Initiating substance use disorder treatment in hospitalized opioid use disorder patients

项目摘要 本申请中的指导研究项目和培训计划将帮助铃木博士成为 独立研究者，以改善最初确定的阿片类药物使用障碍（OUD）患者的治疗 在一般医疗环境中。这是一个巨大的公共卫生关注领域，因为OUD患者 经常访问一般医疗保健，如医院和急诊室，更有可能是 出院后再次入院。因此，一般医疗环境可能是发起 治疗然而，很少有人知道的最佳方法，以启动和保留病人的有效 在住院期间和住院后治疗物质使用障碍。为了满足这一未满足的需求， 该项目将测试ISTOP干预（对住院阿片类药物的物质使用障碍治疗 使用障碍患者），目标是随机临床试验中住院的OUD患者。ISTOP 干预结合丁丙诺啡在医院发起，在医院的护理经理，以解决 域显示，以减少再入院，并恢复教练与参与者在社区后， 放电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 ISTOP干预被证明是有效的，它将为未来的R 01应用奠定基础。铃木博士将 由一组著名的研究人员指导，以实现以下培训目标：1）获得指导 有进行治疗OUD患者的临床试验的经验，2）熟练进行 在社区环境中整合药物和心理社会治疗OUD的研究，3） 发展在一般医疗环境中开始的OUD治疗研究技能，并持续到 社区，和4）发展临床研究所需的定量方法的更好的理解。这些 培训目标将通过密切指导、正式课程、研讨会/讲习班以及 会议出席。培训和研究项目将由一个指导小组监督， 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， OUD的专业知识;共同导师Jane Liebschutz博士，一位专门研究物质使用的研究员 医学环境中的疾病;共同导师大卫斯梅尔森博士，一位具有丰富经验的研究人员， 以社区为基础的研究，包括研究恢复教练;共同导师杰弗里·施尼珀博士， 具有研究住院患者健康结果专业知识的研究员;和共同导师罗伯特·格林博士， 在设计和分析临床试验方面具有丰富经验的研究人员。有了国家卫生研究院资助的 临床和转化科学中心（哈佛催化剂）和职业发展支持， 布里格姆妇女医院和哈佛医学院，铃木博士是在一个理想的学术环境， 实现这些培训目标，并成功地完成拟议的项目。该提案符合 NIDA的战略计划，以开发成功的治疗OUD和提高治疗的可及性。

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.