Infections and Drug Use-Related Morbidity and Mortality among People Who Use Drugs

吸毒者中感染和吸毒相关的发病率和死亡率

基本信息

批准号：
10593896
负责人：
Mary Charlot Figgatt
金额：
$ 2.11万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10593896
关键词：
Abscess Address Antibiotic Therapy Applied Research Area Bacteria Bacterial Infections Behavior Black Populations Cardiac Surgery procedures Caring Cellulitis Cessation of life Characteristics Clinical Clinical effectiveness Communicable Diseases Complex Comprehensive Health Care Data Data Set Death Certificates Diagnosis Disparity Drug usage Drug user Epidemiologic Methods Epidemiology Equipment Ethnic Origin Event FDA approved Face Foundations Gender Goals Harm Reduction Health Health Care Costs Healthcare Heart Hispanic Populations Hospitalization Individual Inequity Infection Infective endocarditis Injecting drug user Injections Injury Intervention Knowledge Link Medicare/Medicaid Medicine Mentorship Methodology Methods Modeling Morbidity - disease rate Mycoses Operative Surgical Procedures Outcome Overdose Patients Personal Satisfaction Pharmaceutical Preparations Population Preparation Principal Investigator Privatization Public Health Race Records Reporting Research Research Design Research Personnel Research Training Resource Allocation Role Sample Size Skin Skin Care Skin Tissue Socioeconomic Status Soft Tissue Infections Substance Use Disorder Surface Symptoms Time Training Training Programs Translational Research United States Woman access disparities adverse outcome career community setting cost effective therapy effectiveness evaluation epidemiology study experience fungus health care settings improved improved outcome infection burden infection rate infection risk injection drug use intersectionality knowledge base long term hospitalization medication for opioid use disorder men mortality multidisciplinary opioid use disorder overdose death people of color research and development research data dissemination skills substance use treatment effect

项目摘要

PROJECT ABSTRACT Bacterial and fungal infections associated with drug use are increasing substantially in the United States. Two such infections, skin and soft tissue infections (SSTI) and infective endocarditis (IE), can lead to significant illness or death among people who use drugs (PWUD). SSTIs, such as abscesses and cellulitis, are highly prevalent with up to 65% of people who inject drugs reporting recent SSTIs. IE is an infection of the heart that typically requires long-term hospitalization. In addition to these infections, some PWUD face other pressing health concerns, most notably opioid use disorder and overdose. Infection-related mortality may be a substantial contributor to all-cause mortality among PWUD. However, from a population perspective, little is known about the determinants and burden of infection-related mortality relative to drug overdose among PWUD. Among some PWUD, opioid use disorder is a potentially serious yet treatable condition. FDA approved medications are known to reduce opioid use disorder symptoms and modify underlying behaviors that may increase risk of infections and overdose, such as injection drug use. Race, ethnicity, and gender inequities in access to and use of medication for opioid use disorder (MOUD) exist, and the role of intersectionality of these identities in MOUD access or use are not known among those receiving care for infectious diseases. The overall objective of this proposal is to expand the knowledge base concerning infection-related mortality, fatal and nonfatal drug overdose, and all-cause mortality in PWUD diagnosed with SSTIs and IE, with a particular focus on opioid use disorder. Primarily, the project will document the burden and predictors of infection and drug overdose mortality among PWUD with a particular focus on those facing these infections. Additionally, we will quantify the effect of MOUD on increasing survival and improving health outcomes in PWUD with SSTIs and IE. Finally, the project will examine disparities in MOUD by race, ethnicity, and gender. The project will utilize an extensive dataset of healthcare records for over half of North Carolinians linked with death certificate data. The specific aims of this study are to (1) assess predictors of infection-related mortality and drug overdose among PWUD, (2) estimate the effect of MOUD on infection-related mortality and drug overdose mortality among PWUD diagnosed with SSTIs or IE, and (3) examine receipt of MOUD and continuation among PWUD diagnosed with SSTIs or IE by race, ethnicity, and gender. Accompanying the proposed research, a specialized training plan for the principal investigator will enhance her skill set in: (1) study design of drug use-related health outcomes, (2) robust methodological approaches to the use of administrative data in translational research, and (3) professional development and research dissemination in scientific and community settings. Through the proposed research and mentorship from a multidisciplinary team, the principal investigator will undertake a specialized training program that will lay the foundation for a career as an independent researcher in the areas of substance use epidemiology and translational research.

项目摘要在美国，与吸毒相关的细菌和真菌感染正在大大增加。二这种感染，皮肤和软组织感染（SSTI）和感染性心内膜炎（IE）可能会导致显着使用毒品的人的疾病或死亡（PWUD）。 SSTI，例如脓肿和蜂窝织炎，是高度普遍存在，有多达65％的注射近期SSTI的药物的人普遍存在。 IE是心脏的感染通常需要长期住院。除了这些感染外，有些人面对其他压力健康问题，最著名的是阿片类药物使用障碍和过量。与感染有关的死亡率可能是 PWUD中全因死亡率的重要贡献。但是，从人口的角度来看很少关于与药物过量相对于感染相关死亡率的决定因素和负担已知在Pwud中。在某些pwud中，阿片类药物使用障碍是一种潜在的严重但可治疗的疾病。 FDA 已知批准的药物可减少阿片类药物使用障碍症状并修改潜在行为这可能会增加感染和过量的风险，例如注射药物使用。种族，种族和性别存在使用和使用药物治疗阿片类药物使用障碍（MOUD）的不平等现象，并且这些身份在木德访问或使用中的交叉性在接受护理的人中尚不清楚传染病。该提案的总体目的是扩大有关的知识库与感染相关的死亡率，致命和非致命药物过量以及诊断为PWUD的全因死亡率 SSTIS和IE，特别关注阿片类药物使用障碍。该项目主要将记录负担以及PWUD中感染和药物过量死亡的预测因素，特别关注那些面对的人这些感染。此外，我们将量化MOUD对增加生存和改善健康的影响与SSTIS和IE的PWUD成果。最后，该项目将根据种族，种族，种族，种族，和性别。该项目将利用超过一半的北卡罗来纳州人的大量医疗记录数据集与死亡证书数据有关。这项研究的具体目的是（1）评估与感染相关的预测指标 PWUD中的死亡率和药物过量，（2）估计Moud对感染相关死亡率的影响诊断为SSTI或IE的PWUD中的药物过量死亡率，以及（3）检查MOUD和通过种族，种族和性别诊断为SSTIS或IE的PWUD之间的延续。伴随拟议的研究，首席研究人员的专门培训计划将提高她的技能：（1）与药物使用相关的健康结果的研究设计，（2）使用的强大方法论方法转化研究中的行政数据，以及（3）专业发展和研究传播科学和社区环境。通过跨学科的拟议研究和指导团队，首席调查员将进行一项专业的培训计划，为作为物质领域的独立研究人员，使用流行病学和转化研究。