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

患有阿片类药物使用障碍的老年人的慢性病和健康结果

• 批准号: 10440937
• 负责人: Benjamin Hyun Han
• 金额: $ 10.75万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-28 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10440937
• 关键词: 2019-nCoV; Acute; Address; Administrative Supplement; Adult; Affect; Aging; Attitude; Award; COVID-19 pandemic; California; Caring; Cessation of life; Chronic Disease; Complex; Comprehensive Health Care; County; Data; Data Set; Development; Discrimination; Disease Management; Disease model; Elderly; Enrollment; Ethnic Origin; Ethnic group; Evidence based intervention; Face; Funding; Goals; Grant; Health; Health Planning; Healthcare; Hispanics; Indigenous; Infrastructure; Institutes; Intervention; Interview; K-Series Research Career Programs; Knowledge; Language; Latinx; Lead; Left; Life Experience; Limited English Proficiency; Literature; Measures; Medical; Medical Care Costs; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Minority Groups; Modeling; National Institute of Drug Abuse; Older Population; Outcome; Overdose; Parents; Pharmaceutical Preparations; Plant Roots; Population; Population Heterogeneity; Prevalence; Race; Research; Research Methodology; Research Personnel; Research Support; Risk; Risk Factors; Services; Structural Racism; Substance Use Disorder; Time; United States; acute care; addiction; adverse outcome; barrier to care; base; bilingualism; career; chronic care model; clinical care; disparity reduction; ethnic minority population; evidence base; experience; falls; frailty; functional decline; health care service utilization; health disparity; health equity; health inequalities; health service use; high risk; hospitalization rates; implementation strategy; improved; marginalized population; minority health; multiple chronic conditions; opioid treatment program; opioid use disorder; overdose risk; racial and ethnic disparities; racial minority; racism; research study; response; social; social stigma; substance use; substance use treatment; success; treatment program

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.

项目摘要/摘要： 该申请正在响应于NOT-DA-21-044：行政补充以支持 NIDA资助的赠款奖中的健康公平研究。家长K23奖试图改善交货 为患有药物使用障碍的老年人协调的慢性疾病管理，并接受护理 成瘾治疗环境。衰老和药物使用障碍的复合污名老年人 患有多种慢性疾病，老年病毒的阿片类药物使用障碍（OUD）高风险 临床护理和高急性护理利用。但是，这些结果在 鉴于具有歧视，种族主义和护理障碍的终生经验的老年人。 此外，将基于老年医学的干预措施交付到药物使用治疗环境中，这是 父母K23要开发，必须考虑与Oud不同老年人的语言和文化背景。 这种行政补充提出了一项混合方法研究，以提高对 OUD老年人面临的健康差异。从拟议的研究中获得的信息将更好 告知干预措施以实现这一多样化人群的健康公平。这项研究的第一部分将涉及 使用加利福尼亚州全州健康计划与发展办公室的非公共数据集使用 （OSHPD）定量测量高利用率和风险因素的差异 急性医疗保健，高昂的医疗费用和多种慢性病的老年人OUD 和种族（目标1）。在AIM 1和国家少数民族健康与健康差异的指导下 研究框架，我们将增加父母K23定性研究的计划入学率 特别是讲西班牙语的老年人，他们认同为西班牙裔/拉丁裔。这项定性研究 将检查整合老年和慢性的上下文障碍，态度，接受和可行性 与OUD治疗的护理疾病模型以及这与非西班牙语人群有何不同 阿片类药物治疗计划（AIM 2）。该补充剂的发现将为广泛整合的努力提供信息 基于循证的基于老年病的慢性疾病评估和管理对现有的干预措施 毒品使用治疗计划，适用于各种OUD的老年人。