Using existing data to understand and ameliorate risk in opioid agonist therapy

利用现有数据了解和改善阿片类激动剂治疗的风险

• 批准号: 9904242
• 负责人: Louisa Degenhardt
• 金额: $ 4.86万
• 依托单位: UNIVERSITY OF NEW SOUTH WALES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9904242
• 关键词: Adverse event; Aftercare; Buprenorphine; Cessation of life; Clinic; Clinical; Comorbidity; Criminal Justice; Data; Data Set; Development; Drug abuse; Epidemic; Event; Goals; Health; Hospitalization; Knowledge; Link; Logistics; Machine Learning; Methadone; Methods; Modeling; Neoadjuvant Therapy; New South Wales; Outcome; Overdose; Patient risk; Patients; Persons; Pharmaceutical Preparations; Population; Prisons; Probability; Provider; Recording of previous events; Research; Risk; Risk Assessment; Risk Factors; Safety; Specialist; Specific qualifier value; Techniques; Time; Training; United States; Withholding Treatment; adverse event risk; adverse outcome; base; effective therapy; experience; individualized medicine; innovation; learning strategy; mortality; mortality risk; novel; opioid agonist therapy; opioid epidemic; opioid use; opioid use disorder; overdose death; point of care; population based; population health; prediction algorithm; prescription opioid; protective factors; random forest; response; risk minimization; risk prediction model; scale up; treatment duration; treatment planning

PROJECT SUMMARY/ABSTRACT The United States is in the midst of an opioid epidemic, leading to unprecedented levels of overdose deaths and other harms. Effective treatment for opioid use disorders is available, in the form of opioid agonist therapy (OAT) with methadone or buprenorphine. However, there are significant questions about the risk of adverse clinical outcomes, including mortality and hospitalization during and after treatment, and unplanned treatment cessation. What is the magnitude of these risks, and what patient, treatment setting, and provider factors may contribute to or protect against risk? Additionally, it is increasingly clear that more sophisticated approaches to patient assessment and treatment planning than are currently used are needed to minimise risk. We aim to: 1. Determine the magnitude of risk for specific adverse clinical outcomes (e.g. mortality, hospitalization and ED presentation, and unplanned treatment cessation) during and after OAT with methadone and buprenorphine; 2. Identify patient, treatment setting, and provider risk factors associated with adverse clinical outcomes during and after OAT with methadone and buprenorphine; and 3. Develop a risk prediction model to identify patients at greatest risk of adverse clinical outcomes during and after OAT. To achieve these aims, this project will use existing population-based Australian data on OAT, linked to several health and criminal justice datasets to provide a rich understanding of treatment exposures and outcomes. These data will be used to inform strategies to guide the delivery of high-quality treatment for opioid use disorder in the United States. Specifically, the project will provide data about the magnitude of risk of adverse clinical outcomes during specific treatment and post-treatment periods, and identify patient, treatment setting and provider factors that influence risk. Additionally, it will use innovative machine learning techniques to demonstrate the potential for routinely collected data to be used to assess patient risk at point-of-care, allowing for the development of tailored treatment plans that minimize risk and maximize treatment retention.

项目总结/文摘

项目成果

Correlates of indicators of potential extra-medical opioid use in people prescribed opioids for chronic non-cancer pain.

服用阿片类药物治疗慢性非癌性疼痛的患者中潜在的非医疗阿片类药物使用指标的相关性。

• DOI: 10.1111/dar.13021
• 发表时间: 2020
• 期刊: Drug and alcohol review
• 影响因子: 3.8
• 作者: SantoJr,Thomas;Larance,Briony;Bruno,Raimondo;Gisev,Natasa;Nielsen,Suzanne;Degenhardt,Louisa;Campbell,Gabrielle
• 通讯作者: Campbell,Gabrielle

Risks of harm with cannabinoids, cannabis, and cannabis-based medicine for pain management relevant to patients receiving pain treatment: protocol for an overview of systematic reviews.

大麻素、大麻和以大麻为基础的药物用于与接受疼痛治疗的患者相关的疼痛管理的危害风险：系统评价概述的方案。

• DOI: 10.1097/pr9.0000000000000742
• 发表时间: 2019
• 期刊: Pain reports
• 影响因子: 4.8
• 作者: Gilron,Ian;Blyth,FionaM;Degenhardt,Louisa;DiForti,Marta;Eccleston,Christopher;Haroutounian,Simon;Moore,Andrew;Rice,AndrewSC;Wallace,Mark
• 通讯作者: Wallace,Mark

The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

• DOI: 10.1016/s2215-0366(18)30337-7
• 发表时间: 2018-12
• 期刊: The lancet. Psychiatry
• 作者: GBD 2016 Alcohol and Drug Use Collaborators

Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study.

• DOI: 10.1016/s2468-2667(18)30110-5
• 发表时间: 2018-07
• 期刊: The Lancet. Public health
• 作者: Campbell G;Hall WD;Peacock A;Lintzeris N;Bruno R;Larance B;Nielsen S;Cohen M;Chan G;Mattick RP;Blyth F;Shanahan M;Dobbins T;Farrell M;Degenhardt L
• 通讯作者: Degenhardt L

Cannabis use and non-cancer chronic pain - Authors' reply.

大麻的使用和非癌症慢性疼痛 - 作者的答复。

• DOI: 10.1016/s2468-2667(18)30182-8
• 发表时间: 2018
• 期刊: The Lancet. Public health
• 作者: Campbell,Gabrielle;Hall,Wayne;Degenhardt,Louisa;Dobbins,Timothy;Farrell,Michael
• 通讯作者: Farrell,Michael