Population-Based Analyses of Healthcare Utilization and Outcomes in Users of Medical Marijuana

基于人群的医用大麻使用者医疗保健利用和结果分析

• 批准号: 10666578
• 负责人: Teresa Jo Hudson
• 金额: $ 40.73万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10666578
• 关键词: Accident and Emergency department; Accidental Injury; Accidents; Admission activity; Adverse event; Affect; Ambulatory Care; American; Anxiety; Arkansas; Behavioral; Benefits and Risks; Benzodiazepines; COVID-19 impact; Cannabis; Cannabis policy; Cessation of life; Characteristics; Clinical; Clinical Decision Support Systems; Consensus; Consumption; Data; Data Sources; Databases; Diagnosis; Dose; Drug Prescriptions; Eligibility Determination; Emergency department visit; Engineering; Epilepsy; Future; Geography; Glaucoma; Goals; Guidelines; Health; Health Policy; Healthcare; Healthcare Systems; Hospital Departments; Individual; Intervention; Investigation; Knowledge; Legal; Link; Marijuana; Measures; Medical; Medical Informatics; Medical Marijuana; Medical Records; Medicine; Mental Health; Mental disorders; Motor; Multiple Sclerosis; Opioid; Opioid Rotation; Outcome; Outcome Study; Overdose; Patients; Persons; Pharmaceutical Preparations; Physicians; Police; Policies; Policy Maker; Population; Population Research; Post-Traumatic Stress Disorders; Qualifying; Recreation; Registries; Research; Source; Substance abuse problem; Suicide; THC concentration; Ulcerative Colitis; United States National Academy of Sciences; Vehicle crash; Vital Statistics; adverse outcome; chronic pain; clinical care; cohort; cost; cost outcomes; health care service utilization; health data; innovation; inpatient service; insurance claims; interest; marijuana use; marijuana user; mortality; opioid epidemic; opioid use; pharmacologic; population based; population health; practice setting; public health research; reduce symptoms; response; socioeconomics; symposium; vehicular accident

PROJECT SUMMARY Limited scientific consensus exists on the clinical, healthcare system, financial, or societal impact of legalization of medical marijuana (MMJ) in states. The swift changes in state policies regarding MMJ use, combined with the current national opioid epidemic, creates an impending need to better understand the clinical, pharmacological, and behavioral impact of MMJ. The state of Arkansas approved MMJ use in 2016 by individuals with select conditions, and dispensaries opened in May 2019. Unique data assets available through the Arkansas Healthcare Transparency Initiative and the Arkansas Health Data Initiative (HDI) consist of individually linked but de-identified mandatory all-payer claims, vital statistics, hospital and emergency department (ED) discharge, and state police motor vehicular crash data, along with data on individuals who qualify for MMJ use. This will be the first population-level analysis that measures clinical and adverse events in a population of MMJ users and non-users through three specific aims: Specific Aim 1: Describe demographic, geographic, socioeconomic, and clinical characteristics; healthcare utilization, adverse events (new mental health diagnoses, substance abuse/overdose, suicide, accidental injury, or MVA accidents); and opioid and benzodiazepine use among three groups: 1) individuals eligible for MMJ in Arkansas who do not obtain an MMJ card (non-cardholders) , 2) individuals who are eligible and obtain a MMJ card but do not purchase MMJ (cardholders), and 3) those who are eligible, obtain a card, and purchase MMJ (consumers). Specific Aim 2: Compare 12-month pre- and post-healthcare use and costs (inpatient and outpatient care, ED visits, and prescription medications), and adverse events between consumers and non-cardholders. As a sub-aim, we will evaluate changes in opioid and benzodiazepine utilization after commencing a course of MMJ therapy. Specific Aim 3: Examine the impact of COVID-19 on MMJ cardholder requests, MMJ purchases, healthcare use, and adverse events. This project brings together five data sources to examine the impact of MMJ on Arkansans. This includes the Arkansas All Payer Claims Database (APCD), the MMJ registry, vital statistics files, and data documenting emergency department visits and MVAs. These data are linkable at the person level which allows person-level analyses or healthcare utilization and outcomes. This will be the first population-level analysis that measures clinical and adverse events in a population of MMJ users and non-users. Results of this research will help fill the gap in scientific knowledge by determining whether MMJ use has benefits (e.g, decreased healthcare use and cost, substitution opioids and benzodiazepines) while producing no additional harm (e.g., new mental health diagnosis, MVAs) and thus inform future MMJ policy.

项目摘要 在临床，医疗系统，财务或社会影响方面存在有限的科学共识 州医用大麻（MMJ）合法化。有关MMJ使用的州政策的迅速变化， 结合当前的国家阿片类药物流行，产生了即将来临的需求 MMJ的临床，药理和行为影响。阿肯色州在2016年批准了MMJ使用 具有精选条件的个人和2019年5月开放的药房。 阿肯色州医疗保健透明度计划和阿肯色州健康数据计划（HDI）由 单独链接但被取消确定的强制性全付款人索赔，重要统计，医院和紧急情况 部门（ED）出院和州警察机动车辆撞车数据，以及有关个人的数据 有资格使用MMJ使用。这将是第一次测量临床和不良事件的人群级分析 MMJ用户和非用户的人口通过三个具体目标： 特定目的1：描述人口，地理，社会经济和临床特征；卫生保健 利用，不良事件（新的心理健康诊断，药物滥用/过量，自杀，偶然 受伤或MVA事故）；以及三组之间的阿片类药物和苯二氮卓类药物的使用：1）符合条件的个人 对于未获得MMJ卡（非卡持有人）的阿肯色州的MMJ，2）符合条件的个人 并获得MMJ卡，但不购买MMJ（持卡人），以及3）符合条件的人，获得 卡，并购买MMJ（消费者）。 具体目标2：比较12个月的健康前和后健康服务和成本（住院和门诊护理，ED 访问和处方药）以及消费者与非核心持有人之间的不利事件。作为 Sub-aim，我们将在开始课程后评估阿片类药物和苯二氮卓类利用的变化 MMJ疗法。 特定目标3：检查Covid-19对MMJ持卡人请求，MMJ购买，医疗保健的影响 使用和不利事件。 该项目汇集了五个数据源，以检查MMJ对阿肯色州的影响。这包括 阿肯色州所有付款人索赔数据库（APCD），MMJ注册表，生命统计文件和数据记录 急诊科和MVA。这些数据可以在人级别上链接，该级别允许人级 分析或医疗保健利用和结果。这将是第一个衡量的人口级分析 MMJ用户和非用户人群中的临床和不利事件。 这项研究的结果将通过确定MMJ使用是否具有 福利（例如，医疗保健使用和成本降低，替代阿片类药物和苯二氮卓类药物）在生产时 没有额外的伤害（例如，新的心理健康诊断，MVA），因此为未来的MMJ政策提供了信息。