Integrated Care for Hepatitis C: Current Uptake & Impact on Future Treatment

丙型肝炎综合护理：目前的采用情况

• 批准号: 10217080
• 负责人: Shashi Kapadia
• 金额: $ 17.24万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10217080
• 关键词: Adoption; Affect; Antiviral Agents; Area; Award; Caring; Cessation of life; Communicable Diseases; Complex; County; Data; Data Set; Disease Outbreaks; Drug user; Economics; Enabling Factors; Enrollment; Epidemic; Experimental Designs; Funding; Future; Goals; Health; Health Insurance; Health Services Accessibility; Health system; Healthcare; Hepatitis C; Hepatitis C Incidence; Hepatitis C Therapy; Hepatitis C Transmission; Improve Access; Incidence; Individual; Injecting drug user; Insurance; Insurance Coverage; Intervention; Interview; K-Series Research Career Programs; Learning; Liver diseases; Medicaid; Medical; Medicine; Mentored Research Scientist Development Award; Mentors; Mentorship; Methodology; Methods; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Needle-Exchange Programs; New York; Oral; Outcome; Patients; Physicians; Policies; Policy Research; Population Heterogeneity; Positioning Attribute; Primary Health Care; Provider; Public Health; Regimen; Research; Research Methodology; Research Personnel; Research Training; Review Literature; Rotation; Rural; Service delivery model; Service setting; Specialist; Substance Use Disorder; Surveys; Syringes; System; Testing; Training; United States; base; behavioral health; care providers; care systems; design; experience; experimental analysis; hands on research; improved; injection drug use; insight; instructor; medical specialist; medical specialties; models and simulation; mortality; opioid epidemic; opioid use disorder; population health; prevent; primary care setting; prior authorization; programs; public health intervention; rural area; rural setting; scale up; skills; substance use; substance use treatment; treatment program; treatment services; trend; uptake; urban area

PROJECT SUMMARY/ABSTRACT In this proposal for a K01 Mentored Research Scientist Development award, Shashi Kapadia, MD MS proposes a training and research program that will enable him to become an independent physician-researcher focused on policy and systems factors that impact drug user health. Dr. Kapadia is currently an Instructor in Medicine in the Division of Infectious Diseases at Weill Cornell Medicine whose research focuses on hepatitis C (HCV) treatment access for people who inject drugs (PWID). To achieve his long-term goal, Dr. Kapadia will obtain skills in evaluating care delivery models that integrate medical and behavioral health care, particularly the care of substance use disorders. He will learn methodological approaches to policy research that include natural experimental designs and analysis of administrative/claims data, conducting mixed-methods research, and using simulation models to predict the impact of public health interventions. He will achieve these training objectives with a combination of formal coursework, rotations in diverse care settings, mentorship, and hands-on research experience. He will be mentored by Dr. Bruce Schackman (primary), Dr. Yuhua Bao, Dr. David Perlman, Dr. Kristen Marks, and Dr. Erika Martin, as well as a team of expert consultants. Combined, these individuals have expertise in all of the training areas that Dr. Kapadia seeks to develop during this award period. The population health problem that Dr. Kapadia will study during the proposed career development award is the need to improve access to HCV treatment for PWID, with a focus on New York State. Expanded treatment access is needed to prevent long-term morbidity and mortality from liver disease, and can potentially eliminate HCV transmission. Integrating HCV treatment into primary care and substance use treatment settings may help alleviate barriers to expanded treatment. In his proposed research, Dr. Kapadia will use data from New York State Medicaid to study trends in HCV treatment uptake in primary care (Aim 1). He will conduct interviews to contextualize these quantitative findings, and to elicit factors that would further support treatment integration into primary care, substance use treatment, and syringe service programs. (Aim 2). He will then develop a simulation model, based on these findings, to forecast the impact of integrated care models on HCV treatment of PWID in New York State (Aim 3). The proposed research will test whether integrated HCV care is being effectively utilized, describe the barriers to achieving it, and analyze its impact on the health of HCV-infected individuals, especially PWID. It will be relevant to policymakers and public health practitioners. Additionally, the skills that Dr. Kapadia will gain through completion of this mentored research and training plan will enable him to seek future R01 funding and achieve his goal of becoming an independent investigator.

项目总结/摘要 在K 01指导研究科学家发展奖的提案中，Shashi Kapadia，MD MS 提出了一个培训和研究计划，使他成为一个独立的医生，研究人员 侧重于影响吸毒者健康的政策和制度因素。Kapadia博士目前是一名讲师， 威尔康奈尔大学传染病部医学，其研究重点是丙型肝炎 (HCV)为注射毒品者提供治疗。 为了实现他的长期目标，Kapadia博士将获得评估护理提供模式的技能， 整合医疗和行为健康护理，特别是对物质使用障碍的护理。他将学习 政策研究的方法论方法，包括自然的实验设计和分析， 行政/索赔数据，进行混合方法研究，并使用模拟模型来预测 公共卫生干预措施的影响。他将实现这些培训目标， 课程作业，在不同的护理环境，指导和实践研究经验的轮换。他将 由布鲁斯沙克曼博士（初级）、鲍玉华博士、大卫帕尔曼博士、克里斯汀马克斯博士和 艾丽卡·马丁，以及一个专家顾问团队。结合起来，这些人在所有的专业知识， Kapadia博士在此奖项期间寻求发展的培训领域。 卡帕迪亚博士在拟议的职业发展期间将研究的人口健康问题 奖励是需要改善PWID的HCV治疗，重点是纽约州。扩大 需要治疗途径来预防肝病的长期发病率和死亡率， 消除HCV传播。将HCV治疗纳入初级保健和物质使用治疗 环境可能有助于减轻扩大治疗的障碍。在他的研究计划中，卡帕迪亚博士将使用数据 来自纽约州医疗补助计划，研究初级保健中HCV治疗吸收的趋势（目标1）。他将 进行访谈，将这些定量研究结果置于背景中，并引出进一步支持的因素 将治疗纳入初级保健、物质使用治疗和注射器服务方案。(Aim 2）。他 然后，将根据这些发现开发一个模拟模型，以预测综合护理模式的影响 关于纽约州PWID的HCV治疗（目标3）。 拟议的研究将测试是否正在有效利用综合HCV护理，描述 实现它的障碍，并分析其对HCV感染者健康的影响，特别是PWID。它 将与决策者和公共卫生从业人员相关。此外，卡帕迪亚博士将 通过完成这一指导研究和培训计划，他将能够寻求未来的R 01 他的目标是成为一名独立的调查员。