Beyond Treatment Initiation: Enhancing Opioid Use Disorder Care Transitions Across Health System Touchpoints

除了治疗启动之外：加强阿片类药物使用障碍护理在卫生系统接触点的转变

基本信息

批准号：
10592062
负责人：
Noa Krawczyk
金额：
$ 18.18万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-15 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10592062
关键词：
Accident and Emergency department Active Learning Address Award Buprenorphine Caring Case Study Characteristics Classification Clinical Communities Competence Comprehension Data Data Collection Data Set Dedications Discharge Plannings Effectiveness Electronic Health Record Ensure Epidemic Epidemiology Equity Evidence based practice Evidence based treatment Frequencies Future Goals Grant Harm Reduction Health Health Services Health Services Research Health system Healthcare Hospital Referrals Hospitalization Hospitals Improve Access Individual Inpatients Institution Intervention Intervention Studies Interview Knowledge Life Link Medicaid Mentored Research Scientist Development Award Mentorship Methadone Methods Modeling Morbidity - disease rate Naltrexone National Institute of Drug Abuse Nature Opioid Outcome Overdose Overdose reduction Participant Patients Perception Persons Pharmaceutical Preparations Policies Provider Public Hospitals Qualitative Methods Questionnaires Reporting Research Research Personnel Review Literature Role Series Services Structure Substance Use Disorder Surveys Taxonomy Training Treatment outcome Wages Work Writing acute care addiction care systems career clinical practice cognitive interview community barrier diverse data evidence base follow-up health care settings high risk implementation research improved integrated care medical schools medication for opioid use disorder meetings mortality multilevel analysis opioid epidemic opioid overdose opioid use disorder overdose risk patient-level barriers prevent programs provider-level barriers rapid growth skills sociodemographics standard care substance use treatment success symposium treatment services uptake virtual

Accident and Emergency department Active Learning Address Award Buprenorphine Caring Case Study Characteristics Classification Clinical Communities Competence Comprehension Data Data Collection Data Set Dedications Discharge Plannings Effectiveness Electronic Health Record Ensure Epidemic Epidemiology Equity Evidence based practice Evidence based treatment Frequencies Future Goals Grant Harm Reduction Health Health Services Health Services Research Health system Healthcare Hospital Referrals Hospitalization Hospitals Improve Access Individual Inpatients Institution Intervention Intervention Studies Interview Knowledge Life Link Medicaid Mentored Research Scientist Development Award Mentorship Methadone Methods Modeling Morbidity - disease rate Naltrexone National Institute of Drug Abuse Nature Opioid Outcome Overdose Overdose reduction Participant Patients Perception Persons Pharmaceutical Preparations Policies Provider Public Hospitals Qualitative Methods Questionnaires Reporting Research Research Personnel Review Literature Role Series Services Structure Substance Use Disorder Surveys Taxonomy Training Treatment outcome Wages Work Writing acute care addiction care systems career clinical practice cognitive interview community barrier diverse data evidence base follow-up health care settings high risk implementation research improved integrated care medical schools medication for opioid use disorder meetings mortality multilevel analysis opioid epidemic opioid overdose opioid use disorder overdose risk patient-level barriers prevent programs provider-level barriers rapid growth skills sociodemographics standard care substance use treatment success symposium treatment services uptake virtual

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项目摘要

7. PROJECT SUMMARY/ABSTRACT The opioid epidemic continues to rage, taking a vast toll on morbidity and mortality across the U.S. Despite efforts to expand availability of life-saving medications for opioid use disorder (MOUD), a significant gap re- mains in access to and continuity in these treatments. Given the high frequency of encounters with acute-care settings among patients with opioid use disorder (OUD), emergency departments and hospitals are increas- ingly seen as ‘touchpoints’ to promote initiation of MOUD treatment. Growing evidence around the efficacy of initiating MOUD in the hospital and linking people to community treatment has led to a rapid growth of such hospital-based interventions. However, little is known about the nature or success of strategies used to transi- tion patients from hospital settings to community-based MOUD treatment. Knowing which transition strategies are most effective in improving engagement in MOUD treatment post-hospitalization is critical to supporting patients through the ‘OUD Cascade of Care’ towards reduced overdose risk and improved health. The goal of this K01 Award is to address these gaps while advancing the candidate’s career goal of becom- ing an independent investigator who works at the interface of intervention and implementation research, epide- miology, and policy to advance knowledge on strategies to improve access to, uptake and sustainability of evi- dence-based services for opioid and other substance use disorders. Through coursework, scientific confer- ences, experiential learning, and close mentorship from experts in addiction, health services research and qualitative and quantitative methods at the NYU Grossman School of Medicine and partner institutions, Dr. Krawczyk will develop competency in the delivery of addiction services and acute care interventions; mixed methods for collecting and analyzing data on healthcare practices and their implementation; analysis of multi- level healthcare data from diverse datasets; and professional skills for grant writing and research partnerships. The proposed research will employ quantitative and qualitative methods to study the nature and role of transition strategies used to link OUD patients from hospitals to ongoing MOUD engagement in the community using a case study of 11 public hospitals in NYC. Research aims are to (1) Develop a taxonomy and subse- quent survey of hospital OUD care transition strategies via review of the literature and input from an expert Delphi panel; (2) Conduct in-depth interviews with provider and patient stakeholders regarding primary barriers and facilitators to effective transitions, and; (3) Explore multi-level associations between patient characteristics, hospital transition strategies, and post-discharge MOUD engagement outcomes. This work is in line with NIDA’s goals to conduct research that addresses real-world complexities, explores sustainable implementation of evidence-based practices for substance use treatment, and studies the integration of treatment services in diverse health care settings. By providing salary support, training, and a formal mentorship structure, this award will facilitate Dr. Krawczyk’s transition to an independent career in addiction health services research.

7。项目摘要/摘要阿片类药物的流行仍在继续愤怒，尽管为扩大阿片类药物使用障碍（MOUD）的挽救生命的药物的努力，这是一个很大的差距这些治疗方法的通道和连续性。考虑到急性护理的高频阿片类药物使用障碍患者（OUD），急诊科和医院的设置增加 - i Lyse认为是“接触点”，以促进MOUD治疗的启动。围绕效率的越来越多的证据在医院启动穆德并将人们与社区治疗联系起来，导致了这种迅速的增长基于医院的干预措施。但是，关于用于转变的策略的性质或成功知之甚少从医院环境到基于社区的MOUD治疗的患者。知道哪些过渡策略在改善院后的莫德治疗方面最有效，对于支持至关重要通过“一系列护理级联”的患者降低了过量的风险和改善的健康状况。该K01奖的目标是解决这些差距，同时推进候选人的职业目标 - 在干预和实施研究界面工作的独立研究者，发作 - MIology和政策，以提高有关改善获得，吸收和可持续性的战略知识的知识基于DNCE的阿片类药物和其他物质使用障碍的服务。通过课程，科学会议 - 加密，专家学习以及成瘾，卫生服务研究专家的心态纽约大学格罗斯曼医学院和合作伙伴机构的定性和定量方法，博士 Krawczyk将在成瘾服务和急性护理干预措施的提供方面发展能力；混合收集和分析有关医疗保健实践及其实施数据的方法；分析多来自潜水员数据集的水平医疗保健数据；以及授予写作和研究合作伙伴关系的专业技能。拟议的研究将采用定量和定性方法来研究用于将OUD患者从医院连接到社区持续参与的过渡策略使用纽约市11家公立医院的案例研究。研究目的是（1）开发分类法和分类。通过审查文献和专家的意见，对医院Oud护理过渡策略进行量化调查 Delphi面板；（2）与提供者和患者利益相关者有关主要障碍的深入访谈并促进有效的过渡，以及；（3）探索患者特征之间的多层次关联，医院过渡策略和入院后MOUD参与结果。这项工作符合 NIDA进行研究以解决现实世界复杂性的研究，探讨可持续实施基于证据的物质使用治疗的实践，并研究治疗服务的整合多样化的医疗保健环境。通过提供薪水支持，培训和形式的心态结构，奖项将有助于克劳奇克博士过渡到成瘾健康服务研究中的独立职业。