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

项目总结： 阿片使用障碍(OUD)的风险通常始于青春期和青春期。吸引和留住 青少年和青壮年(统称为“青春期”)在早期、有效的治疗对改善是至关重要的 上瘾的生活轨迹。适用于接受OUD、办公室阿片类药物治疗(OBOT)的成年人 协作式护理方法优化了患者在护理中的参与度和保留率。这种方法结合了 医生访问、护士护理管理和行为治疗。协作式护理OBOT特别 对于年轻人来说很有希望，他们可以在同样熟悉的情况下从值得信赖的初级保健提供者那里接受治疗 在这种情况下，他们会得到他们通常的医疗护理。然而，到目前为止，OBOT还没有正式改编为 治疗年轻人。该项目的中心目标是开发和试验OBOT模型，该模型针对 这在发展上是适当的，也是以家庭为中心的。该项目包括：(1)分析 马萨诸塞州公共卫生部数据，以衡量年轻人的治疗模式和结果 OUD，从而识别在治疗期间失去随访和药物使用复发的高风险时期；(2) 对青年、照顾者和关键信息提供者(如经验丰富的OBOT提供者和 在艾滋病高发地区为青年提供初级保健服务)，以确定对 青年OBOT模型；以及(3)青年OBOT增强型单臂适应性先导研究，使用 实施和完善科学技术，优化干预措施。首席调查员， 哈德兰医生是一名职业生涯早期的临床医生兼研究员，拥有普通儿科三板认证， 青春期医学和成瘾医学，以及在临床流行病学方面的研究经验。有了这个 项目，他寻求提高自己在介入研究方面的技能，专注于发展分析技能 高级生存分析和相关数据的使用，在干预中获取基础知识 发展，并使用实施和改进科学方法论来优化干预 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，在成瘾医学和研究方面处于全国领先地位。这个 该项目由具有高级专业知识的跨学科指导和咨询团队提供支持 生物统计分析、定性研究、干预发展、发展心理学和 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.