Developing and pilot testing a novel remotely delivered intensive outpatient program for individuals with opioid use disorder hospitalized with serious injection-related infections
为因严重注射相关感染而住院的阿片类药物使用障碍患者开发并试点测试一种新型远程密集门诊项目
基本信息
- 批准号:10510136
- 负责人:
- 金额:$ 18.51万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-08-01 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AbscessAbstinenceAddressAftercareAmbulatory CareAntibioticsBehavior TherapyBehavioral MechanismsBehavioral ModelBenchmarkingCOVID-19 pandemicConsultationsCoping SkillsDevelopmentEducational process of instructingEnrollmentEnsureEvaluationEvidence based treatmentFeedbackGoalsHospitalizationHospitalsHourIndividualInfectionInfective endocarditisInheritedInjectionsInpatientsInterruptionInterventionIntravenousLifeMedicalModificationNational Institute of Drug AbuseOperative Surgical ProceduresOsteomyelitisOutcomeOutpatientsParticipantPatientsPeriodicityPharmaceutical PreparationsPhasePilot ProjectsPublic HealthRecoveryResearchResidential TreatmentServicesSiteSpinalTestingTimeTrainingTreatment EfficacyUnited States National Institutes of Healthaddictionbehavior changecomorbiditydesigndisorder later incidence preventioneffective therapyefficacy trialexperiencefeasibility testingfeasibility trialhandheld mobile devicehigh riskillicit opioidimprovedinnovationmortalitynovelonline deliveryopioid useopioid use disorderoutpatient programspatient populationpeerpilot testprimary outcomeprogramspsychosocial wellbeingrecruitreduced substance useremote deliveryresponsesecondary outcometherapy developmenttooltreatment group
项目摘要
Project Summary Abstract
One of the devastating consequences of opioid use disorder (OUD) is the development of serious injection-
related infections, such as infective endocarditis, spinal abscesses, and osteomyelitis. Nationally,
hospitalizations for these life-threatening infections have doubled between 2008 and 2014. Even though
hospitals readily provide evidence-based treatments for these infections, the underlying OUD that caused the
infection in the first place often go unaddressed due to the lack of addiction treatment expertise in hospitals.
Therefore, addiction treatment for these patients is typically offered after discharge from the hospital. This delay
may represent a missed opportunity because patients with these serious infections require 6 weeks or more of
hospitalization to receive intravenous antibiotics. Intensive outpatient programs (IOPs) have robust empirical
support in reducing substance use and promoting abstinence, similar in impact to inpatient and residential
treatment. Unfortunately, conventional IOPs are ill-suited for hospitalized patients given the need to remain in
the hospital and the frequent interruptions inherit to the inpatient setting. However, research to develop and test
an IOP tailored for hospitalized OUD patients is entirely absent. To address this need, we will conduct a NIH
stage 1A/1B behavioral intervention development trial using a sequential exploratory design to adapt and pilot
test an online IOP program (“SmartIOP”) that allows intensive treatment to be remotely delivered using a mobile
device at a time that is most convenient for the patient. The program, when offered in the outpatient setting, is
completed over 6-12 weeks, consisting of asynchronous video modules and periodic live individual therapy
sessions. In the first phase (Stage 1A), SmartIOP will be adapted to the unique needs of hospitalized patients
by conducting a qualitative study of OUD patients who are currently hospitalized or have had a prior
hospitalization for serious injection-related infections to obtain feedback about the content and format of the
program. Recruitment will continue until thematic saturation is reached. Initial modifications will then be made,
the new program pilot tested, and further modifications made if necessary. Training materials and fidelity tools
to ensure the faithful administration of the intervention will be developed. In the second phase (Stage 1B), we
will conduct a pilot study to assess the intervention’s feasibility and preliminary efficacy with 10 OUD patients
hospitalized with serious infections. Feasibility will be determined by examining recruitment and program
completion according to a priori benchmarks. As an exploratory outcome, preliminary efficacy will be assessed
by examining OUD-related outcomes after discharge from the hospital including illicit opioid use and treatment
retention. Possible mechanisms of behavior change will also be assessed. The results of this study will help
inform the design of a Stage II or III efficacy trial. This line of research will remain relevant after the COVID-19
pandemic given the limited options of addiction treatment available to hospitalized OUD patients.
项目摘要
阿片类药物使用障碍(OUD)的破坏性后果之一是严重注射的发展-
相关感染,如感染性心内膜炎、脊髓脓肿和骨髓炎。在全国范围内,
2008年至2014年期间,因这些危及生命的感染而住院的人数增加了一倍。即使
医院很容易为这些感染提供循证治疗,导致这些感染的潜在OUD
首先,由于医院缺乏成瘾治疗专业知识,感染往往得不到解决。
因此,对这些患者的成瘾治疗通常在出院后提供。该延迟
这可能意味着错过了机会,因为这些严重感染的患者需要6周或更长时间的治疗。
住院接受静脉注射抗生素。强化门诊计划(IOPs)具有强大的经验
支持减少药物使用和促进禁欲,其影响与住院和住院患者相似
治疗不幸的是,传统的IOP不适合住院患者,因为需要保持在
医院和频繁的中断继承了住院设置。然而,研究开发和测试
完全没有为住院OUD患者定制的IOP。为了满足这一需求,我们将开展一项国家卫生研究院
阶段1A/1B行为干预开发试验,采用序贯探索性设计进行适应和试点
测试在线IOP程序(“SmartIOP”),其允许使用移动的
在对患者最方便的时间使用器械。该计划,当提供门诊设置,是
在6-12周内完成,包括异步视频模块和定期现场个人治疗
sessions.在第一阶段(第1A阶段),SmartIOP将适应住院患者的独特需求
通过对目前住院或既往有过OUD的患者进行定性研究,
严重注射相关感染的住院治疗,以获得有关
程序.征聘工作将继续进行,直至达到专题饱和。然后进行初步修改,
新的程序进行了试点测试,并在必要时进行进一步修改。培训材料和保真工具
以确保干预的忠实管理将得到发展。在第二阶段(第1B阶段),我们
我将进行一项试点研究,以评估干预的可行性和初步疗效与10个OUD患者
因严重感染住院。可行性将通过审查招聘和计划来确定
根据先验基准完成。作为探索性结局,将评估初步疗效
通过检查出院后OUD相关结局,包括非法阿片类药物使用和治疗
潴留还将评估行为改变的可能机制。这项研究的结果将有助于
为II期或III期疗效试验的设计提供信息。在COVID-19之后,这一研究方向仍将具有相关性
由于住院的OUD患者可获得的成瘾治疗选择有限,因此这是一种流行病。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Joji Suzuki其他文献
Joji Suzuki的其他文献
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{{ truncateString('Joji Suzuki', 18)}}的其他基金
Oral buprenorphine as a novel low-dose induction strategy for individuals with opioid use disorder
口服丁丙诺啡作为阿片类药物使用障碍患者的新型低剂量诱导策略
- 批准号:
10574877 - 财政年份:2023
- 资助金额:
$ 18.51万 - 项目类别:
Oral complications from sublingual buprenorphine treatment: A prospective cohort study
舌下含服丁丙诺啡治疗引起的口腔并发症:一项前瞻性队列研究
- 批准号:
10765272 - 财政年份:2023
- 资助金额:
$ 18.51万 - 项目类别:
Developing and pilot testing a novel remotely delivered intensive outpatient program for individuals with opioid use disorder hospitalized with serious injection-related infections
为因严重注射相关感染而住院的阿片类药物使用障碍患者开发并试点测试一种新型远程密集门诊项目
- 批准号:
10673880 - 财政年份:2022
- 资助金额:
$ 18.51万 - 项目类别:
Initiating substance use disorder treatment in hospitalized opioid use disorder patients
对住院阿片类药物使用障碍患者启动药物使用障碍治疗
- 批准号:
10224152 - 财政年份:2017
- 资助金额:
$ 18.51万 - 项目类别:
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