Primary care prevention of stimulant diversion by high school students with ADHD

患有多动症的高中生兴奋剂转移的初级保健预防

基本信息

项目摘要

 DESCRIPTION (provided by applicant): Nonmedical use of psychoactive stimulant medication (medication that is prescribed for the treatment of Attention-Deficit/Hyperactivity Disorder; ADHD) is an increasingly prevalent form of prescription drug misuse among high school students (McCabe & West, 2013) and prevalence rates continue to rise. Stimulant-related emergency department visits increased threefold in recent years (SAMHSA, 2013a). Students with prescriptions are the primary source of stimulant diversion (selling, sharing one's medication). However, with the exception of developmental research we recently launched, clinical strategies for management of stimulant diversion have yet to be developed and empirically evaluated for primary care providers - a professional population that frequently treats ADHD and that is being targeted by NIDA (Volkow, 2012), especially with regard to nonmedical use of prescription drugs including stimulants (Volkow, 2010). Our work with primary care providers revealed 1) concern about the problem, 2) a lack of strategies for addressing it, and 3) willingness to adopt new strategies to decrease diversion potential. This application proposes to test the implementation of brief clinical practice strategies, designed to prevent stimulant diversion that pediatricians may use with their teenage patients receiving stimulant prescriptions and their parents. In response to RFA-DA-15-010, Interventions for youth who misuse/abuse prescription stimulant medications in high school and/or college-attending youth (U01)," we will conduct a randomized trial to examine the effect on patient diversion, attitudes, and intentions, of an intervention to be delivered by pediatric providers at the time of stimulant prescribing. N=375 13-17 year old patients will be enrolled across six pediatric practices for assessment prior to, and following, provider training in stimulant diversion practices. Following baseline assessment, providers at half of the practices, randomly selected within matched pairs, will receive training in the Stimulant Diversion Prevention (SDP) protocol; the remainder will implement Treatment as Usual (TAU). Providers and parents will also participate in the assessments and electronic medical record data will be collected for participating patients. We will also characterize prescribing patterns in all participating and non participating practices in the UPMC pediatric provider network independent of study participation (543 pediatricians) for comparison to regional trends. The results of this study will provide the first empirical test of a brief provider-led intervention for stimulant diversion reduction in primary care. The goals are innovative given the complete absence of such strategies in evidence-based ADHD treatment guidelines. The project addresses an immediate public health concern and is based on developmental work (R34 DA035464) that includes stakeholders (providers) as consultants to develop feasible strategies with a high likelihood of delivery. Thus, the impact of the work is expected to be high, with the result being a pragmatic, low cost, and highly disseminable means by which prescription stimulant diversion may be decreased.
 描述(由申请人提供):非医疗使用精神活性兴奋剂药物(用于治疗注意力缺陷/多动障碍的药物; ADHD)是高中生中日益普遍的处方药滥用形式(McCabe & West,2013),患病率继续上升。近年来,与兴奋剂相关的急诊就诊增加了三倍(SAMHSA,2013 a)。有处方的学生是兴奋剂转移的主要来源(出售、分享药物)。然而,除了我们最近启动的发展研究外,尚未为初级保健提供者开发和经验评估管理兴奋剂转移的临床策略-一个经常治疗ADHD的专业人群,并且是NIDA的目标人群(Escherow,2012),特别是关于非医疗使用处方药,包括兴奋剂(Escherow,2010)。我们与初级保健提供者的工作显示:1)对问题的关注,2)缺乏解决问题的战略,3)愿意采取新的战略来减少转移的可能性。本申请旨在测试简短的临床实践策略的实施,旨在防止儿科医生可能与接受兴奋剂处方的青少年患者及其父母一起使用兴奋剂转移。为了回应RFA-DA-15-010,对高中和/或大学就读青年中误用/滥用处方兴奋剂药物的青少年的干预措施(U 01),”我们将进行一项随机试验,以检查儿科提供者在 兴奋剂处方N=375例13-17岁的患者将在6个儿科实践中入组,以在提供者接受兴奋剂转移实践培训之前和之后进行评估。在基线评估之后,在配对中随机选择的一半实践中的提供者将接受刺激剂转移预防(SDP)协议的培训;其余的将实施治疗(TAU)。提供者和父母也将参与评估,并将为参与患者收集电子病历数据。我们还将描述所有参与者和非参与者的处方模式。 参与UPMC儿科提供者网络的实践独立于研究参与(543名儿科医生),以与区域趋势进行比较。这项研究的结果将 提供了第一个经验性测试的一个简短的供应商主导的干预措施,减少兴奋剂转用在初级保健。这些目标是创新的,因为在循证ADHD治疗指南中完全没有这种策略。该项目解决了一个紧迫的公共卫生问题,并以发展工作(R34 DA 035464)为基础,其中包括利益相关者(提供者)作为顾问,以制定可行的战略,并具有很高的交付可能性。因此,预计这项工作的影响将是高的,其结果是一个务实的,低成本的,高度传播的手段,处方兴奋剂转移可能会减少。

项目成果

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BROOKE S.G. MOLINA其他文献

BROOKE S.G. MOLINA的其他文献

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{{ truncateString('BROOKE S.G. MOLINA', 18)}}的其他基金

The Pittsburgh ADHD Longitudinal Study: Predicting alcohol misuse, problems and disorder in mid-adulthood
匹兹堡多动症纵向研究:预测中年时期的酒精滥用、问题和障碍
  • 批准号:
    10686855
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
The Pittsburgh ADHD Longitudinal Study: Predicting alcohol misuse, problems and disorder in mid-adulthood
匹兹堡多动症纵向研究:预测中年时期的酒精滥用、问题和障碍
  • 批准号:
    10268965
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
A prospective examination of stimulant diversion and related risk factors for young adults with childhood- or adult-diagnosed ADHD
对儿童或成人诊断为多动症的年轻人的兴奋剂转移和相关危险因素的前瞻性检查
  • 批准号:
    10624336
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
The Pittsburgh ADHD Longitudinal Study: Predicting alcohol misuse, problems and disorder in mid-adulthood
匹兹堡多动症纵向研究:预测中年时期的酒精滥用、问题和障碍
  • 批准号:
    10470217
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
The Pittsburgh ADHD Longitudinal Study: Predicting alcohol misuse, problems and disorder in mid-adulthood
匹兹堡多动症纵向研究:预测中年时期的酒精滥用、问题和障碍
  • 批准号:
    9884028
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
A prospective examination of stimulant diversion and related risk factors for young adults with childhood- or adult-diagnosed ADHD
对儿童或成人诊断为多动症的年轻人的兴奋剂转移和相关危险因素的前瞻性检查
  • 批准号:
    10200733
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
A prospective examination of stimulant diversion and related risk factors for young adults with childhood- or adult-diagnosed ADHD
对儿童或成人诊断为多动症的年轻人的兴奋剂转移和相关危险因素的前瞻性检查
  • 批准号:
    10405503
  • 财政年份:
    2020
  • 资助金额:
    $ 60万
  • 项目类别:
Pathways to adult substance use and abuse from childhood ADHD in the MTA
MTA 儿童多动症导致成人药物使用和滥用的途径
  • 批准号:
    9150603
  • 财政年份:
    2015
  • 资助金额:
    $ 60万
  • 项目类别:
Primary care prevention of stimulant diversion by high school students with ADHD
患有多动症的高中生兴奋剂转移的初级保健预防
  • 批准号:
    9125776
  • 财政年份:
    2015
  • 资助金额:
    $ 60万
  • 项目类别:
Stimulant diversion by young adults with ADHD: piloting primary care prevention
患有多动症的年轻人的兴奋剂转移:试点初级保健预防
  • 批准号:
    8700085
  • 财政年份:
    2014
  • 资助金额:
    $ 60万
  • 项目类别:

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