Using Default Opioid Prescription Settings to Limit Excessive Opioid Prescribing to Adolescents and Young Adults

使用默认阿片类药物处方设置来限制青少年和年轻人的过量阿片类药物处方

基本信息

批准号：
10608175
负责人：
Kao-Ping Chua
金额：
$ 19.66万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-05-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10608175
关键词：
Address Adenoidal structure Adenoidectomy Adolescent and Young Adult Award Behavior Therapy Blue Cross Blue Shield Characteristics Child Clinical Data Decision Making Dedications Development Plans Doctor of Philosophy Dose Electronic Health Record Environment Excision Future Goals Grant Health Policy Health Services Heterogeneity Institution Insurance Carriers Interruption Intervention Interview Medicaid Mentors Mentorship Methods Michigan Mission National Institute of Drug Abuse Operative Surgical Procedures Opioid Otolaryngologist Pain management Patient Outcomes Assessments Patients Pattern Physicians Pilot Projects Population Postoperative Period Private Hospitals Procedures Provider Regulation Reporting Research Research Methodology Research Personnel Risk Sampling Structure Surveys System Time Series Analysis Tonsil Tonsillectomy Training Universities Vulnerable Populations age group aged career development clinical practice design electronic health record system experience implementation cost implementation research individual patient insight intervention effect intervention refinement meetings opioid misuse opioid use patients who use opioids pediatrician prescription opioid prescription opioid misuse prevent provider behavior substance misuse success therapy design young adult

项目摘要

PROJECT SUMMARY / ABSTRACT Candidate: Kao-Ping Chua, MD, PhD, is a general pediatrician and health services researcher who aims to become a national leader in appropriate opioid prescribing to children and young adults. Research Context: Adolescents and young adults collectively have the highest rates of prescription opioid misuse of any age group, and leftover opioids from prior prescriptions are a key driver of this misuse. Therefore, it is crucial to ensure that quantities in opioid prescriptions match the needs of adolescents and young adults. This proposal will pilot an electronic health record-based intervention using default opioid prescription settings to limit excessive opioid prescribing to adolescents and young adults undergoing tonsillectomy and/or adenoidectomy (removal of the tonsils and/or adenoids), which are common surgeries associated with high rates and quantities of opioid prescribing. In the pilot study, the default settings will be informed by data on baseline patient-reported post-operative opioid consumption, thereby increasing the likelihood that these settings reflect patient need. Specific Aims: 1) To pilot a behavioral intervention using default opioid prescription settings among adolescents and young adults undergoing tonsillectomy and/or adenoidectomy at the University of Michigan; 2) To refine the intervention for future research by assessing providers’ experiences with the default settings; and 3) To identify additional high-priority procedures and conditions for default setting interventions. Research Plan: Dr. Chua will design and implement an intervention using default opioid prescription settings for adolescents and young adults undergoing tonsillectomy and/or adenoidectomy at the University of Michigan. Dr. Chua will use an interrupted time series analysis to evaluate the effect of the intervention on the dosing of the initial post-operative opioid prescription and patient-reported outcomes, and will additionally interview providers to assess their experiences with the intervention. To determine additional potential targets for future default setting interventions in an R01 grant, Dr. Chua will analyze claims from adolescents and young adults insured by Blue Cross Blue Shield of Michigan and Michigan Medicaid to identify other procedures and conditions with high rates and quantities of opioid prescribing. Career Development Plan: Dr. Chua will develop expertise in 1) Qualitative and mixed methods research; 2) Implementation research; and 3) Opioid prescribing and substance misuse. His career development will be supported by close mentorship, advanced coursework, and research meetings/seminars. Environment: The University of Michigan offers the ideal environment for Dr. Chua to pursue this training, with the outstanding guidance of well-established mentors and interdisciplinary institutes dedicated to his success.

项目概要/摘要候选人：Kao-Ping Chua，医学博士、哲学博士，是一名普通儿科医生和卫生服务研究员，旨在成为为儿童和年轻人开适当阿片类药物处方的国家领导者。研究背景：青少年和年轻人的处方阿片类药物比例最高任何年龄段的滥用，以及先前处方中剩余的阿片类药物是这种滥用的关键驱动因素。因此，确保阿片类药物处方中的数量符合青少年和青少年的需求至关重要。该提案将试行使用默认阿片类药物的基于电子健康记录的干预措施。处方设置限制青少年和年轻人过量服用阿片类药物扁桃体切除术和/或腺样体切除术（切除扁桃体和/或腺样体），这是常见的手术在试点研究中，默认设置将与阿片类药物处方的高比率和数量相关。根据患者报告的术后阿片类药物消耗量的基线数据提供信息，从而增加这些设置反映患者需求的可能性。具体目标：1) 使用默认阿片类药物处方设置进行行为干预试点在密歇根大学接受扁桃体切除术和/或腺样体切除术的青少年和年轻人2) 通过评估提供者对默认设置的体验来完善未来研究的干预措施； 3) 确定默认设置干预措施的额外高优先级程序和条件。研究计划：蔡博士将使用默认阿片类药物处方设置设计和实施干预措施对于在大学接受扁桃体切除术和/或腺样体切除术的青少年和年轻人密歇根州蔡博士将使用中断时间序列分析来评估干预措施对术后初始阿片类药物处方的剂量和患者报告的结果，并且还将采访提供者以评估他们的干预经验，以确定其他潜在目标。对于未来 R01 拨款中的默认设置干预措施，蔡博士将分析青少年的索赔和由密歇根州 Blue Cross Blue Shield 和密歇根州医疗补助计划 (Michigan Medicaid) 承保的年轻人，以确定其他人阿片类药物处方率高且数量大的程序和条件。职业发展计划：蔡博士将发展以下方面的专业知识：1) 定性和混合方法研究；2) 实施研究；以及 3) 阿片类药物处方和药物滥用。得到密切指导、高级课程和研究会议/研讨会的支持。环境：密歇根大学为蔡博士接受培训提供了理想的环境，知名导师和跨学科机构的出色指导致力于他的成功。