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SPOiLER: towards Safer Prescribing of Legal Opioids from the Emergency Room

剧透：在急诊室更安全地开出合法阿片类药物

基本信息

批准号：
10364730
负责人：
William Edward Soares
金额：
$ 18.47万
依托单位：
BAYSTATE MEDICAL CENTER, INC.
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-03-01 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10364730
关键词：
Accident and Emergency department Acute Applications Grants Attitude Behavior Behavioral Belief Benefits and Risks Characteristics Chronic Clinical Cohort Analysis Data Databases Dependence Development Drug Monitoring Drug Prescriptions Education Emergency Department Physician Emergency Department patient Emergency Situation Epidemic Equilibrium Event Evidence based practice Frequencies Funding Future Goals Grant Harm Reduction Hospitals Individual Interview Leadership Legal Massachusetts Mentors Methods National Institute of Drug Abuse New Hampshire Opioid Outpatients Overdose Pain Patient-Focused Outcomes Patients Physicians Planning Theory Policies Policy Research Probability Provider Qualitative Methods Quasi-experiment Regulation Research Research Personnel Research Project Grants Retrospective cohort Risk Role State Government Statutes and Laws Structure Substance Use Disorder Training United States addiction adverse outcome base behavior change behavioral outcome career development clinically relevant evidence base evidence based guidelines experience health care service utilization implementation trial indexing nonmedical use opioid epidemic opioid policy opioid therapy opioid use opioid use disorder peer pill prescription opioid prevent social norm theories

项目摘要

PROJECT SUMMARY The objective of this NIDA K08 career development proposal is to gain experience and training to become an independent investigator focused on the development of evidence-based practices to prevent and treat substance use disorders in the emergency department. Opioid use disorders, including overdose and addiction, have become epidemic in the United States. While research has largely focused on long-term opioid prescribing in the outpatient setting, emergency department opioid prescribing for acute painful conditions as a portal for future adverse patient outcomes remains poorly defined. State governments, including the Commonwealth of Massachusetts, have reacted to the opioid crisis in part by crafting legislation to broadly limit legal opioid prescriptions. However, opioid medications remain an important treatment option for some acute painful conditions, and evidence based guidance on appropriate prescribing is lacking, in part because the factors that impact providers opioid prescribing behaviors and subsequent patient associated adverse outcomes remains unknown. Understanding the underlying factors that influence opioid prescribing behaviors and future patient outcomes, including state legislation, peer behaviors, hospital attitudes, and local culture, is a critical step in developing integrated, evidence-based recommendations that focus on transforming the culture surrounding safe opioid prescribing practices. Using the theory of planned behavior as a framework, the goals of this K08 grant application are to understand opioid prescribing behaviors and adverse patient outcomes through the following aims: First, we will assess the influence of state legislation, specifically the 2016 Massachusetts (MA) Opioid Law, on the formation of hospital-based regulations and providers' perceived attitudes towards opioid prescribing through qualitative interviews with local physician leaders in MA. Second, using comprehensive claims data, we will evaluate the impact of the 2016 MA Opioid Law on statewide opioid prescribing, using a neighboring state without opioid legislation as a natural control. Finally, we will examine the association of an initial opioid prescription on clinically relevant patient outcomes in order to better understand how restricting opioid prescriptions through legislation may impact emergency department patients presenting with an acute painful condition. From our results, we will create evidence-based recommendations to enhance existing opioid legislation, as well as develop and execute R01 funded comprehensive implementation trials that focus not only on changing behaviors of individual providers, but also transforming the group culture and social norms that influence opioid prescribing behaviors. !

项目总结