Appalachian Node

摘要： NIDA临床试验网络(CTN)的阿巴拉契亚节点将解决出现的临床研究问题 来自阿巴拉契亚中部，目前阿片类药物流行的中心。它是阿片类药物使用率最高的国家之一 全国服药过量死亡和相关疾病。它的乡村地理，独立的文化，紧张 经济和无法获得药物使用治疗都是造成这一流行病的原因。结合在一起 匹兹堡大学(匹兹堡)、西弗吉尼亚大学(WVU)和宾夕法尼亚州立医学院(PSU)， 阿巴拉契亚节点将由经验丰富的临床研究人员简·利布舒茨博士(皮特)和朱迪思博士领导 范伯格(Feinberg)。该节点将汇聚成功的多学科合作调查员，其中许多人曾 以前在其他已建立的节点有CTN经验，并已被招募到这些机构进行响应 到了地区性的物质使用流行。附属学术医学中心覆盖中西区 宾夕法尼亚州(PA)和整个西弗吉尼亚州(WV)，并拥有广泛的生物信息学数据库和电子 健康记录和索赔数据。利用利益相关者咨询小组，得到区域支付者的支持，并关闭 与州和地方政策和公共卫生官员的联系将确保研究具有相关性和高度的 研究完成后可持续发展的可能性。该节点的三个目标是：1)进行多点试验 这将解决目前的阿片类药物危机(和其他物质滥用)，重点是进行研究 在农村和其他服务不足的人群中，2)提出研究以测试现有资源的创新使用 (当地药店、同伴导航员/同伴康复教练、移动技术、最先进的健康信息 系统)实施循证做法，将最先进的护理扩展到资源匮乏的地区， 农村和城市，以及3)向地区支付者和政策制定者、实践者和 社区。该节点将定义本地解决方案，以克服服务不足地区障碍的复杂相互作用 农村和城市地区。我们的资源和CTN提供的资源相结合，将使我们能够 对阿巴拉契亚中部和全国的阿片类药物流行产生重大影响。以工作为基础的拟议研究 节点调查人员包括：1)与注射吸毒有关的严重细菌感染：质量指标和 干预(Liebschutz，Pollini)，2)药剂师辅助丁丙诺啡治疗(Winstanley)，3)利用 激励阿片类药物使用障碍药物辅助康复的学习健康系统(Kraemer)， 4)智能手机应用和可穿戴设备的复发风险预警系统(Kawasaki， 温斯坦利)。

Abstract: The Appalachian Node of NIDA Clinical Trials Network (CTN) will address clinical research questions that arise from Central Appalachia, an epicenter of the current opioid epidemic. It has among the highest rates of opioid overdose deaths and related morbidities in the nation. Its rural geography, culture of independence, strained economy and lack of access to substance use treatment have all contributed to the epidemic. Joining together University of Pittsburgh (Pitt), West Virginia University (WVU) and Penn State College of Medicine (PSU), the Appalachian Node will be led by experienced clinical investigators, Drs. Jane Liebschutz (Pitt) and Judith Feinberg (WVU). The node will bring together successful multi-disciplinary co-investigators, many of whom had prior CTN experience in other established nodes and who have been recruited to these institutions to respond to the regional substance use epidemic. The affiliated academic medical centers cover central and western Pennsylvania (PA) and all of West Virginia (WV) and have extensive bioinformatics databases with electronic health record and claims data. Use of a Stakeholder Advisory Group, support from regional payors, and close ties with state and local policy and public health officials will ensure that research has relevance and a high likelihood of sustainability after study completion. The three aims of the node are to: 1) conduct multisite trials that will address the current opioid crisis (and other substance misuse), with an emphasis on conducting studies among rural and other underserved populations, 2) propose studies to test innovative uses of existing resources (local pharmacies, peer navigators/peer recovery coaches, mobile technology, state-of-the-art health information systems) to implement evidence-based practices that will extend state-of-the-art care into resource-poor regions, both rural and urban, and 3) disseminate CTN findings to regional payers and policymakers, practitioners, and the community. The node will define local solutions to overcome the complex interplay of barriers in underserved rural and urban areas. The combination of our resources and those provided by the CTN will enable us to make a significant impact on the opioid epidemic in central Appalachia and nationally. Proposed studies built on work of node investigators include: 1) Serious Bacterial Infections Related to Injection Drug Use: Quality Metrics and Intervention (Liebschutz, Pollini), 2) Pharmacist-Assisted Buprenorphine Treatment (Winstanley), 3) Leveraging the Learning Health System to Incentivize Medication-Assisted Recovery for Opioid Use Disorder (Kraemer), and 4) An “Early Warning” System for Relapse Risk with Smartphone Apps and Wearable Devices (Kawasaki, Winstanley).