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Collaborating to Heal Addiction and Mental Health in Primary care (CHAMP)

合作治愈初级保健成瘾和心理健康 (CHAMP)

基本信息

批准号：
9902764
负责人：
JOHN C. FORTNEY
金额：
$ 1480.05万
依托单位：
UNIVERSITY OF WASHINGTON
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：
2019-09-12 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9902764
关键词：
Address Adherence Adoption American Area Automobile Driving Buprenorphine Caring Cessation of life Clinic Clinical effectiveness Comorbidity Computerized Medical Record Control Groups Country Data Detection Diagnosis Diagnostic Effectiveness Electronic Health Record Eligibility Determination Enrollment Gold Hybrids Improve Access Intervention Maintenance Mediating Mental Health Mental disorders Methadone Modeling Monitor Naltrexone National Institute of Mental Health Outcome Patient Outcomes Assessments Patients Pharmaceutical Preparations Phase Premature Mortality Prevalence Primary Health Care Process Qualitative Methods Quality of life Randomized Reporting Research Risk Factors Running Services Site Surveys Symptoms Testing Universities Washington addiction base collaborative care compare effectiveness design effective therapy effectiveness trial electronic data follow-up group intervention healing illicit opioid implementation strategy improved improved outcome medical specialties medication-assisted treatment opioid misuse opioid overdose opioid use opioid use disorder overdose risk pragmatic trial prevent primary care setting primary outcome programs recruit rural area screening standard care trial comparing

项目摘要

Medication Assisted Treatment, with buprenorphine, methadone, or naltrexone, represents the gold-standard intervention for Opioid Use Disorder (OUD) and significantly reduces risk for overdose or death. However, only 20% of Americans with OUD received any formal or informal addiction treatment in the past year. Even in addiction treatment settings, only 32% of patients with OUD received Medication Assisted Treatment. Lack of access and engagement in Medication Assisted Treatment is driving poor OUD outcomes, especially in rural areas lacking specialty addiction services. To close this engagement gap, more patients with OUD need access to Medication Assisted Treatment in primary care settings. Over the last ten years, the Advancing Integrated Mental health Solutions (AIMS) Center at the University of Washington has successfully helped over a thousand primary care clinics across the country implement Collaborative Care for mental health disorders. The proposed study will determine whether Collaborative Care can be used to successfully treat mental health disorders and OUD concurrently in primary care settings. The proposed research addresses three important objectives including: 1) Can OUD screening be effectively incorporated into primary care mental health screening protocols?; 2) Does implementing Collaborative Care for OUD and mental health disorders improve outcomes?; 3) What implementation strategies are effective at sustaining Collaborative Care programs that concurrently manage mental health disorders and OUD? We will recruit 24 clinics from areas with high OUD prevalence from a network of clinics which have previously partnered with the AIMS Center to implement Collaborative Care for mental health. Clinics still offering Collaborative Care will take part in a pragmatic trial that will randomize sites to adding OUD to their Collaborative Care program or maintaining Collaborative Care for mental health disorders. Clinics no longer offering Collaborative Care will take part in a second pragmatic trial that will randomize sites to implementing Collaborative Care for OUD and mental health disorders simultaneously or implementing Collaborative Care for mental health disorders only. Patient reported outcomes will be collected by survey from patients at baseline and at 3- and 6-month follow-up. Process of care data and medication prescription fills for OUD medications will be collected from chart review. Screening for OUD will start at the beginning of each trial at all clinics and electronic health record data will be used to determine if screening improves the detection of new cases of OUD. At the end of the pragmatic trials, the clinics implementing Collaborative care for OUD and mental health will be randomized to receive a low-intensity or high-intensity implementation strategy to promote sustainability. Mixed quantitative and qualitative methods will be used to evaluate these sustainability implementation strategies.

丁丙诺啡、美沙酮或纳曲酮等药物辅助治疗代表了黄金标准

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Integrating Routine Screening for Opioid Use Disorder into Primary Care Settings: Experiences from a National Cohort of Clinics.

DOI：
10.1007/s11606-022-07675-2
发表时间：
2023-03
期刊：
JOURNAL OF GENERAL INTERNAL MEDICINE
影响因子：
5.7
作者：
Austin, Elizabeth J.;Briggs, Elsa S.;Ferro, Lori;Barry, Paul;Heald, Ashley;Curran, Geoffrey M.;Saxon, Andrew J.;Fortney, John;Ratzliff, Anna D.;Williams, Emily C.
通讯作者：
Williams, Emily C.

Potential for Precision Medicine in Methadone Treatment of Opioid Use Disorder.

美沙酮治疗阿片类药物使用障碍的精准医学潜力。