alcohol and medication use trends have not manifested uniformly in the population. For example, recent increases in binge drinking are concentrated among adults age 45+ and differences in national drinking patterns between males and females are shrinking rapidly. In parallel, prescriptions for central nervous system depressant (CNS-D) medication (e.g., opioids, benzodiazepines, and Z-drug sleep medications) increased substantially and are also concentrated among those age 45+ and among females. Concurrent use of alcohol and CNS-D medications amplifies the risk of injury or poisoning, and this risk may be even further magnified among certain subgroups (e.g., older adults or females). These dynamics may be contributing disproportionately to morbidity trends. By using restricted data files to link prescription medication data in the Medical Expenditure Panel Survey (MEPS) with alcohol use data for the same individual in the National Health Interview Survey (NHIS), we can develop a more comprehensive explanatory model of alcohol- and medication-related morbidity in the U.S. The research project within this F32 is aimed at determining (1) which patterns of alcohol use, medication use, and demographics alter the risk of injury or poisoning, and (2) the extent to which changes in the prevalence of high-risk alcohol and medication use patterns account for population-level injury and poisoning trends. Training: The training plan in this fellowship outlines four learning objectives: (1) alcohol epidemiology and alcohol policy research; (2) advanced analytical methods in epidemiology and pharmacoepidemiology; (3) content-knowledge and analysis of national health surveys; (4) professional development (including responsible conduct of research and K01 grant development). These objectives will be achieved through formal courses, directed readings, discussions with mentors, and execution of the proposed project. These experiences fill specific knowledge and skill gaps and will enhance the applicant's ability to develop an independent research career.

项目摘要 奖学金申请人的长期目标是建立学术酒精和药物流行病学研究 程序（1）阐明酒精和吸毒的种群水平模式的原因和后果 （2）生成可以转化为公共卫生政策建议的结果。相互的 在此提案中加强培训计划和研究研究旨在帮助申请人接受 必要的方法和专业步骤朝着他的目标迈进。 项目理由和目标：近年来，由于受伤，中毒，自杀和肝病而导致的死亡率 大幅增加，并导致美国预期寿命下降。酒精和处方 用药使用已被确定为关键贡献者，但是这种贡献的性质和范围需要 进一步澄清以创建有效的解决方案。风险的酒精和药物使用趋势尚未 在人口中均匀表现出来。例如，暴饮暴食的最近增加 在45岁以上的成年人中，男性和女性之间的民族饮酒方式差异正在萎缩 迅速。同时，中枢神经系统抑制剂（CNS-D）药物的处方（例如，阿片类药物， 苯二氮卓类药物和Z-frug睡眠药物）大大增加了，也集中在 那些45岁以上的人和女性。同时使用酒精和CNS-D药物会放大 伤害或中毒，这种风险可能会在某些亚组中进一步放大（例如，老年人或 女性）。这些动态可能会导致发病趋势的不成比例。通过使用限制数据 将医疗支出面板调查（MEP）中的处方药数据与酒精使用联系起来的文件 国家健康访谈调查（NHIS）中同一个人的数据，我们可以开发更多 美国酒精和药物有关的发病率的全面解释模型 该F32中的项目旨在确定（1）饮酒，用药和 人口统计学改变了受伤或中毒的风险，以及（2）患病率的变化的程度 高风险酒精和药物使用模式解释了人口水平的伤害和中毒趋势。 培训：该奖学金的培训计划概述了四个学习目标：（1）酒精流行病学和 酒精政策研究； （2）流行病学和药物ePidemiology的高级分析方法； （3） 国家健康调查的内容知识和分析； （4）专业发展（包括 负责任的研究和K01赠款发展）。这些目标将通过 正式课程，定向阅读，与导师的讨论以及拟议项目的执行。这些 经验填补了特定的知识和技能差距，并将增强申请人发展的能力 独立研究职业。