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

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. 项目概要/摘要阿片类药物流行病继续肆虐，给美国各地的发病率和死亡率造成了巨大损失为了扩大阿片类药物使用障碍 (MOUD) 的救生努力药物的供应，一个重大差距重新鉴于紧急护理的频率很高，因此这些治疗的获得和连续性至关重要。阿片类药物使用障碍 (OUD) 患者、急诊室和医院的设置正在增加—— 越来越多的证据表明 MOUD 治疗的有效性。在医院启动 MOUD 并将人们与社区治疗联系起来导致了此类疾病的快速增长然而，人们对用于转移的策略的性质或成功知之甚少。了解患者从医院环境到社区 MOUD 治疗的过渡策略。在提高住院后 MOUD 治疗的参与度方面最有效，这对于支持患者通过“OUD 级联护理”降低用药过量风险并改善健康状况。 K01 奖的目标是解决这些差距，同时推进候选人的职业目标：一名独立调查员，从事干预和实施研究的工作，流行病学生物学和政策，以增进对战略的了解，以改善对教育的获取、吸收和可持续性通过课程作业、科学会议，为阿片类药物和其他物质使用障碍提供基于疾病的服务。瘾、健康服务研究和专家的密切指导纽约大学格罗斯曼医学院和合作机构的定性和定量方法，博士。 Krawczyk 将提高提供成瘾服务和急性护理混合干预的能力；收集和分析医疗保健实践数据的方法及其实施分析；整理来自不同数据集的医疗保健数据；以及用于资助撰写和研究合作的专业技能。拟议的研究将采用定量和定性方法来研究用于将来自医院的 OUD 患者与社区中持续参与的 MOUD 联系起来的过渡策略通过对纽约市 11 家公立医院进行案例研究，研究目标是 (1) 制定分类法并进行分类。通过查阅文献和专家的意见，对医院 OUD 护理过渡策略进行了一系列调查德尔福小组；(2) 就主要障碍与提供者和患者利益相关者进行深入访谈和有效转变的促进者；(3) 探索患者特征之间的多层次关联，医院过渡策略和出院后 MOUD 参与结果符合这项工作。 NIDA 的目标是开展解决现实世界复杂性的研究，探索可持续实施物质使用治疗的循证实践，并研究治疗服务的整合通过提供薪资支持、培训和正式的指导结构，这可以实现多样化的医疗保健环境。该奖项将有助于 Krawczyk 博士过渡到成瘾健康服务研究领域的独立职业。