CTN-0121: Integrated Care and Treatment for Severe Infectious Diseases and Substance Use Disorders among Hospitalized Patients

项目摘要/摘要 这是NIDA的CTN佛罗里达节点联盟(FNA)21-25年的申请。联邦航空管理局覆盖了佛罗里达州， 佐治亚州和波多黎各，美国的一些地区，这些地区继续遭受药物过量的高比率和 阿片类药物、可卡因和甲基苯丙胺不断流行。这些地区有未得到满足的治疗需求， 在实施循证治疗方面存在差异。FNA的目标是在我们的 在医疗保健环境中领导和实施试验并将物质使用整合到 医疗保健的主流。我们建议将FNA在青少年方面的丰富专业知识带到CTN 治疗，药物使用人群中艾滋病毒和丙型肝炎的持续护理，精神健康并存，e- 卫生、数据科学、文化科学、卫生经济学、培训、实施/传播和工作 有西班牙裔人口。FNA的研究议程将提供科学领导，以开发、测试和 对青少年和成人的所有物质使用实施干预措施，并制定战略 将SU预防/筛查/治疗服务纳入主流青少年和成人保健服务。 FNA还旨在应用我们在实施科学、数据科学和电子健康使用方面的专业知识 记录(EHR)通过以下方式促进建立在精准医疗原则基础上的学习医疗系统 实施和改进方法以预测个体对治疗的反应。建立在…的基础上 双向协作，FNA建议制定、测试和实施干预措施，以解决 在FNA的临床和研究网络中提供服务的连续体。这些网络由SUD组成 治疗和一般医疗环境、卫生系统、临床研究网络和以实践为基础 研究网络。为了实现其目标，FNA正在提出一项创新的概念研究议程，这些概念 (1)将儿科护理中的行为健康和以家庭为重点的干预措施与电子技术的使用结合起来， (2)在医院环境中提供共病SU和艾滋病毒的综合护理模式；(3)解决 精神健康和兴奋剂使用的并存，(4)使用电子健康记录、登记和环境数据来改善 治疗的精确度，以及(5)利用背景和文化来改善治疗结果。FNA提议 与其他节点协作设计和实施CTN试验，并通过提供 成功执行研究所需的基础设施和能力。FNA网络合作伙伴拥有 具有进行护理点试验和研究的经验，这些试验和研究利用电子病历和 索赔数据。迈阿密大学CTSI、佛罗里达大学CTSI和佐治亚州CTSA将为 CTN是CTSA国家联盟的生物信息学工具。这些CTSA与 FNA，促进在众多环境中接触到1600多万患者的多样化患者群体 作为初级保健、急诊室、医院、FQHC、校本诊所、SUD治疗和减少伤害的场所。

PROJECT SUMMARY/ABSTRACT This is an application for years 21-25 of NIDA’s CTN Florida Node Alliance (FNA). The FNA covers Florida, Georgia and Puerto Rico, areas of the US that continue to suffer from high rates of drug overdoses and unceasing opioid, cocaine and methamphetamine epidemics. These areas have unmet treatment needs and experience disparities in the implementation of evidence-based treatments. The FNA aims to build on our record of success in leading and implementing trials in healthcare settings and integrating substance use into mainstream of healthcare. We propose to bring to the CTN the FNA’s considerable expertise in adolescent treatment, the HIV and HCV care continua in substance-using populations, mental health comorbidities, e- Health, data science, culturalized science, health economics, training, implementation/dissemination, and work with Hispanic populations. The FNA’s research agenda will provide scientific leadership to develop, test, and implement interventions for the full spectrum of substance use in adolescents and adults, and strategies for the integration of SU prevention/screening/treatment services into mainstream adolescent and adult health care. The FNA also aims to apply our expertise in implementation science, data science, and use of electronic health records (EHRs) to promote learning health care systems that build on precision medicine principles by implementing and refining methods to predict individual response to treatment. Building on a foundation of bidirectional collaboration, the FNA proposes to develop, test and implement interventions that address the service delivery continuum in the FNA’s clinical and research networks. These networks consist of SUD treatment and general medical settings, health systems, clinical research networks, and practice-based research networks. To achieve its aims, the FNA is proposing an innovative research agenda of concepts that (1) integrate behavioral health and family focused interventions in pediatric care with the use of e-technologies, (2) deliver integrative models of care for comorbid SU and HIV in hospital settings, (3) address the comorbidities of mental health and stimulant use, (4) use EHR, registry and environmental data to improve treatment precision, and (5) use context and culture to improve treatment outcomes. The FNA proposes to collaborate with other Nodes on the design and implementation of CTN trials and by providing the infrastructure and capabilities required for successful study execution. FNA network partners have demonstrated experience in conducting point of care trials and studies that leverage the use of EHR and claims data. The University of Miami CTSI, University of Florida CTSI, and the Georgia CTSA, will bring to the CTN the bioinformatics tools of the CTSA National Consortium. These CTSAs together with partners of the FNA, facilitate access to a diverse patient population of 16+ million patients across a numerous settings such as primary care, EDs, hospitals, FQHCs, school-based clinics, SUD treatment and harm reduction venues.