Advancing Treatment Outcomes for Pregnant Women with Opioid Use Disorder

改善患有阿片类药物使用障碍的孕妇的治疗效果

• 批准号: 10594948
• 负责人: Ashley A Leech
• 金额: $ 17.23万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10594948
• 关键词: Address; Advisory Committees; Affect; Age; Award; Birth; Budgets; Buprenorphine; Calibration; Career Mobility; Caring; Characteristics; Child; Clinical; Clinical Trials; Consumption; Cost Effectiveness Analysis; Decision Analysis; Decision Making; Doctor of Philosophy; Drug Withdrawal Symptoms; Environment; Expenditure; Exposure to; Family; Frequencies; Funding; Future; Geography; Goals; Grant; Guidelines; Health; Health Benefit; Health Care Sector; Health Policy; Health Resources; Health Services; Health Services Accessibility; Health system; Healthcare; Healthcare Systems; Hospitalization; Implant; Improve Access; Infant; Infant Health; Injectable; Intervention; Leeches; Link; Maternal Exposure; Maternal Health; Maternal and Child Health; Mathematical Model Simulation; Measures; Medical; Mentors; Mentorship; Methadone; Methodology; Methods; Modeling; Naltrexone; Neonatal; Neonatal Abstinence Syndrome; Operations Research; Opioid; Opioid agonist; Outcome; Patients; Pattern; Personal Satisfaction; Pharmacotherapy; Policies; Policy Maker; Population; Pregnancy; Pregnant Women; Prenatal care; Process; Provider; Public Health; Quality of life; Recommendation; Recovery; Relapse; Reproducibility; Research; Research Personnel; Research Priority; Resources; Risk; Risk Reduction; Science; Scientist; Syndrome; Techniques; Training; Treatment outcome; Uncertainty; Universities; Withdrawal; Woman; addiction; care delivery; career; clinical practice; cost; evidence base; evidence based guidelines; fetal; follow-up; health care delivery; health care service utilization; health related quality of life; improved; in utero; infant outcome; marginalization; maternal outcome; medical schools; models and simulation; mortality; opioid agonist therapy; opioid use; opioid use disorder; opioid withdrawal; optimal treatments; overdose risk; professor; reproductive; side effect; treatment optimization; treatment strategy

PROJECT SUMMARY/ABSTRACT Ashley A. Leech, PhD, MS is an Assistant Professor in the Department of Health Policy at the Vanderbilt University School of Medicine. As a health decision scientist and health services researcher, Dr. Leech seeks to identify and improve the delivery of high-value health services to address the specialized needs of reproductive age and pregnant women in the US. This training grant will support her career goal of becoming a leading investigator who specializes in decision science methodology to empirically inform decision making on health services and resource priorities for marginalized women and their children in the US. Specifically, by evaluating real-world tradeoffs associated with treatment strategies and assessing the value of conducting further research to reduce decision uncertainty and optimize treatment benefits, she aims to provide a strong evidence base to improve the care for pregnant women afflicted by addiction. Opioid use disorder in pregnancy has more than quadrupled in the last two decades, resulting in adverse pregnancy and birth outcomes and a subsequent rise in healthcare utilization. Furthermore, access to treatment for pregnant women remains limited and varies geographically and across treatment strategies and care settings. High-value care for opioid use disorder in pregnancy requires methodologically rigorous studies that measure both the value of existing and new interventions and analyze the effects of resource constraints on decision making. To address these gaps, Aim 1 of the proposed research assesses the value of all available treatment options for pregnant women with opioid use disorder and quantifies the value of obtaining more research to guide future treatment and management decisions for these patients. Aim 2 takes this analysis a step further by incorporating resource constraints into the model to optimize care processes and delivery amid an environment with multiple barriers to timely and appropriate access to treatment. Results from these aims will collectively inform clinical practice, resource prioritization, and important policy decisions that can improve the availability of services for this population. During the award period, Dr. Leech will gain additional methodological expertise in advanced calibration, value of information analysis, and optimization methods for decision making, while also becoming well-informed in the clinical and policy space to improve the management and care for pregnant women and children affected by opioid use. Her mentoring and advisory team are nationally recognized clinicians, methodologists, and health policy experts who will provide the critical mentorship necessary to advance her career in the fields of addiction, decision science, and maternal and child health. This award will enable Dr. Leech to become a leading and independently funded research investigator.

项目概要/摘要 Ashley A. Leech 博士、硕士是范德比尔特大学卫生政策系助理教授 大学医学院。作为一名健康决策科学家和健康服务研究员，Leech 博士寻求 确定并改善高价值卫生服务的提供，以满足患者的特殊需求 美国的生育年龄和孕妇。这笔培训补助金将支持她成为一名 专门研究决策科学方法的首席研究员，以经验为决策提供信息 美国边缘化妇女及其子女的卫生服务和资源优先事项。具体来说，通过 评估与治疗策略相关的现实世界权衡并评估进行治疗的价值 她的目标是进一步研究以减少决策不确定性并优化治疗效果 改善对受毒瘾困扰的孕妇的护理的证据基础。 过去二十年里，妊娠期阿片类药物使用障碍增加了四倍多，导致不良后果 怀孕和分娩结果以及随后医疗保健利用率的上升。此外，访问 孕妇的治疗仍然有限，并且因地域和治疗策略的不同而存在差异 护理设置。对妊娠期阿片类药物使用障碍的高价值护理需要在方法上进行严格的研究 衡量现有和新干预措施的价值并分析资源限制的影响 关于决策。为了弥补这些差距，拟议研究的目标 1 评估了所有 患有阿片类药物使用障碍的孕妇的可用治疗方案，并量化获得的价值 更多的研究来指导这些患者未来的治疗和管理决策。目标 2 采取这个 通过将资源约束纳入模型来进一步分析，以优化护理流程和 在一个存在多重障碍的环境中提供及时和适当的治疗。结果来自 这些目标将共同为临床实践、资源优先顺序和重要政策决策提供信息 可以改善该人群获得服务的机会。 在获奖期间，Leech 博士将获得高级校准、价值等方面的额外方法专业知识。 信息分析和决策优化方法，同时也了解 改善对受影响孕妇和儿童的管理和护理的临床和政策空间 通过使用阿片类药物。她的指导和咨询团队是全国公认的临床医生、方法学家和 卫生政策专家将为她在以下领域的职业发展提供必要的关键指导 成瘾、决策科学以及妇幼健康。该奖项将使 Leech 博士成为一名 领先且独立资助的研究调查员。