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The Whole Health Study: Collaborative Care for OUD and Mental Health Conditions

整体健康研究： OUD 和心理健康状况的协作护理

基本信息

批准号：
9903903
负责人：
HILLARY R BOGNER
金额：
$ 1119.73万
依托单位：
UNIVERSITY OF PENNSYLVANIA
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/9903903
关键词：
Address Adoption Affect Anxiety Anxiety Disorders Attention Buprenorphine Caring Case Manager Characteristics Clinic Clinical Communities Comorbidity Consultations Disease Disease remission Effectiveness Elements Enrollment Evaluation Federally Qualified Health Center Funding Future Goals Health Health system Individual Infrastructure Intervention Low Prevalence Major Depressive Disorder Measurement Measures Mental Depression Mental Health Mental disorders Methadone Modeling Morbidity - disease rate Naltrexone National Institute of Mental Health Outcome Patient Care Patients Pennsylvania Pharmaceutical Preparations Pharmacotherapy Philadelphia Post-Traumatic Stress Disorders Primary Care Physician Primary Health Care Probability Psychiatrist Randomized Request for Applications Research Design Resources Rural Site Social Workers Telephone Testing Training Universities Visit Work base care coordination collaborative care community partnership cost cost effectiveness design economic value heroin use illicit opioid implementation strategy improved outcome mortality opioid overdose opioid use opioid use disorder overdose death prescription opioid primary outcome programs prototype psychosocial rural area social health determinants suburb therapy design treatment as usual treatment program uptake waiver

项目摘要

PROJECT SUMMARY This application requests funds to refine and rigorously test a collaborative care model for patients with opioid use disorder (OUD) and major depression, post-traumatic stress disorder, or an anxiety disorder in primary care. We also will examine clinician and practice characteristics associated with successful implementation and the cost effectiveness of different care models. The primary aims of this proposal are: (1) Rapidly prototype and test each element of our collaborative care models to optimize it for implementation; (2) Conduct a randomized study of three collaborative care conditions with 39 practices to determine which is most effective in improving outcomes for people with OUD and mental health conditions: (a) Augmented Usual Care: PCP waivered to prescribe buprenorphine and mental health care manager, (b) Collaborative Care: Waiver PCP; mental health care manager receives OUD training; practice receives telephonic psychiatric consultation, or (c) Collaborative Care + Social Worker to address social determinants of health; (3) Measure clinician and organizational-level factors associated with implementation of each component, with the goal of developing strategies to increase successful implementation; (4) Conduct a cost evaluation of each collaborative care model; and (5) Work with smaller and more rural practices to develop and test effective strategies to manage OUD. Successful completion of the proposed study will provide definitive evidence regarding the most parsimonious set of elements of integrated collaborative care required to maximize outcomes for individuals with OUD and psychiatric disorders. Because of the study design, our examination of implementation factors, and our community partnerships, the results also will have high probability of adoption and implementation.

项目总结此应用程序请求资金来完善和严格测试阿片类药物患者的协作护理模式在小学使用精神障碍(OUD)和严重抑郁、创伤后应激障碍或焦虑障碍关心。我们还将检查与成功实施相关的临床医生和实践特征以及不同护理模式的成本效益。这项建议的主要目标是：(1)迅速制作并测试我们协作护理模式的每个元素，以优化其实施；(2)执行一项对三种协作性护理条件的随机研究，包括39种做法，以确定哪种情况最多有效改善有精神障碍和精神健康状况的人的结局：(A)加强日常护理：免除PCP处方丁丙诺啡和精神卫生保健经理，(B)合作护理：豁免 PCP；精神卫生保健经理接受OUD培训；执业接受电话精神咨询，或(C)协作护理+社会工作者，以解决健康的社会决定因素；(3)衡量临床医生和与每个组成部分的实施有关的组织一级因素，目标是制定增加成功实施的战略；(4)对每项协作护理进行成本评估模式；以及(5)与较小和较农村的做法合作，以制定和测试有效的战略来管理奥德。这项拟议研究的成功完成将为大多数整合协作护理所需的简约要素集，以最大限度地提高个人结果有精神障碍和精神障碍。由于研究设计，我们对实施因素的检查，而我们的社区合作伙伴关系，成果也将有很高的被采纳和实施的概率。