Health Systems Node of the NIDA Clinical Trials Network

NIDA 临床试验网络的卫生系统节点

• 批准号: 10644383
• 负责人: KATHARINE ANTHONY BRADLEY
• 金额: $ 3.42万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10644383
• 关键词: Address; Adolescent; Adult; Attention; Cannabis; Caring; Cellular Phone; Cessation of life; Chronic; Clinical Trials Network; Collaborations; Data; Drug Screening; Electronic Health Record; Evidence based treatment; Faculty; Faculty Recruitment; Family; Friends; HIV; Health; Health Care Visit; Health system; Healthcare; Healthcare Systems; Helping to End Addiction Long-term; Individual; Information Systems; Infrastructure; Leadership; Learning; Legal; Life; Mainstreaming; Measurement; Measures; Medical; Medicine; Methamphetamine use disorder; Methods; Monitor; Morbidity - disease rate; National Institute of Drug Abuse; Newly Diagnosed; Nurses; Opiate Addiction; Opioid; Outcome; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Persons; Population Heterogeneity; Population Research; Population Study; Positioning Attribute; Pregnant Women; Primary Health Care; Provider; Psychiatry; Public Health; Public Health Practice; Quality of Care; Randomized Controlled Trials; Research; Research Design; Research Institute; Research Personnel; Rural Community; Severities; Site; Speed; Stigmatization; Substance Use Disorder; Symptoms; System; Telephone; Testing; Translating; Treatment outcome; Underrepresented Minority; United States; United States National Institutes of Health; Vision; Work; Youth; addiction; base; clinical practice; collaborative care; comparative effectiveness study; disability; effective therapy; experience; illicit drug use; implementation research; implementation trial; improved; innovation; marijuana use; marijuana use disorder; medical specialties; methamphetamine use; mortality; multidisciplinary; neglect; novel; novel strategies; opioid epidemic; opioid misuse; opioid overdose; point of care; pragmatic implementation; pragmatic trial; public health relevance; screening; shared decision making; social stigma; substance use; substance use treatment; success; synthetic opioid; treatment response; young adult

This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction. Substance use (SU) and substance use disorders (SUD) cause extensive morbidity and mortality but have been neglected historically by mainstream health care. The Health Systems Node joined the National Institute on Drug Abuse’s Clinical Trials Network (CTN) in 2015, led by Drs. Campbell, Weisner and Bradley, addiction research leaders in innovative implementation research and pragmatic trials in medical settings. Our node includes 16 Learning Health Systems with national representation and rich population diversity, and represents over 26 million patients. Our faculty are researchers who are embedded in their health systems and committed to cutting-edge addiction research. They bring multidisciplinary expertise in conducting research using innovative methods in different medical settings (e.g. primary care, addiction medicine, OB/GYN, psychiatry, rural communities), and with diverse populations (e.g. under-represented minorities, adolescents, pregnant women, patients with HIV). The node had an outstanding track record in its first 5 years leading 6 multi-site studies, including the CTN’s first entirely electronic health record (EHR)-based pragmatic implementation trial as well as participating in several studies led by other nodes. This renewal application builds upon that success to address the CTN’s objectives over the next 5 years through 3 broad Research Agendas: 1) To test approaches to increasing identification of SU and SUD, and engagement in treatment. For example, we propose a multisite implementation trial to test an innovative approach to implementing cannabis and other drug screening and assessment for SUD; 2) To test new approaches to improve SUD outcomes in medical settings. For example, we propose a point-of-care pragmatic effectiveness trial of telephonic nurse collaborative care and an efficacious smartphone-based SUD treatment, in patients with newly diagnosed SUD; and 3) To develop novel measures and methods for SUD research using EHRs. For example, we propose to validate a 7-item SU severity measure developed by the NIH Roadmap initiative Patient Reported Outcome Measurement Information System (PROMIS) for use in measurement-based care of SUD. These agendas emphasize population-based studies, including pragmatic randomized controlled trials, comparative effectiveness studies, and implementation research, and leverage EHRs. Public Health and Clinical Practice Impact. Over 14.9 million patients with untreated SUD have health care visits annually in the US. If 10% of these patients were identified, engaged and successfully treated, it would translate to 1.5 million patients with resolved SUD each year who otherwise would have gone untreated. The Health Systems Node faculty and infrastructure, in collaboration with the CTN, are uniquely positioned to conduct and disseminate research that advances the integration of SUD treatment into routine medical care, and ultimately to improve patient outcomes and public health.

这项研究是美国国立卫生研究院帮助结束长期成瘾（HEAL）倡议的一部分，该倡议旨在加速科学解决全国阿片类药物公共卫生危机。NIH HEAL倡议支持NIH的研究，以改善阿片类药物滥用和成瘾的治疗。物质使用（SU）和物质使用障碍（SUD）引起广泛的发病率和死亡率，但一直被主流卫生保健忽视。卫生系统节点于2015年加入了国家药物滥用研究所的临床试验网络（CTN）。Campbell， Weisner和Bradley，成瘾