Mid-Career Award in Patient-Oriented Substance Use Research Addressing Opioids, Chronic Pain, and HIV

项目摘要 这个K24奖将支持候选人作为导师和物质使用研究人员的发展， 完成减少或停止阿片类药物治疗对艾滋病毒感染者的影响的研究。的 候选人将完成高级指导培训，并定期与高级导师会面，以提高他的 指导，同时在整个奖励期间增加他的指导负荷。他还将提高自己的能力， 作为一个优秀的物质使用研究人员解决阿片类药物的使用和慢性疼痛，通过完成美国委员会 成瘾医学委员会认证和美国疼痛学会疼痛医学基础课程， 完成独立的结构化阅读程序，解决疼痛研究以及生物统计学， 研究设计，并获得直接的临床经验，在慢性疼痛管理。此外，候选人 将进行新的研究，以检查停止处方阿片类药物使用对艾滋病毒感染者的影响， 阳性患者候选人将对600名处方患者进行广泛的图表提取研究 阿片类药物治疗慢性疼痛（300例HIV阳性，300例频率匹配的HIV阴性）， 奖励期，以描述阿片类药物处方的轨迹和继续使用的理由，或 阿片类药物治疗的变化，比较HIV阳性患者的阿片类药物处方模式和黄旗行为 和HIV阴性患者，并前瞻性评估接受处方阿片类药物 艾滋病毒阳性和阴性患者的临床护理。分析将涉及汇总logistic回归 模型调整频率匹配地层，和广义估计方程，这取决于 假设正在测试中。

Project Abstract This K24 award will support the candidate’s development as a mentor and substance use researcher, while completing a study the impact of reduced or discontinued opioid therapy on patients infected with HIV. The candidate will complete advanced training in mentoring and meet regularly with senior mentors to improve his mentoring, while increasing his mentoring load throughout the award period. He will also enhance his ability to excel as a substance use researcher addressing opioid use and chronic pain by completing American Board of Addiction Medicine board certification and the American Pain Society Fundamentals of Pain Medicine course, completing independent structured reading programs addressing pain research as well as biostatistics and research design, and gaining direct clinical experience in chronic pain management. In addition, the candidate will pursue new research to examine the impact of discontinuation of prescription opioid use among HIV- positive patients. The candidate will perform extensive chart extraction research on 600 patients prescribed opioids for chronic pain (300 HIV-positive, 300 frequency-matched HIV-negative) in years 1-2 and 3-4 of the award period in order to characterize the trajectory of opioid prescribing and rationale for continuation or changes in opioid therapy, compare opioid prescribing patterns and yellow flag behaviors among HIV-positive and HIV-negative patients, and prospectively assess the relationship between receipt of prescription opioids and clinic care of HIV-positive and HIV-negative patients. Analysis will involve pooled logistic regression modeling adjusted for frequency-matching strata, and generalized estimating equations, depending on the hypothesis being tested.