Improving Opioid Use Disorder Treatment for Hospitalized Patients with Endocarditis

改善心内膜炎住院患者的阿片类药物使用障碍治疗

• 批准号: 10478849
• 负责人: Rachel Elizabeth French
• 金额: $ 6.99万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10478849
• 关键词: Accident and Emergency department; Acute; Address; Antibiotics; Caring; Clinic; Collaborations; Communities; Data; Development; Dissemination and Implementation; Endocarditis; Evidence based treatment; Expert Opinion; Faculty; Fellowship; Foundations; Goals; Grant; Healthcare; Hospital Costs; Hospitalization; Hospitals; Individual; Infection; Infective endocarditis; Inpatients; Intervention; Interview; Intravenous; Knowledge; Left; Length of Stay; Medical; Medicine; Mentorship; Methods; Modeling; Morbidity - disease rate; Nurses; Outcome; Pain; Patient-Focused Outcomes; Patients; Pennsylvania; Perception; Persons; Physicians; Population; Preparation; Primary Health Care; Quality of Care; Recovery; Recurrence; Registered nurse; Research; Research Institute; Research Personnel; Scholarship; School Nursing; Social Workers; Specialist; Structure; Substance Use Disorder; Time; Training; Training Activity; Treatment Efficacy; United States; Universities; University Hospitals; Vulnerable Populations; Withdrawal; Work; Writing; base; care delivery; care outcomes; career; cost; design; economic evaluation; effective therapy; effectiveness implementation study; effectiveness implementation trial; efficacy testing; evidence base; high risk; hospital patient care; hospitalization rates; implementation framework; implementation science; implementation strategy; improved; improved outcome; injection drug use; inpatient service; model design; mortality; mortality risk; opioid epidemic; opioid injection; opioid use; opioid use disorder; patient engagement; patient oriented; programs; skills; treatment program

PROJECT SUMMARY/ABSTRACT Patients hospitalized for opioid use disorder-associated infective endocarditis (OUD-IE) have distinctly poor outcomes and high costs. Despite the availably of effective treatment for opioid use disorder and the opportunity to intervene during hospitalization, health care staff tend not to address opioid use disorder during hospitalization for OUD-IE. Existing models of hospital care for patients with opioid use disorder can inform hospital care delivery for OUD-IE patients, though significant adaptation of these models is needed to meet the unique needs of OUD- IE patients related to their prolonged hospital stays. Little is known regarding how to best deploy evidence-based opioid use disorder interventions for medically hospitalized patients. The aims of the proposed study are to: 1) Characterize current practices of health care staff regarding hospital care delivery for OUD-IE patients; 2) Examine the appropriateness, feasibility, and acceptability of implementing evidence-based opioid use disorder care for hospitalized OUD-IE patients; and 3) Adapt an intervention for hospitalized OUD-IE patients and develop a corresponding toolkit of implementation strategies. To accomplish these aims, I will engage health care staff who care for OUD-IE patients at the Hospital of the University of Pennsylvania and will rely on mentorship and collaborators from faculty in the University of Pennsylvania's Schools of Nursing and Medicine. Qualitative data, in conjunction with expert opinion, will be integrated to inform an adapted opioid use disorder intervention for OUD-IE patients and a corresponding toolkit of implementation strategies. Findings from this study will increase the currently limited efficacy of care delivery for hospitalized patients with opioid use disorder and ultimately enhance their outcomes. This program of research and corresponding training activities will facilitate the applicant's long-term goal of pursuing an academic research career committed to improving the quality of care and outcomes for hospitalized people with substance use disorders through implementation science. Specific training goals are to: 1) Understand current practices for care delivery for hospitalized patients with OUD; 2) Acquire a strong foundation in methods for the proposed project and for future research; 3) Develop skills related to designing and implementing new practices in hospitals; and 4) Integrate professional development, grant writing, and scholarship to prepare to be an independent researcher.

项目摘要/摘要 因阿片类药物使用障碍相关感染性心内膜炎(OUD-IE)住院的患者明显较差 结果和高昂的成本。尽管有效治疗阿片类药物使用障碍的有效方法和机会 为了在住院期间进行干预，卫生保健人员往往不会在住院期间解决阿片类药物使用障碍 用于OUD-IE。现有的阿片类药物使用障碍患者的医院护理模式可以为医院的护理提供信息 对于OUD-IE患者，尽管需要对这些模型进行重大调整，以满足OUD-IE的独特需求。 IE患者与其长时间住院有关。关于如何最好地部署循证证据，人们知之甚少 对内科住院患者的阿片类药物使用障碍干预。拟议研究的目的是：1) 描述卫生保健人员目前在为OUD-IE患者提供医院护理方面的做法；2) 审查实施循证阿片类药物使用障碍的适当性、可行性和可接受性 对住院的OUD-IE患者进行护理；3)对住院的OUD-IE患者进行干预，并制定 一个相应的实施战略工具包。为了实现这些目标，我将聘请卫生保健人员 他们在宾夕法尼亚大学医院照顾OUD-IE患者，并将依靠导师和 来自宾夕法尼亚大学护理和医学院教职员工的合作者。定性数据， 将结合专家意见，为适应阿片类药物使用障碍的干预提供信息 OUD-IE患者及相应工具包的实施策略。这项研究的发现将会增加 目前对住院阿片类药物使用障碍患者的护理效果有限，并最终 提高他们的成果。这一研究计划和相应的培训活动将促进 申请者致力于改善护理质量的学术研究职业的长期目标 以及通过实施科学对有药物使用障碍的住院患者的结果。特定的 培训的目标是：1)了解目前为OUD住院患者提供护理服务的做法；2) 为计划中的项目和未来的研究打下坚实的方法基础；3)培养相关技能 在医院设计和实施新的做法；以及4)整合专业发展，资助 写作和奖学金，为成为一名独立研究人员做准备。