Pilot Implementation of Measurement-Based Care in Community Opioid Treatment Programs

在社区阿片类药物治疗计划中试点实施基于测量的护理

• 批准号: 10691007
• 负责人: Kelli Scott
• 金额: $ 18.64万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-25 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10691007
• 关键词: Abstinence; Alcohols; Appointment; Area; Behavior Therapy; Caring; Censuses; Centers for Disease Control and Prevention (U.S.); Cessation of life; Client; Clinical; Collection; Communities; Complement; Computerized Medical Record; Consolidated Framework for Implementation Research; Counseling; Data; Data Collection; Data Reporting; Development; Development Plans; Dissemination and Implementation; Documentation; Effectiveness; Epidemic; Ethnography; Evidence based intervention; Evidence based treatment; Frequencies; Goals; Gold; Group Therapy; Guidelines; Health Personnel; Helping to End Addiction Long-term; Hybrids; Intervention; Interview; Measurement; Measures; Melissa; Mentors; Mentorship; Methods; Modeling; Monitor; National Institute of Drug Abuse; New England; Opiate Addiction; Opioid; Outcome; Overdose; Patient Self-Report; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacotherapy; Phase; Policies; Prescription drug overdose; Procedures; Process; Program Development; Protocols documentation; Provider; Public Health; Recommendation; Recording of previous events; Reporting; Research; Research Activity; Research Personnel; Research Proposals; Site; Site Visit; Strategic Planning; Structure; Surveys; Testing; Training; Training Activity; Training Support; United States; United States Department of Veterans Affairs; Universities; Urine; Work; addiction; base; burden of illness; career; career development; cognitive interview; community based participatory research; community engaged research; community partnership; community setting; design; effectiveness implementation study; effectiveness implementation trial; effectiveness outcome; evidence base; experience; flexibility; group counseling; implementation outcomes; implementation science; improved; mentoring community; multidisciplinary; opioid misuse; opioid overdose; opioid treatment program; opioid use disorder; overdose death; pilot trial; programs; psychosocial; public health emergency; rapid technique; research and development; scale up; substance use treatment; tool

PROJECT SUMMARY Opioid overdose has been recognized as a public health emergency, as lethal drug overdoses have become the leading cause of accidental death in the United States. The gold standard, evidence-based intervention for opioid use disorder is pharmacotherapy, but abstinence rates following pharmacotherapy are sub-optimal. Measurement-based care (MBC), the systematic use of client self-report data to inform and enhance treatment, is an evidence-based intervention that could be uniquely well suited to complement pharmacotherapy for OUD. Unfortunately, very few community opioid treatment programs (OTPs) offer psychosocial interventions to complement pharmacotherapy due to the high volume of patients served and a reliance on group therapy models to accommodate this large census. There is a pressing need for flexible psychosocial intervention structures for use in OTPs that are not associated with typical barriers found in full package, manualized interventions. The training and research activities in this proposal seek to enhance the provision of MBC in community OTPs through two research phases bolstered by four training aims. In Phase 1 of the research plan, the candidate, supported by the experienced mentorship team, will work with 8 OTPs to develop community-engaged research partnerships, complete site visits, and engage treatment providers, leaders, staff, and patients in qualitative interviews and quantitative surveys. Phase 1 outcomes will be used to inform site selection for MBC implementation and to facilitate adaptation of an MBC assessment protocol for use in OTPs. Phase 2 will involve a pilot type I hybrid effectiveness-implementation study with four OTPs. The candidate will work with the OTPs to integrate MBC into electronic medical record documentation procedures. Treatment providers will also receive MBC training and ongoing support, and preliminary MBC effectiveness and implementation data will be collected. To conduct this research, the candidate requires training in four key areas: 1) development and management of community-engaged partnerships to support effectiveness and implementation trials in addiction treatment; 2) training in evidence-based assessment and intervention methods for OUD; 3) training in mixed methods data collection using rapid ethnography; and 4) training in measure design and adaptation. These training aims will be supported by the Brown University Center for Alcohol and Addiction Studies as well as by the candidate’s mentorship team. The mentorship team will be led by Primary Mentor Dr. Sara Becker, an expert in implementation science and community partnership development in substance use treatment settings. The proposal will also be supported by Dr. Francesca Beaudoin, Dr. Lawrence Palinkas, and Dr. Melissa Clark, experts in OUD intervention, rapid mixed methods data collection, and measure design, respectively. Taken together, this research and career development plan will advance a significant public health issue by enhancing the quality of OUD care while launching the independent career of the candidate in the implementation of MBC in OTPs.

项目概要 阿片类药物过量已被视为公共卫生紧急事件，因为致命药物过量已成为 美国意外死亡的主要原因。 阿片类药物使用障碍是药物治疗，但药物治疗后的戒断率并不理想。 基于测量的护理 (MBC)，系统地使用客户自我报告数据来告知和增强 治疗是一种基于证据的干预措施，非常适合补充 不幸的是，很少有社区阿片类药物治疗计划 (OTP) 提供 OUD 药物治疗。 由于接受服务的患者数量较多，因此需要采取社会心理干预措施来补充药物治疗 依靠团体治疗模式来适应这种大规模的人口普查迫切需要灵活的方法。 用于与完全发现的典型障碍无关的 OTP 的心理社会干预结构 本提案中的培训和研究活动旨在加强 通过两个研究阶段在社区 OTP 中提供 MBC，第一阶段有四个培训目标。 根据研究计划，候选人将在经验丰富的导师团队的支持下与 8 位 OTP 合作， 发展社区参与的研究伙伴关系，完成实地考察，并吸引治疗提供者， 第一阶段的结果将用于定性访谈和定量调查中的领导者、工作人员和患者。 为 MBC 实施的选址提供信息，并促进 MBC 评估协议的调整 第二阶段将涉及对四个 OTP 进行 I 类混合有效性实施试点研究。 候选人将与 OTP 合作，将 MBC 集成到电子医疗记录文档程序中。 治疗提供者还将接受 MBC 培训和持续支持以及初步 MBC 有效性 为了进行这项研究，候选人需要接受四个关键方面的培训。 领域： 1) 发展和管理社区参与的伙伴关系，以支持有效性和 成瘾治疗的实施试验；2）循证评估和干预培训 OUD 方法；3) 使用快速民族志的混合方法数据收集培训； 这些培训目标将得到布朗大学中心的支持。 酒精和成瘾研究以及候选人的导师团队将由导师团队领导。 作者：首席导师 Sara Becker 博士，她是实施科学和社区伙伴关系方面的专家 该提案也将得到弗朗西斯卡博士的支持。 Beaudoin、Lawrence Palinkas 博士和 Melissa Clark 博士，OUD 干预、快速混合方法专家 分别将数据收集和测量设计结合起来，进行这项研究和职业发展计划。 通过提高 OUD 护理质量，同时启动 候选人在 OTP 中实施 MBC 的独立职业生涯。