Trends and racial/ethnic differences in opioid prescribing safety and use of nonpharmacologic treatments for chronic pain in adults with co-occurring opioid use disorder
患有并发阿片类药物使用障碍的成人慢性疼痛的阿片类药物处方安全性和非药物治疗使用的趋势和种族/民族差异
基本信息
- 批准号:10666622
- 负责人:
- 金额:$ 9.66万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-08-01 至 2023-04-03
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAttentionBenzodiazepinesCaringCategoriesCenters for Disease Control and Prevention (U.S.)ClimateClinicalClinical Practice GuidelineDataDisparityEnrollmentEquityEvidence based treatmentFutureGoalsGuidelinesHealthHealth InsuranceInpatientsInterventionMedicareMinorityMorbidity - disease rateNaloxoneOpioidOutcomeOutpatientsPainPain managementPersonsPoliciesPrevention GuidelinesPublic HealthRecommendationResearchRiskSafetySamplingSourceSpecialistSubgroupTimeaddictionchronic painchronic pain managementchronic pain patientcomorbiditydisorder riskdisparity reductiondosageethnic differenceethnic disparityethnic minorityhealth disparityimprovedmortalitynon-drugnon-opioid analgesicnondrug therapyopioid policyopioid use disorderpharmacologicprescription opioidracial differenceracial disparityracial minoritytreatment disparitytreatment patterntrend
项目摘要
In the climate of increased opioid-related morbidity and mortality in the U.S., the safe, effective and
comprehensive management of chronic pain is critically important. People with comorbid chronic pain and
OUD and racial and ethnic minorities deserve specific attention due to their potential under-treatment of
pain and OUD, and elevated risk of adverse health outcomes. In 2016, the Centers for Disease Control
and Prevention (CDC) released a prominent clinical practice guideline that emphasizes non-opioid and
non-drug alternatives for pain management, and recommends safer prescribing practices if opioids are
prescribed to treat chronic pain. An examination of chronic pain treatment patterns over time and in
vulnerable subgroups of minorities and people with co-occurring OUD is needed to understand and
address health disparities in the delivery of guideline concordant treatment for chronic pain. Using 2015 to
2018 Medicare enrollment data combined with inpatient, outpatient and prescription claims data from a
20% national sample, the proposed research aims to: (1) assess racial and ethnic disparities in the types
of chronic pain treatments provided to people with comorbid OUD, and (2) evaluate whether the
implementation of the CDC guideline influenced racial/ethnic disparities in the treatment of chronic pain
for those with OUD. We will categorize pain treatments as pharmacologic, non-pharmacologic, and
combination of pharmacologic and non-pharmacologic. Among those prescribed opioids, we will assess
the guideline concordance of prescribing as it relates to opioid dosage and concurrent benzodiazepine
prescriptions. We hypothesize that racial/ethnic minorities with OUD are less likely to receive guideline
concordant opioid management and non-drug therapy than White chronic pain patients with OUD. We
further anticipate worsened disparities in chronic pain treatment following release of the CDC opioid
guideline. If confirmed, we will explore potential sources of disparities (e.g., co-prescribing of naloxone,
involvement of pain and addiction specialists) that could inform interventions to improve chronic pain
treatment in those with cooccurring OUD. The long-term goal of this research is to characterize and
reduce disparities in receipt of recommended standards of care and evidence-based treatment for people
with co-occurring chronic pain and OUD. Our findings will provide much needed evidence for more
effective and equitable public health and health insurance policy, and can inform future clinical guidelines.
在美国阿片类药物相关发病率和死亡率上升的环境下,安全、有效和
慢性疼痛的综合治疗至关重要。患有慢性疼痛和慢性疼痛的人
种族和族裔少数群体应受到特别关注,因为他们可能受到不公平待遇。
疼痛和OUD,以及不良健康后果的风险增加。2016年,美国疾病控制中心
和预防(CDC)发布了一份重要的临床实践指南,强调非阿片类药物和
用于止痛的非药物替代品,并建议如果阿片类药物
用来治疗慢性疼痛的处方。对慢性疼痛治疗模式随时间和时间的检查
需要了解少数族裔的弱势亚群和患有先天性巨结肠的人
解决慢性疼痛指南一致性治疗过程中的健康差异问题。利用2015年
2018年联邦医疗保险登记数据与住院、门诊和处方索赔数据相结合
20%的国家样本,拟议的研究旨在:(1)评估类型中的种族和民族差异
以及(2)评估慢性疼痛治疗是否
疾控中心指南的实施影响了慢性疼痛治疗中的种族/民族差异
对于那些有OUD的人。我们将疼痛治疗分为药物治疗、非药物治疗和
药理与非药理相结合。在这些处方的阿片类药物中,我们将评估
阿片类药物用量与同时服用苯二氮卓类药物处方的一致性
处方。我们假设,患有OUD的种族/少数民族不太可能收到指导方针
整合阿片类药物治疗和非药物治疗的慢性疼痛患者的疗效优于怀特。我们
在CDC阿片类药物释放后,慢性疼痛治疗中的差异进一步恶化
指导方针。如果得到证实,我们将探索差异的潜在来源(例如,纳洛酮的联合处方,
疼痛和成瘾专家的参与),可以为改善慢性疼痛的干预措施提供信息
对伴发OUD的患者的治疗。这项研究的长期目标是表征和
减少人们接受建议的护理和循证治疗标准方面的差距
同时伴有慢性疼痛和OUD。我们的发现将提供更多亟需的证据
有效和公平的公共健康和健康保险政策,并可为未来的临床指南提供参考。
项目成果
期刊论文数量(0)
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会议论文数量(0)
专利数量(0)
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Patience Moyo Dow其他文献
Patience Moyo Dow的其他文献
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{{ truncateString('Patience Moyo Dow', 18)}}的其他基金
Impact of Medicaid Prescription Cap Policies on Treatment Outcomes for Opioid Use Disorder: A National Mixed Methods Study
医疗补助处方上限政策对阿片类药物使用障碍治疗结果的影响:一项国家混合方法研究
- 批准号:
10637024 - 财政年份:2023
- 资助金额:
$ 9.66万 - 项目类别:
Skilled Nursing Facility Care and Outcomes After Hospitalizations Involving Opioid Use Disorder
涉及阿片类药物使用障碍的住院后熟练护理机构的护理和结果
- 批准号:
10371281 - 财政年份:2022
- 资助金额:
$ 9.66万 - 项目类别:
Skilled Nursing Facility Care and Outcomes After Hospitalizations Involving Opioid Use Disorder
涉及阿片类药物使用障碍的住院后熟练护理机构的护理和结果
- 批准号:
10609800 - 财政年份:2022
- 资助金额:
$ 9.66万 - 项目类别:
Chronic Pain Management and Outcomes in Adults With and Without Opioid Use Disorder
有和没有阿片类药物使用障碍的成年人的慢性疼痛管理和结果
- 批准号:
10302666 - 财政年份:2021
- 资助金额:
$ 9.66万 - 项目类别:
Chronic Pain Management and Outcomes in Adults With and Without Opioid Use Disorder
有和没有阿片类药物使用障碍的成年人的慢性疼痛管理和结果
- 批准号:
10434917 - 财政年份:2021
- 资助金额:
$ 9.66万 - 项目类别:
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