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

好了！ 项目摘要/摘要： 这个项目是对以患者为导向的研究事业发展奖的修订申请。我的 长期目标是成为衰老和成瘾研究的领先者，拥有开发慢性护理的专业知识 在老年人的物质使用治疗中协调的分娩模式。这个职业奖项将提供 额外的培训和促进完成拟议的指导性研究以继续我的职业生涯 发展成为独立的临床医生调查员。这项拟议的研究解决了一项关键知识 在老年人药物使用障碍流行的背景下存在差距。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，人们对此知之甚少 关于他们的具体健康状况和这一弱势群体的需求。我打算从事的职业 发展计划将使我能够通过与导师团队以及 与纽约市卫生和精神卫生部门和纽约市卫生医院 综合医疗系统将监督和协作实现以下培训目标：(1)实现 在应用于大型成瘾健康管理数据集的高级定量方法方面的专业知识 服务研究；(2)培养定性研究的理论和实践技能；(3)熟练掌握 以及制定护理干预措施的经验。在我的指导下，我将实现这些培训目标 我的指导团队辅以正式的课程和研讨会，并进行了一项研究 采用混合方法的议程，具体目标如下：(1)说明流行率和 急性医疗保健利用率高、医疗费用高、多种慢性病和死亡率的风险因素 在患有OUD的老年人中；(2)检查工作人员和患者对 将老年护理模式纳入阿片类药物治疗方案；(3)开发和试点可行性， 以老年为基础的老年护理模式为老年疾病和慢性疾病管理提供服务 在R01上进行测试。这项提议与国家药物研究所的优先事项直接一致。 滥用药物战略规划工作组关于“药物使用障碍的复杂性和 物质使用问题“，以更好地了解复杂情况下个人的物质使用情况。 这项研究将为广泛整合基于证据的老年病模型制定未来的研究议程。 将慢性病评估和管理纳入现有的药物使用治疗方案。 好了！

! 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. !