Scope and impact of methadone take-home and telehealth practice changes during the COVID-19 pandemic
COVID-19 大流行期间美沙酮带回家和远程医疗实践变化的范围和影响
基本信息
- 批准号:10539988
- 负责人:
- 金额:$ 53.78万
- 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:2022-09-30 至 2026-06-30
- 项目状态:未结题
- 来源:
- 关键词:AdherenceAdministratorAdmission activityAffectAreaBehavioralCOVID-19COVID-19 pandemicCenters for Disease Control and Prevention (U.S.)Cessation of lifeClinicClinicalCoronavirusCounselingCrowdingDataDeath RecordsDecision MakingDoseDropoutDrug usageEthnic OriginFrequenciesGoalsHealth BenefitHealth ServicesHealth Services AccessibilityHealthcare SystemsHomeIndividualInterruptionLinkMedicineMethadoneMethodsModelingMonitorOpioidOutcomeOutpatientsOverdosePainPatient CarePatient MonitoringPatient-Focused OutcomesPatientsPersonsPharmaceutical PreparationsPoliciesPopulationPositioning AttributeProviderPublic HealthRaceRegulationRelapseResearchRiskSeriesShapesStructureSystemTimeTravelUnited States Substance Abuse and Mental Health Services Administrationadvanced analyticsanalytical methodbehavioral healthcare deliverycare seekingcombatcoronavirus diseasedrug testingeffective therapyhealth equityindexingmethadone treatmentmodels and simulationmortalitynovelopiate toleranceopioid mortalityopioid overdoseopioid treatment programopioid use disorderoverdose deathoverdose riskpost-COVID-19predictive modelingprematurepublic health emergencyresponseservice deliverysextelehealthtransmission processtreatment responsetrendwillingness
项目摘要
Abstract
Methadone is an effective treatment for opioid use disorder (OUD) that is delivered in the U.S. through
specialized Opioid Treatment Programs (OTPs). Since the inception of the OTP system many decades ago,
federal regulations have required frequent clinic attendance to monitor patients’ response to treatment and
reduce the risks of methadone diversion. Patients can only ‘earn’ take-home methadone after significant time
in treatment while demonstrating rigid standards for adherence and stability. However, these classic
regulations are not grounded in strong empirical evidence.
The COVID-19 pandemic transformed service delivery practices at OTPs. To reduce crowding in clinics,
SAMHSA regulators swiftly issued regulatory exemptions that gave OTPs unprecedented discretion to provide
take-home methadone doses and deliver counseling via telehealth. OTPs were suddenly permitted to dispense
up to 14 days of take-home methadone for ‘less stable’ patients, and 28 days for ‘stable’ patients. More
recently, SAMHSA reaffirmed the regulatory exemptions and announced intentions to pursue permanent
regulatory reform for OTPs. However, research is needed to examine the scope and impact of these major
changes to care delivery.
This study will (1) characterize practice changes at OTPs following the COVID-19 pandemic and the issuance
of regulatory exemptions, (2) Examine the relationship of two major practice changes (expanded take-home
methadone and telehealth practices) and patient outcomes, (3) develop a prediction model to inform decision-
making about when patients can safely receive take-homes without increasing risk of negative outcomes, and
(4) examine the relationship between expanded take-home methadone and methadone overdose deaths at a
population level.
The study will use clinical and administrative data from BayMark Health Services, the largest provider of
outpatient OUD treatment in the U.S., with 100 OTPs in 23 states. Advanced analytical methods will be applied
to answer the research questions, including multilevel generalized linear mixed modeling, predictive modeling
and simulation methods, and interrupted time series. All analyses will consider behavioral health equity and
examine disparities with respect to patients’ sex, race, and ethnicity.
This study will provide critical data for regulators, OTP administrators, and practitioners. It will yield highly
novel data to support evidence-driven regulatory reform, and could shape methadone treatment delivery over
the next decade and beyond. The COVID-19 pandemic and associated federal exemptions offer an
unprecedented opportunity to evaluate long-held assumptions about how methadone treatment should be
structured to maximize its benefits while safeguarding patients and the public from unintended harm.
摘要
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)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Jan Gryczynski其他文献
Jan Gryczynski的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Jan Gryczynski', 18)}}的其他基金
Scope and impact of methadone take-home and telehealth practice changes during the COVID-19 pandemic
COVID-19 大流行期间美沙酮带回家和远程医疗实践变化的范围和影响
- 批准号:
10705259 - 财政年份:2022
- 资助金额:
$ 53.78万 - 项目类别:
Opioid Use Disorder Treatment Linkage at STD Clinics using Buprenorphine (OUTLAST-B)
在 STD 诊所使用丁丙诺啡治疗阿片类药物使用障碍治疗联动 (OUTLAST-B)
- 批准号:
9905496 - 财政年份:2019
- 资助金额:
$ 53.78万 - 项目类别:
Opioid Use Disorder Treatment Linkage at STD Clinics using Buprenorphine (OUTLAST-B)
在 STD 诊所使用丁丙诺啡治疗阿片类药物使用障碍治疗联动 (OUTLAST-B)
- 批准号:
10348119 - 财政年份:2019
- 资助金额:
$ 53.78万 - 项目类别:
People Preferring Fentanyl (PPF): Characteristics, Outcomes, and Perspectives
人们偏好芬太尼 (PPF):特征、结果和前景
- 批准号:
9973245 - 财政年份:2019
- 资助金额:
$ 53.78万 - 项目类别:
Navigation Services to Avoid Rehospitalization (NavSTAR) among substance abusers
为药物滥用者提供避免再住院的导航服务 (NavSTAR)
- 批准号:
9220776 - 财政年份:2015
- 资助金额:
$ 53.78万 - 项目类别:
A randomized clinical trial of SBIRT services in school-based health centers
学校健康中心 SBIRT 服务的随机临床试验
- 批准号:
9262891 - 财政年份:2014
- 资助金额:
$ 53.78万 - 项目类别:
A randomized clinical trial of SBIRT services in school-based health centers
学校健康中心 SBIRT 服务的随机临床试验
- 批准号:
8845183 - 财政年份:2014
- 资助金额:
$ 53.78万 - 项目类别:
相似海外基金
EAGER: Toward a Decentralized Cross-administrator Zone Management System: Policy and Technology
EAGER:走向去中心化的跨管理员区域管理系统:政策和技术
- 批准号:
2331936 - 财政年份:2023
- 资助金额:
$ 53.78万 - 项目类别:
Standard Grant
COLLABORATIVE RESEARCH: Social Influence in Eyewitness Identification Procedures: Do Blind Administrator Behaviors Magnify the Effects of Suspect Bias?
合作研究:目击者识别程序中的社会影响:盲目的管理员行为是否会放大嫌疑人偏见的影响?
- 批准号:
2043230 - 财政年份:2021
- 资助金额:
$ 53.78万 - 项目类别:
Continuing Grant
COLLABORATIVE RESEARCH: Social Influence in Eyewitness Identification Procedures: Do Blind Administrator Behaviors Magnify the Effects of Suspect Bias?
合作研究:目击者识别程序中的社会影响:盲目的管理员行为是否会放大嫌疑人偏见的影响?
- 批准号:
2043334 - 财政年份:2021
- 资助金额:
$ 53.78万 - 项目类别:
Continuing Grant
Making of the base for patient safety management skill of visiting nurse administrator by the web conference system
利用网络会议系统构建出诊护士管理者患者安全管理技能基础
- 批准号:
19K10768 - 财政年份:2019
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Development of the nursing administrator training program to improve leadership behavior focused on emotional intelligence
制定护理管理人员培训计划,以改善以情商为重点的领导行为
- 批准号:
18K17464 - 财政年份:2018
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Early-Career Scientists
Automated Network Management that Dynamically Reflects Administrator Intent
动态反映管理员意图的自动化网络管理
- 批准号:
18K18038 - 财政年份:2018
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Early-Career Scientists
Administrator support perceived as useful for professional growth by novice psychiatric home-visit nursing staff
新手精神科家访护理人员认为管理员支持对专业成长有用
- 批准号:
17H07005 - 财政年份:2017
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Research Activity Start-up
The Facts and Problems on Management of Public Museums: Validation of Designated Administrator System
公共博物馆管理的事实与问题:指定管理员制度的验证
- 批准号:
17K01212 - 财政年份:2017
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
A Study on Transformation of the School Administrator Preparation and Evaluation System in the United States
美国学校管理人员培养与评价体系转型研究
- 批准号:
26780449 - 财政年份:2014
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Young Scientists (B)
The Family Court's Supervision of Property Administrator
家庭法院对财产管理人的监督
- 批准号:
26380108 - 财政年份:2014
- 资助金额:
$ 53.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)














{{item.name}}会员




