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

项目摘要/摘要： 本申请是针对NOT-DA-21-044：行政补充支持提交的 NIDA资助奖助金中的健康公平性研究。家长K23奖旨在改善交付 为患有药物使用障碍的老年人提供协调的慢性病管理，这些老年人在 成瘾治疗设置。衰老和药物使用障碍的复合耻辱将老年人置于 阿片类药物使用障碍(OUD)有多种慢性病、老年病的高风险，组织混乱 临床护理，急诊护理利用率高。然而，这些结果在不同的人群中并不相同 由于终生遭受歧视、种族主义和护理障碍，老年人患有OUD。 此外，在物质使用治疗环境中提供以老年为基础的干预措施，这是 家长K23的制定，必须考虑到不同的语言和文化背景下的老年人与OUD。 这份行政副刊提出了一种混合方法的研究，以提高对 患有自闭症的老年人面临的健康差距。从拟议的研究中获得的信息将会更好 告知干预措施，以实现这一多样化人口的健康公平。本研究的第一部分将涉及 加州全州卫生规划和发展办公室的非公开数据集的使用 (OSHPD)，以定量衡量高使用率的患病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疾病在不同种族的OUD老年人中 和族裔(目标1)。由Aim 1和国家少数民族健康和健康差距研究所指导 研究框架，我们将加大计划招生家长K23定性学习的重点 特别是说西班牙语的老年人，他们认为自己是西班牙裔/拉丁裔。这项定性研究 将研究整合老年病和慢性病的背景障碍、态度、接受度和可行性 治疗OUD的疾病模式及其与非西班牙语人群在以下方面的不同 阿片类药物治疗方案(目标2)。本副刊的调查结果将为广泛整合 对现有老年慢性病评估和管理的循证干预 物质使用治疗方案，适用于不同年龄的OUD老年人。

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.