Patients decline buprenorphine from the emergency department CTN:0107 add on

患者拒绝从急诊科使用丁丙诺啡 CTN:0107 添加

• 批准号: 10666250
• 负责人: KATHLEEN T. BRADY
• 金额: $ 27.58万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10666250
• 关键词: Accident and Emergency department; Address; Buprenorphine; Consolidated Framework for Implementation Research; Country; Data; Dimensions; Emergency Department patient; Emergency Medicine; Evidence based treatment; Foundations; Funding; Harm Reduction; Individual; Instruction; Intervention; Interview; Knowledge; Length; Life; Medical; Minority; Modification; Opioid; Overdose; Overdose reduction; Pathway interactions; Patients; Pharmaceutical Preparations; Placebos; Principal Investigator; Provider; Public Health; Quality of Care; Recovery; Research; Research Design; Savings; Science; Social Functioning; South Carolina; Structure; Survey Methodology; Time; United States Dept. of Health and Human Services; acute care; addiction; buprenorphine treatment; comparative effectiveness study; craving; implementation science; improved; mortality; opioid epidemic; opioid use; opioid use disorder; patient engagement; patient-level barriers; peer; programs; therapy design; therapy development; uptake; user centered design

Program Director/Principal Investigator (Last, First, Middle): Brady, Kathleen T PROJECT SUMMARY (See instructions): Why do patients decline buprenorphine from the emergency department?: Add-on study to CTN-0107 Emergency department-initiated buprenorphine (EDIB) successfully doubles retention in treatment at 30 days when compared to referral alone. Additionally, there are significant benefits to treatment with buprenorphine and other medications for opioid use disorder (MOUD) including significant reductions in overdose and all-cause mortality, better retention compared to placebo or no medication increased length of time in recovery, decreased opioid use, decreased craving, and improved social functioning. Emergency departments (EDs) are well-suited to engage patients in buprenorphine treatment, resulting in significantly improved ED quality of care and increased access to this life-saving treatment. Unfortunately, only a minority of patients eligible and offered EDIB receive it. The specific objective of this proposal is to systematically evaluate reasons why EDIB-eligible patients with OUD decline EDIB. This study will be a qualitative study utilizing semi-structured interviews with ED medical providers, ED staff, and patients who are deemed eligible for EDIB to evaluate provider/staff-level and patient-level barriers and facilitators to EDIB acceptance among eligible patients. This knowledge is imperative to public health efforts addressing the opioid epidemic, as results can be used to improve harm reduction interventions by addressing critical gaps for ED patients with OUD. This proposal would be the first to examine why a minority of patients eligible for EDIB accept it when it is available and recommended. This study will provide an important initial step in better understanding reasons for declining EDIB and informing intervention design and implementation to increase EDIB uptake. This study can be completed rapidly and has potential to positively impact the thousands of patients with OUD seen in EDs across the country. Our team of experts in addiction science, survey methods, qualitative data, implementation science and emergency medicine are uniquely qualified to carry out this proposal. RELEVANCE (See instructions): The proposed research will provide the foundation to address systematic problems with ED-initiated buprenorphine programs, which will in turn improve patient engagement in evidenced-based treatments.

项目负责人/主要研究者（最后一名、第一名、中间名）：布雷迪、Kathleen T 项目总结（见说明）： 为什么病人拒绝丁丙诺啡从紧急情况 部门？：CTN-0107的附加研究 急诊科启动的丁丙诺啡（EDIB）成功地使治疗保留率增加一倍， 与单独转诊相比，30天。此外，使用以下药物治疗也有显著的益处： 丁丙诺啡和其他阿片类药物使用障碍（MOUD），包括显着减少 药物过量和全因死亡率，与安慰剂相比更好的保留或无药物增加的长度 恢复时间，减少阿片类药物的使用，减少渴望，改善社会功能。紧急 科室（ED）非常适合让患者参与丁丙诺啡治疗， 提高艾德的护理质量，增加获得这种挽救生命的治疗的机会。不幸的是，只有一个 少数符合条件并提供EDIB的患者接受它。 该提案的具体目标是系统地评估EDIB合格患者 与OUD下降EDIB。本研究将是一项质性研究，采用半结构式访谈与艾德 医疗服务提供者、艾德工作人员和被认为有资格接受EDIB评估的患者 和患者水平的障碍和促进EDIB接受合格的患者。这种知识是 解决阿片类药物流行的公共卫生工作势在必行，因为结果可用于改善危害 通过解决OUD患者的艾德关键差距来减少干预。 这项建议将是第一个研究为什么少数符合EDIB条件的病人接受它时， 可用并推荐。这项研究将为更好地了解 减少EDIB的原因，并为干预措施的设计和实施提供信息，以增加EDIB的吸收。 这项研究可以迅速完成，并有可能对成千上万的患者产生积极影响。 全国各地的急诊室都可以看到OUD。我们的成瘾科学、调查方法、 定性数据、实施科学和急救医学是唯一有资格进行这一工作的。 提议 相关性（参见说明）： 这项研究将为解决ED引发的系统性问题提供基础。 丁丙诺啡项目，这反过来又会提高患者对循证治疗的参与度。