Chronic Disease and Health Outcomes of Older Adults with Opioid Use Disorders

！ 项目摘要/摘要： 该项目是指导患者导向研究职业发展奖的修订申请。我的 长期目标是成为老龄化和成瘾研究领域的领导者，并拥有开发慢性护理方面的专业知识 老年人药物滥用治疗中协调的交付模式。该职业奖将提供 额外的培训并促进完成拟议的指导研究以继续我的职业生涯 发展成为一名独立的临床医生研究者。拟议的研究涉及关键知识 患有药物滥用障碍的老年人流行病的差距。尽管人们认识到 患有阿片类药物使用障碍 (OUD) 的老年人通常在医学和社会方面都很复杂，但人们知之甚少 关于这一弱势群体的具体健康状况和需求。我提议的职业 发展计划将使我能够通过与导师团队合作来解决这一知识差距 与纽约市健康和心理卫生局以及纽约市健康医院合作 综合医疗保健系统将监督和协作实现以下培训目标：(1) 实现 先进定量方法的专业知识应用于成瘾健康的大型管理数据集 服务研究； (2) 培养定性研究理论和实践技能； (3) 达到熟练程度 以及制定护理干预措施的经验。我将在以下人员的指导下实现这些培训目标 我的导师团队辅以正式的课程和研讨会，并进行了一项研究 使用混合方法的议程具有以下具体目标：(1) 描述患病率和 急性医疗保健高利用率、高医疗费用、多种慢性病和死亡率的危险因素 患有 OUD 的老年人； (2) 检查工作人员和患者对治疗的态度、接受度和障碍 将老年护理模式纳入阿片类药物治疗计划； (3) 制定并试点可行性 针对老年病症和 OUD 老年人慢性病管理的老年护理模式 在 R01 中进行测试。该提案与国家药物研究所的优先事项直接一致 Abuse 的“药物使用障碍的复杂性和连续性”战略规划工作组 物质使用问题”，以更好地了解病情复杂的个体的物质使用情况。 这项研究将为广泛整合老年病学的循证模型设定未来的研究议程。 将慢性病评估和管理纳入现有的药物使用治疗计划。 ！

! Project Summary/Abstract: This project is a revised application for a Mentored Patient-Oriented Research Career Development Award. My long-term goal is to be a leader in aging and addiction research with expertise in developing chronic care delivery models coordinated within substance use treatment for older adults. This career award will provide additional training and facilitate the completion of the proposed mentored research to continue my career development into an independent clinician investigator. The proposed research addresses a critical knowledge gap in the setting of an epidemic of older adults with substance use disorders. Although it is recognized that older adults with opioid use disorders (OUD) are often medically and socially complex, very little is known regarding their specific health status and needs of this vulnerable population. My proposed career development plan will allow me to address this knowledge gap by working with a team of mentors as well as with the New York City Department of Health and Mental Hygiene and the New York City Health + Hospitals' integrated healthcare system who will supervise and collaborate on the following training goals: (1) to achieve expertise in advanced quantitative methods as applied to large administrative datasets for addiction health services research; (2) to develop skills in qualitative research theory and practice; and (3) to attain proficiency and experience in the development of a care intervention. I will attain these training goals with guidance from my mentorship team complemented by formal coursework and seminars, and by conducting a research agenda that uses a mixed methods approach with the following specific aims: (1) describe the prevalence and risk factors for high utilization of acute healthcare, high medical costs, multiple chronic conditions, and mortality among older adults with OUD; (2) examine staff and patient attitudes, acceptance, and barriers regarding the integration of geriatric models of care into opioid treatment programs; (3) develop and pilot for feasibility, a geriatric-based care model for geriatric conditions and chronic disease management for older adults with OUD to be tested in an R01. This proposal is directly aligned with the priorities of the National Institute on Drug Abuse’s strategic planning workgroup on the "Complexity of Substance Use Disorders and the Continuum of Substance Use Problems" to better understand substance use among individuals with complex conditions. This research will set a future research agenda for widely integrating an evidence-based model of geriatric- based chronic disease assessment and management into existing substance use treatment programs. !