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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)

基本信息

批准号：
10348119
负责人：
Jan Gryczynski
金额：
$ 68.8万
依托单位：
FRIENDS RESEARCH INSTITUTE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-15 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10348119
关键词：
Accident and Emergency department Adherence Admission activity Antibiotics Appointment Authorization documentation Behavior Biological Markers Buprenorphine Caring Centers for Disease Control and Prevention (U.S.)Clinic Clinic Visits Communities Coupled Data Drug usage Epidemic Event Exposure to Fentanyl Funding HIV HIV Infections Health Health Services Heroin High Prevalence Hospitals Hotlines Individual Intake Interview Jail Lead Link Medical Methods Morbidity - disease rate Naloxone National Institute of Drug Abuse Nurse Practitioners Opiate Addiction Opioid Analgesics Outcome Outpatients Overdose Participant Patients Pharmaceutical Preparations Physician Assistants Physicians Population Primary Care Provider Public Health Recommendation Regimen Reporting Research Research Design Resources Risk Risk Behaviors Services Sexually Transmitted Diseases Statutes and Laws Structure Substance Use Disorder Testing Time United States Walking Writing arm authority buprenorphine treatment care seeking cost effective therapy effectiveness evaluation experience follow-up health record high risk high risk population illicit opioid innovation meetings mortality novel novel strategies opioid epidemic opioid use opioid use disorder overdose death overdose prevention patient navigation patient navigator patient population prescription opioid primary outcome public health emergency randomized, clinical trials treatment as usual treatment program trial comparing usual care arm waiver

项目摘要

Abstract Untreated opioid use disorder (OUD) is a continuing public health emergency in the United States. OUD is associated with significant morbidity and mortality, including overdose death. Buprenorphine is an effective treatment for OUD, but most individuals who need such treatment do not access it. Public STD clinics are high-volume, episodic care medical settings that serve a high-risk population, often on a walk-in basis. STD clinic patients have high prevalence of OUD and health-risking behaviors. This proposed study, entitled Opioid Use Disorder Treatment Linkage at STD Clinics using Buprenorphine (OUTLAST-B), will examine OUD treatment linkage strategies for opioid-dependent patients seeking services at public STD clinics. This three-arm, parallel randomized clinical trial (RCT) will compare Usual Care (UC), vs. referral via Patient Navigation (PN), vs. Patient Navigation with STD-clinic initiated buprenorphine (PN+BUP). The UC Arm will include standard services at the STD clinic. The PN Arm will include all UC Arm services, with the addition of a Patient Navigator who will assist the participant in selecting a community OUD treatment program, facilitate an intake appointment, help to resolve barriers and coordinate OUD treatment entry, and support early retention in OUD treatment. The PN+BUP Arm will include all PN Arm services, with the addition of meeting with the STD clinic’s buprenorphine-waivered provider (typically a nurse practitioner) to initiate buprenorphine treatment, as a bridge until successful transfer to OUD treatment in the community. Research assessments consisting of a structured interview battery and biomarkers for drug use and STDs will be conducted at baseline, 3-, and 6-month follow-up. Selected outcomes will be examined through 12-months via health record linkage methods. The study will examine participant outcomes in the domains of: (1) OUD treatment entry and retention, (2) Opioid use and related problems (including fatal and non-fatal overdose), and (3) HIV/STD-related outcomes. This innovative study could identify new approaches to engaging a high-risk patient population in OUD treatment. The study could have high impact because findings could be scaled to STD clinics throughout the nation, spurring novel integration across two traditionally separate service sectors of STD care and OUD treatment.

摘要