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

项目概要/摘要： 本申请是根据NOT-DA-21-044：支持的行政补充材料提交的 NIDA资助的补助金中的健康公平性研究。母公司K23奖旨在改善交付 协调慢性病管理的老年人与物质使用障碍谁接受照顾， 戒毒治疗机构。衰老和物质使用障碍的复合耻辱使老年人 阿片类药物使用障碍（OUD）具有多种慢性疾病的高风险，老年疾病， 临床护理和高急性护理利用率。然而，这些结果并没有在所有人中得到同等的体验。 考虑到终生遭受歧视、种族主义和护理障碍的经历，患有OUD的老年人。 此外，将基于老年人的干预措施纳入药物使用治疗环境，这是 父母K23的发展，必须考虑不同的老年人与OUD的语言和文化背景。 这份行政补充材料提出了一项混合方法的研究，以提高对 老年人面临的健康差距与OUD。从拟议的研究中获得的信息将更好地 采取知情的干预措施，在这一多样化的人口中实现健康公平。本研究的第一部分将涉及 使用来自加州全州卫生规划和发展办公室的非公开数据集 （OSHPD）定量测量高利用率的患病率和风险因素的差异， 按种族划分的OUD老年人的急性医疗保健、高医疗费用和多种慢性疾病 种族（目标1）。在目标1和国家少数民族健康和健康差异研究所的指导下， 研究框架，我们将增加计划入组的家长K23定性研究的重点 特别是对西班牙语的老年人与OUD谁确定为西班牙裔/拉丁裔。质性研究 将研究背景的障碍，态度，接受，以及整合老年和慢性病的可行性 治疗OUD的护理疾病模型，以及这与非西班牙语人群的不同之处， 阿片类药物治疗计划（目标2）。本补编的调查结果将为广泛整合 老年慢性病评估和管理的循证干预措施， 物质使用治疗计划，为不同的老年人与OUD。

Project Summary/Abstract: This application is being submitted in response to NOT-DA-21-044: Administrative Supplements to Support Research on Health Equity in NIDA-funded Grant Awards. The parent K23 award seeks to improve the delivery of coordinated chronic disease management for older adults with substance use disorder who receive care in addiction treatment settings. The compound stigma of aging and substance use disorder places older adults with opioid use disorder (OUD) at high risk for multiple chronic diseases, geriatric conditions, disorganized clinical care, and high acute care utilization. However, these outcomes are not experienced equally among older adults with OUD, given the lifelong experience of discrimination, racism, and barriers to care. Furthermore, delivering geriatric-based interventions into substance use treatment settings, which is the goal of the parent K23 to develop, must consider the language and cultural contexts of diverse older adults with OUD. This administrative supplement proposes a mixed methods research study to improve the understanding of the health disparities faced by older adults with OUD. The information gained from the proposed study will better inform interventions to achieve health equity in this diverse population. The first part of this study will involve the use of non-public datasets from the California Office of Statewide Health Planning and Development (OSHPD) to quantitatively measure the differences in the prevalence of and risk factors for high utilization of acute healthcare, high medical costs, and multiple chronic conditions among older adults with OUD by race and ethnicity (Aim 1). Guided by Aim 1 and The National Institute on Minority Health and Health Disparities Research Framework, we will increase the planned enrollment of the parent K23 qualitative study to focus specifically on Spanish-speaking older adults with OUD who identify as Hispanic/Latinx. This qualitative study will examine the contextual barriers, attitudes, acceptance, and feasibility of integrating geriatric and chronic disease models of care with treatment for OUD and how this differs from non-Spanish speaking populations in opioid treatment programs (Aim 2). Findings from this supplement will inform efforts to widely integrate evidence-based interventions of geriatric-based chronic disease assessment and management into existing substance use treatment programs for diverse older adults with OUD.