Adoption and scale-up of long-acting medications for opioid use disorder by U.S. clinicians.

美国临床医生采用并扩大治疗阿片类药物使用障碍的长效药物。

基本信息

批准号：
10621210
负责人：
Chelsea Leigh Shover
金额：
$ 17.86万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10621210
关键词：
AIDS prevention Adopted Adoption Award Buprenorphine California Caring Clinic Clinical Clinical Trials Communication Communities Complex Consolidated Framework for Implementation Research Crime Data Data Set Diffuse Pattern Dose Educational workshop Epidemiologist Epidemiology Evidence based treatment Formularies Formulation Frequencies Geography Goals Grant Health Insurance Health Services Health Services Research Health system Implant Individual Injectable Injections Insurance Intervention Interview K-Series Research Career Programs Learning Life Maintenance Medicaid Medicare Medicine Mentors Mentorship Methadone Mission Modality Morbidity - disease rate Motivation Naltrexone National Institute of Drug Abuse Oral Outpatients Pain Patient Selection Patients Persons Pharmaceutical Preparations Pharmacotherapy Physicians Policies Population Primary Care Primary Care Physician Principal Investigator Procedures Provider Psychiatrist Psychiatry Public Health Qualitative Research Reach, Effectiveness, Adoption, Implementation, and Maintenance Recovery Research Research Personnel Resources Structure Substance Use Disorder System Testing Time Training Treatment outcome United States United States Food and Drug Administration Veterans Health Administration Visit Writing addiction career disease transmission experience follow-up illicit opioid implementation science implementation study improved insurance claims large datasets longitudinal analysis medical specialties medication for opioid use disorder mortality novel opioid epidemic opioid overdose opioid use opioid use disorder patient-level barriers prevent primary care clinician provider behavior scale up service intervention skills structural determinants substance use substance use treatment symposium system-level barriers systemic barrier tenure track uptake willingness

项目摘要

PROJECT SUMMARY AND ABSTRACT Opioid use disorder (OUD) causes significant morbidity and mortality in the United States. Efficacious pharmacotherapies that can be delivered in a primary care or specialty clinic setting have been developed but most patients with OUD do not receive them. In recent years, three kinds of long-acting medication for OUD (MOUD) have been approved by the Food and Drug Administration (FDA): monthly injectable naltrexone (2010), six-monthly implantable buprenorphine (2016) and monthly injectable buprenorphine (2017). These modalities have several theoretical advantages over daily buprenorphine or methadone – e.g., stabilizes dosing, reduces frequency of follow-up visits, prevents diversion – but their uptake and dissemination in real- world settings have not been characterized. The proposed research will investigate provider- and systems- level barriers and facilitators to adoption of long-acting MOUD. In this mentored career development award (K01), Dr. Shover will characterize clinicians who are early adopters of long-acting MOUD, identify context- specific barriers and facilitators to prescribing and administering long-acting MOUD, and longitudinally compare dissemination of long-acting MOUD to that of daily MOUD. In Aim 1, Dr. Shover will use insurance claims data to characterize individual and organizational attributes of providers who prescribe long-acting buprenorphine or naltrexone to treat OUD in the first year of their FDA approval. In Aim 2, Dr. Shover will conduct qualitative interviews with primary care physicians, pain medicine physicians, and psychiatrists to identify subjective factors that influence willingness or capacity to prescribe long-acting MOUD. In Aim 3, Dr. Shover will conduct a longitudinal analysis of dissemination of long-acting MOUD in their first five years, comparing geographic and systems-level patterns diffusion to those of daily oral MOUD. Through the award, Dr. Shover will build on her doctoral training as an epidemiologist and experience in substance use policy and community-based HIV prevention to develop new skills needed to conduct impactful addiction health services research. These skills will include working with claims data, qualitative interviewing, implementation science, grant-writing, and scientific communication. Through coursework, clinical observation in psychiatry and pain medicine clinics, mentorship, and external conferences and workshops, Dr. Shover will gain the skills needed to apply for her first R01 and pursue a career as a tenure-track principal investigator.

项目摘要和摘要在美国，阿片类药物使用障碍（OUD）引起明显的发病率和死亡率。有效已经开发了可以在初级保健或专业诊所环境中提供的药物治疗措施，但大多数OUD患者没有收到它们。近年来，OUD的三种长效药物（MOUD）已获得食品药品监督管理局（FDA）的批准：每月可注射的纳曲酮（2010年），六个月植入的丁丙诺啡（2016年）和每月可注射的丁丙诺啡（2017年）。这些模式比每日丁丙诺啡或MEADADONE具有多种理论优势 - 例如，稳定剂量，减少随访的频率，防止转移 - 但它们的吸收和传播世界设置尚未被描述。拟议的研究将调查提供商和系统 - 采用长效穆德的水平障碍和促进者。在这个修订的职业发展奖中（K01），Shover博士将描述那些早期采用长效MOUD的临床医生，确定环境 - 特定的障碍和促进者开处方和管理长效穆德，并纵向将长效穆德与每日穆德的传播进行比较。在AIM 1中，Shover博士将使用保险索赔数据以表征准备长效的提供者的个人和组织属性丁丙诺啡或纳曲酮在FDA批准的第一年治疗Oud。在AIM 2中，Shover博士将对初级保健医生，止痛医师和精神科医生进行定性访谈确定影响准备长效穆德的意愿或能力的主观因素。在AIM 3中，博士 Shover将对长效MOUD在头五年的传播进行纵向分析，将地理和系统级别模式的扩散与每日口服MOUD进行比较。通过奖励， Shover博士将以她作为流行病学专家的博士培训以及在物质使用政策方面的经验以及基于社区的艾滋病毒预防，以发展有影响力的成瘾健康服务所需的新技能研究。这些技能将包括使用索赔数据，定性访谈，实施科学，赠款和科学沟通。通过课程，精神病学和疼痛的临床观察医学诊所，精神训练以及外部会议和讲习班，Shover博士将获得所需的技能申请她的第一个R01并购买职业生涯。

项目成果

期刊论文数量（13）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Polysubstance use and lived experience: new insights into what is needed.

多物质的使用和生活体验：对需求的新见解。

DOI：
10.1097/yco.0000000000000876
发表时间：
2023
期刊：
Current opinion in psychiatry
影响因子：
6.9
作者：
Shover,ChelseaL;Spoliansky,JordanG;Godvin,Morgan
通讯作者：
Godvin,Morgan

Longitudinal changes in co-involved drugs, comorbidities, and demographics of methamphetamine-related deaths in Los Angeles County.

DOI：
10.1016/j.josat.2023.209101
发表时间：
2023-08
期刊：
JOURNAL OF SUBSTANCE USE & ADDICTION TREATMENT
影响因子：
0
作者：
Shover, Chelsea L.;Friedman, Joseph R.;Romero, Ruby;Buhr, Russell;Chu, Brian;Tang, Amber;Medina, Jesus A.;Wisk, Lauren;Lucas, Jonathan;Goodman-Meza, David
通讯作者：
Goodman-Meza, David

COVID-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County: a Three-Stage Field Survey.

DOI：
10.1007/s11524-022-00659-x
发表时间：
2022-06
期刊：
Journal of urban health : bulletin of the New York Academy of Medicine
影响因子：
0
作者：
通讯作者：

COVID-19 Mortality Rates in Los Angeles County Among People Experiencing Homelessness, March 2020-February 2021.

DOI：
10.1177/00333549221115658
发表时间：
2022-11
期刊：
PUBLIC HEALTH REPORTS
影响因子：
3.3
作者：
Chang, Alicia H.;Kwon, Jennifer J.;Shover, Chelsea L.;Greenwell, Lisa;Gomih, Ayodele;Blake, Jerome;Del Rosario, Aubrey;Jones, Padma S.;Fisher, Rebecca;Balter, Sharon;Brosnan, Hannah K.
通讯作者：
Brosnan, Hannah K.

Community Health Worker Perspectives on Engaging Unhoused Peer Ambassadors for COVID-19 Vaccine Outreach in Homeless Encampments and Shelters.

DOI：
10.1007/s11606-022-07563-9
发表时间：
2022-06
期刊：
Journal of general internal medicine
影响因子：
5.7
作者：
Choi K;Romero R;Guha P;Sixx G;Rosen AD;Frederes A;Beltran J;Alvarado J;Robie B;Richard L;Coleman A;Rice A;Rosales M;Baez A;Thomas E;Shover CL
通讯作者：
Shover CL