Collaborative Care Office-Based Opioid Treatment for Adolescents and Young Adults

项目概要： 阿片类药物使用障碍（OUD）的风险通常始于青春期和青年期。接合和保持 青少年和青壮年（统称“青年”）在早期，有效的治疗是至关重要的，以改善 成瘾的生命轨迹对于患有OUD的成人，基于办公室的阿片类药物治疗（OBOT）， 协作式护理方法优化了患者参与和保留护理。这种方法结合了 医生访问，护士护理管理和行为治疗。协作护理OBOT特别是 年轻人有希望，他们可以在熟悉的环境中接受值得信赖的初级保健提供者的治疗， 让他们接受常规的医疗护理。然而，迄今为止，OBOT尚未正式适应 对待青春该项目的中心目标是开发和试点一种OBOT模式， 这是一个适合发展和以家庭为中心的概念。该项目包括：（1）分析 马萨诸塞州公共卫生部的数据，以衡量青少年的治疗模式和结果 OUD，从而确定治疗期间失访和药物使用复发的高风险期;（2） 对青年、看护人和关键知情人（如经验丰富的OBOT提供者和 青少年的初级保健提供者在高OUD患病率的地区），以确定必要的修改， 青年OBOT模型;（3）青年OBOT增强单臂适应性试点研究，使用 实施和改进科学技术，以优化干预。主要研究者， 博士哈德兰，是一个早期的职业临床研究员与三重认证的普通儿科， 青少年医学和成瘾医学，以及先前在临床流行病学方面的研究经验。与此 项目，他寻求提高他在介入研究的技能，重点是发展分析技能， 先进的生存分析和相关数据的使用，获得干预的基础知识 开发，并使用实施和改进科学方法来优化干预措施 最初是为成年人设计的，供年轻人使用。哈德兰博士将在波士顿医疗中心进行这项研究。 中心和波士顿大学医学院，在成瘾医学和研究的国家领导人。的 该项目由一个跨学科的导师和咨询团队提供支持，他们拥有先进的专业知识， 生物统计分析，定性研究，干预发展，发展心理学， 实施和改进科学。

PROJECT SUMMARY: Risk for opioid use disorder (OUD) often begins in adolescence and young adulthood. Engaging and retaining adolescents and young adults (collectively, “youth”) in early, effective treatment to is critical in order to improve the life course trajectory of addiction. For adults with OUD, office-based opioid treatment (OBOT) with a collaborative care approach optimizes patient engagement and retention in care. This approach combines physician visits, nurse care management, and behavioral therapy. Collaborative care OBOT is especially promising for youth, who can receive treatment from a trusted primary care provider in the same familiar setting they receive their usual medical care. To date, however, OBOT has not been formally adapted for treating youth. The central objective of this project is to develop and pilot an OBOT model that is enhanced for youth and that is developmentally appropriate and family-centered. The project includes: (1) an analysis of Massachusetts Department of Public Health data to measure treatment patterns and outcomes among youth with OUD, thus identifying periods of high risk for loss to follow-up and drug use relapse during treatment; (2) qualitative interviews with youth, caretakers, and key informants (such as experienced OBOT providers and primary care providers of youth in areas of high OUD prevalence) to determine necessary modifications to the OBOT model for youth; and (3) a single-arm adaptive pilot study of OBOT enhanced for youth, using implementation and improvement science techniques to optimize the intervention. The Principal Investigator, Dr. Hadland, is an early career clinician-investigator with triple board certification in General Pediatrics, Adolescent Medicine, and Addiction Medicine, and prior research experience in clinical epidemiology. With this project, he seeks to enhance his skills in interventional research, focusing on developing analytic skills in advanced survival analysis and use of correlated data, acquiring foundational knowledge in intervention development, and using implementation and improvement science methodology to optimize an intervention initially designed for adults for use among youth. Dr. Hadland will conduct this research at Boston Medical Center and Boston University School of Medicine, national leaders in addiction medicine and research. The project is supported by an interdisciplinary mentorship and advisory team with expertise in advanced biostatistical analysis, qualitative research, intervention development, developmental psychology, and implementation and improvement science.