Initiating substance use disorder treatment in hospitalized opioid use disorder patients

项目总结 本申请中的指导研究项目和培训计划将帮助铃木Joji博士成为一名 改善阿片类药物使用障碍(OUD)患者治疗的独立调查者初步确定 在普通医疗环境中。这是一个引起巨大公共卫生关注的领域，因为患有ODS的患者 经常获得普通医疗服务，如医院和急诊室，而且更有可能是 出院后再次入院。因此，普通医疗环境可能是启动的重要场所 治疗。然而，人们对启动和留住患者的最佳方法知之甚少。 住院期间和住院后的物质使用障碍治疗。为了满足这一未得到满足的需求，拟议的 该项目将测试istop干预措施(启动住院阿片类药物使用障碍治疗 在一项随机临床试验中，以住院患者为目标。ISTOP 干预结合了丁丙诺啡在医院启动，医院的护理经理解决 显示可以减少重新接纳的域名，以及恢复教练，以便在之后与社区成员合作 出院。其目标是增加治疗保留率，减少非法阿片类药物使用，并减少再入院。如果 ISOP干预被证明是有效的，它将为未来R01的应用奠定基础。铃木博士将 接受一组知名研究人员的指导，以实现以下培训目标：1)获得指导 进行临床试验治疗OUD患者的经验，2)熟练地进行 在社区环境中整合药物治疗和心理社会治疗的研究，3) 培养在普通医疗环境中开始并持续到 社区，以及4)更好地理解临床研究所需的定量方法。这些 培训目标将通过密切指导、正式课程、研讨会/讲习班和 出席会议。培训和研究项目将由一个由以下人员组成的指导小组监督 他的主要导师罗杰·韦斯博士是一位国际公认的成瘾研究人员，拥有相当多的 OUD方面的专业知识；共同导师简·利布舒茨博士，一位研究物质使用的专家 医疗环境中的障碍；共同导师大卫·斯梅尔森博士，一位具有丰富经验的研究员 社区研究，包括研究康复教练；共同导师杰弗里·施尼珀博士， 研究住院患者健康结果的专业研究人员，以及共同导师罗伯特·格林博士， 在设计和分析临床试验方面有丰富经验的研究人员。有权获得美国国立卫生研究院资助的 临床和转化科学中心(哈佛催化剂)和职业发展支持通过 布里格姆妇女医院和哈佛医学院，铃木博士处于理想的学术环境中 实现这些培训目标，并顺利完成拟议的项目。这项提议与 NIDA的战略计划是开发成功的OUD治疗方法，并改善治疗的可及性。

Project summary The mentored research project and training plan in this application will help Dr Joji Suzuki become an independent investigator to improve the treatment of patients with opioid use disorders (OUD) initially identified in general medical settings. This is an area of enormous public health concern because patients with OUDs frequently access general medical care, such as hospitals and emergency rooms, and are more likely to be readmitted following discharge. As such, general medical settings may be important venues in which to initiate treatment. However, very little is known about the optimal methods to initiate and retain patients in effective substance use disorder treatment during and after hospitalizations. To fill this unmet need, the proposed project will test the ISTOP intervention (Initiating Substance Use Disorder Treatment for Hospitalized Opioid Use Disorder Patients) targeting hospitalized OUD patients in a randomized clinical trial. The ISTOP intervention combines buprenorphine initiated in the hospital, a care manager in the hospital to address domains shown to reduce readmissions, and a recovery coach to work with participants in the community after discharge. The goal is to increase treatment retention, reduce illicit opioid use, and reduce readmissions. If the ISTOP intervention proves to be effective, it will lay the foundation for a future R01 application. Dr Suzuki will be mentored by a group of renowned researchers to achieve the following training goals: 1) obtain a mentored experience conducting a clinical trial for the treatment of OUD patients, 2) gain proficiency in conducting research that integrates pharmacologic and psychosocial treatments for OUD in the community setting, 3) develop skills in researching treatments for OUD initiated in general medical settings and continued into the community, and 4) develop greater understanding of quantitative methods needed for clinical research. These training goals will be met by a combination of close mentorship, formal coursework, seminars/workshops, and conference attendance. The training and research project will be overseen by a mentoring team composed of his primary mentor Dr Roger Weiss, an internationally recognized addiction researcher with considerable expertise in OUD; co-mentor Dr Jane Liebschutz, a researcher with expertise studying substance use disorders in medical settings; co-mentor Dr David Smelson, a researcher with considerable experience with community-based research including researching recovery coaches; co-mentor Dr Jeffrey Schnipper, a researcher with expertise studying health outcomes for hospitalized patients; and co-mentor Dr Robert Glynn, a researcher with extensive experience in designing and analyzing clinical trials. With access to a NIH-funded Clinical and Translational Science Center (Harvard Catalyst) and the career development support through Brigham and Women's Hospital and Harvard Medical School, Dr Suzuki is in an ideal academic environment to realize these trainings goals and to successfully complete the proposed project. The proposal is consistent with NIDA's strategic plan to develop successful treatments for OUD and improve treatment accessibility.