Diagnosing and Treating Veterans with Chronic Pain and Opioid Misuse

诊断和治疗患有慢性疼痛和阿片类药物滥用的退伍军人

基本信息

  • 批准号:
    10595496
  • 负责人:
  • 金额:
    --
  • 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:
    2022-01-01 至 2025-12-31
  • 项目状态:
    未结题

项目摘要

Background: As many as 30% of the ~10 million Americans prescribed long-term opioid therapy (LTOT) are estimated to misuse opioids. Receiving LTOT is associated with opioid-related harms, and misuse leads to an increase in the dose consumed and other risky behavior, further worsening outcomes. However, there is a gap in knowledge on how to identify and treat this patient population particularly when they do not meet diagnostic criteria to be treated by medications for Opioid Use Disorder (OUD). In recent years, guidelines from the Centers for Disease Control and the Veterans Health Administration (VHA) have effected widespread tapering to reduce misuse. Buprenorphine, a medication used for both pain and OUD, may also be effective in reducing opioid-related harms while controlling pain for patients on LTOT with misuse; however, buprenorphine is yet to be tested rigorously in this patient population. Therefore, studies are needed to identify patients on LTOT with misuse and to compare the efficacy of different treatments on patient outcomes. Significance: Chronic pain, LTOT for pain, and opioid misuse are common among Veterans and lead to multiple health-related harms. The VHA has made improving pain care and reducing opioid harms a major priority of clinical initiatives, and this proposal responds to the Health Services Research and Development (HSR&D) Funding Announcement #HX-21-024 to address those opioid-related priorities. By filling a crucial evidence gap, this proposal will significantly impact the way we treat pain and minimize harm for Veterans with opioid misuse. Innovation and Impact: This proposal is innovative and impactful in many ways. First, this project will utilize the unique capabilities of the VHA’s Corporate Data Warehouse (CDW) to develop a novel algorithm to identify patients on LTOT with misuse. If successful, this automated identification process has the potential to be scaled to VHA sites across the country. Second, the comparative effectiveness of different treatments will be determined by an emulated trial, an innovative and efficient study design that can lead to greater generalizability than standard trials, which suffer significantly from selection bias in this area. The treatments being evaluated in the emulated trial are readily available, so if specific treatments are found to improve patient symptoms and reduce adverse outcomes, it will be feasible for Veterans with opioid misuse to access these treatments nationwide. Finally, we will gather feedback from providers and Veterans to understand the best strategies and interventions to scale the identification process and better inform Veterans and providers of evidence-based treatment options. Specific Aims: This project aims to 1) Classify a cohort of patients on LTOT with opioid misuse but without OUD by a) building on a previously developed augmented chart review methodology and b) applying an algorithm to structured data; 2) Conduct an emulated trial to compare the effectiveness of pharmacologic treatment options on patient-centered and patient safety outcomes; and 3) Understand current practices and how to translate our findings into improved care via semi-structured interviews with providers and Veterans. Methodology: The study population is VHA patients on LTOT with opioid misuse 2014-present. The proposal uses mixed quantitative and qualitative methods including augmented structured chart review, large dataset classification using ordinal elastic net regression, emulated trials, and qualitative interviews. Next Steps/Implementation: We expect findings to be of use to VHA leaders, prescribing clinicians, and patients with chronic pain. If successful, the automated identification process from Aim 1 could be scaled to VHA sites, and if treatments evaluated in Aim 2 are effective in improving symptoms and reducing adverse outcomes, these could also be implemented widely. In Aim 3, we will gather Veteran input on how to best implement findings from Aims 1 and Aim 2 into clinical practice in a variety of settings.
背景:在约1000万美国人的长期阿片类药物治疗(LTOT)中,有多达30%的人服用了阿片类药物

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 }}

Amy S B Bohnert其他文献

Amy S B Bohnert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('Amy S B Bohnert', 18)}}的其他基金

Mobile Technology to Optimize Depression Treatment
移动技术优化抑郁症治疗
  • 批准号:
    10563279
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Mobile Technology to Optimize Depression Treatment
移动技术优化抑郁症治疗
  • 批准号:
    10700120
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Diagnosing and Treating Veterans with Chronic Pain and Opioid Misuse
诊断和治疗患有慢性疼痛和阿片类药物滥用的退伍军人
  • 批准号:
    10313694
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Reducing Non-Medical Opioid Use: An automatically adaptive mHealth Intervention
减少非医疗阿片类药物的使用:自动适应的移动医疗干预措施
  • 批准号:
    9416993
  • 财政年份:
    2016
  • 资助金额:
    --
  • 项目类别:
Primary care intervention to reduce prescription opioid overdoses
初级保健干预减少处方阿片类药物过量
  • 批准号:
    10027245
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
Primary care intervention to reduce prescription opioid overdoses
初级保健干预减少处方阿片类药物过量
  • 批准号:
    10162313
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
Primary care intervention to reduce prescription opioid overdoses
初级保健干预减少处方阿片类药物过量
  • 批准号:
    10165792
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
Primary care intervention to reduce prescription opioid overdoses
初级保健干预减少处方阿片类药物过量
  • 批准号:
    9145508
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
Developing a Prescription Opioid Overdose Prevention Intervention
制定处方阿片类药物过量预防干预措施
  • 批准号:
    8636645
  • 财政年份:
    2014
  • 资助金额:
    --
  • 项目类别:
Developing a Prescription Opioid Overdose Prevention Intervention
制定处方阿片类药物过量预防干预措施
  • 批准号:
    8811923
  • 财政年份:
    2014
  • 资助金额:
    --
  • 项目类别:

相似海外基金

RII Track-4:NSF: From the Ground Up to the Air Above Coastal Dunes: How Groundwater and Evaporation Affect the Mechanism of Wind Erosion
RII Track-4:NSF:从地面到沿海沙丘上方的空气:地下水和蒸发如何影响风蚀机制
  • 批准号:
    2327346
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Standard Grant
BRC-BIO: Establishing Astrangia poculata as a study system to understand how multi-partner symbiotic interactions affect pathogen response in cnidarians
BRC-BIO:建立 Astrangia poculata 作为研究系统,以了解多伙伴共生相互作用如何影响刺胞动物的病原体反应
  • 批准号:
    2312555
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Standard Grant
How Does Particle Material Properties Insoluble and Partially Soluble Affect Sensory Perception Of Fat based Products
不溶性和部分可溶的颗粒材料特性如何影响脂肪基产品的感官知觉
  • 批准号:
    BB/Z514391/1
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Training Grant
Graduating in Austerity: Do Welfare Cuts Affect the Career Path of University Students?
紧缩毕业:福利削减会影响大学生的职业道路吗?
  • 批准号:
    ES/Z502595/1
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Fellowship
Insecure lives and the policy disconnect: How multiple insecurities affect Levelling Up and what joined-up policy can do to help
不安全的生活和政策脱节:多种不安全因素如何影响升级以及联合政策可以提供哪些帮助
  • 批准号:
    ES/Z000149/1
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Research Grant
感性個人差指標 Affect-X の構築とビスポークAIサービスの基盤確立
建立个人敏感度指数 Affect-X 并为定制人工智能服务奠定基础
  • 批准号:
    23K24936
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Grant-in-Aid for Scientific Research (B)
How does metal binding affect the function of proteins targeted by a devastating pathogen of cereal crops?
金属结合如何影响谷类作物毁灭性病原体靶向的蛋白质的功能?
  • 批准号:
    2901648
  • 财政年份:
    2024
  • 资助金额:
    --
  • 项目类别:
    Studentship
ERI: Developing a Trust-supporting Design Framework with Affect for Human-AI Collaboration
ERI:开发一个支持信任的设计框架,影响人类与人工智能的协作
  • 批准号:
    2301846
  • 财政年份:
    2023
  • 资助金额:
    --
  • 项目类别:
    Standard Grant
Investigating how double-negative T cells affect anti-leukemic and GvHD-inducing activities of conventional T cells
研究双阴性 T 细胞如何影响传统 T 细胞的抗白血病和 GvHD 诱导活性
  • 批准号:
    488039
  • 财政年份:
    2023
  • 资助金额:
    --
  • 项目类别:
    Operating Grants
How motor impairments due to neurodegenerative diseases affect masticatory movements
神经退行性疾病引起的运动障碍如何影响咀嚼运动
  • 批准号:
    23K16076
  • 财政年份:
    2023
  • 资助金额:
    --
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了