Collaborative Care Office-Based Opioid Treatment for Adolescents and Young Adults

针对青少年和年轻人的基于协作护理办公室的阿片类药物治疗

• 批准号: 9979815
• 负责人: Scott Evan Hadland
• 金额: $ 18.53万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9979815
• 关键词: Address; Adolescence; Adolescent Medicine; Adolescent and Young Adult; Adoption; Adult; Advisory Committees; Age; Area; Behavior Therapy; Behavioral; Biometry; Board Certification; Boston; Buprenorphine; Care given by nurses; Caring; Case Manager; Childhood; Data; Data Set; Development; Drug usage; Evidence based treatment; Family; Foundations; Funding; Future; Goals; Health Personnel; Individual; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Life Cycle Stages; Massachusetts; Measures; Medical; Medical center; Medicine; Mentorship; Methadone; Methodology; Methods; Modeling; Modification; Naltrexone; National Institute of Drug Abuse; Neurocognitive; Nursing Care Management; Opioid; Outcome; Outpatients; Parents; Pattern; Pediatrics; Pharmacotherapy; Physicians; Pilot Projects; Prevalence; Primary Health Care; Principal Investigator; Privatization; Public Health; Qualitative Research; Recovery; Relapse; Reporting; Research; Research Personnel; Research Proposals; Risk; Role; Sampling; Science; Specialist; Strategic Planning; Structure; Surveys; Survival Analysis; Techniques; Time; Treatment outcome; Trust; Universities; Visit; Visiting Nurse; Youth; addiction; adolescent substance use; arm; base; care outcomes; care providers; career; clinical epidemiology; collaborative care; design; developmental psychology; effective intervention; effective therapy; expectation; experience; field study; follow-up; health data; heroin use; high risk; improved; informant; insurance claims; medical schools; opioid epidemic; opioid treatment program; opioid use disorder; patient engagement; prescription opioid misuse; primary care setting; primary outcome; programs; psychosocial; public health emergency; skills; therapy development; treatment as usual; trend; young adult

PROJECT SUMMARY: Risk for opioid use disorder (OUD) often begins in adolescence and young adulthood. Engaging and retaining adolescents and young adults (collectively, “youth”) in early, effective treatment to is critical in order to improve the life course trajectory of addiction. For adults with OUD, office-based opioid treatment (OBOT) with a collaborative care approach optimizes patient engagement and retention in care. This approach combines physician visits, nurse care management, and behavioral therapy. Collaborative care OBOT is especially promising for youth, who can receive treatment from a trusted primary care provider in the same familiar setting they receive their usual medical care. To date, however, OBOT has not been formally adapted for treating youth. The central objective of this project is to develop and pilot an OBOT model that is enhanced for youth and that is developmentally appropriate and family-centered. The project includes: (1) an analysis of Massachusetts Department of Public Health data to measure treatment patterns and outcomes among youth with OUD, thus identifying periods of high risk for loss to follow-up and drug use relapse during treatment; (2) qualitative interviews with youth, caretakers, and key informants (such as experienced OBOT providers and primary care providers of youth in areas of high OUD prevalence) to determine necessary modifications to the OBOT model for youth; and (3) a single-arm adaptive pilot study of OBOT enhanced for youth, using implementation and improvement science techniques to optimize the intervention. The Principal Investigator, Dr. Hadland, is an early career clinician-investigator with triple board certification in General Pediatrics, Adolescent Medicine, and Addiction Medicine, and prior research experience in clinical epidemiology. With this project, he seeks to enhance his skills in interventional research, focusing on developing analytic skills in advanced survival analysis and use of correlated data, acquiring foundational knowledge in intervention development, and using implementation and improvement science methodology to optimize an intervention initially designed for adults for use among youth. Dr. Hadland will conduct this research at Boston Medical Center and Boston University School of Medicine, national leaders in addiction medicine and research. The project is supported by an interdisciplinary mentorship and advisory team with expertise in advanced biostatistical analysis, qualitative research, intervention development, developmental psychology, and implementation and improvement science.

项目概要： 阿片类药物使用障碍 (OUD) 的风险通常始于青春期和成年早期。吸引和保留 青少年和年轻人（统称为“青年”）的早期有效治疗对于改善病情至关重要 成瘾的生命历程轨迹。对于患有 OUD 的成人，可进行基于办公室的阿片类药物治疗 (OBOT) 协作护理方法优化了患者的护理参与度和保留率。这种方法结合了 医生就诊、护士护理管理和行为治疗。协同护理 OBOT 特别是 对年轻人来说是有希望的，他们可以在同样熟悉的环境中接受值得信赖的初级保健提供者的治疗 他们接受通常的医疗护理。然而，迄今为止，OBOT 尚未正式应用于 对待青春。该项目的中心目标是开发和试点 OBOT 模型，该模型针对 青年人，这是适合发展并以家庭为中心的。该项目包括：（1）分析 马萨诸塞州公共卫生部数据用于衡量青少年的治疗模式和结果 使用 OUD，从而确定治疗期间失访和吸毒复发的高风险时期； (2) 对青少年、看护者和关键信息提供者（例如经验丰富的 OBOT 提供者和 OUD 流行率高地区的青少年初级保健提供者），以确定对 青少年OBOT模式； (3) 针对青少年的 OBOT 增强型单臂适应性试点研究，使用 实施和改进科学技术以优化干预。首席研究员， Hadland 博士是一位早期职业临床医生兼研究员，拥有普通儿科三重委员会认证， 青少年医学、成瘾医学以及临床流行病学的先前研究经验。有了这个 在该项目中，他寻求提高介入研究的技能，重点是培养以下领域的分析技能： 高级生存分析和相关数据的使用，获取干预的基础知识 开发，并使用实施和改进科学方法来优化干预措施 最初是为成年人设计的，供青少年使用。哈德兰博士将在波士顿医学中心进行这项研究 中心和波士顿大学医学院，是成瘾医学和研究领域的全国领导者。这 该项目得到了具有先进专业知识的跨学科指导和咨询团队的支持 生物统计分析、定性研究、干预开发、发展心理学和 实施和改进科学。