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

项目摘要/摘要 在K01指导研究科学家发展奖的提案中，Shashi Kapadia医学博士 提出一个培训和研究计划，使他能够成为一名独立的医生-研究员 重点关注影响吸毒者健康的政策和制度因素。卡帕迪亚博士目前是 威尔·康奈尔大学传染病科医学，其研究重点是丙型肝炎 (丙型肝炎病毒)注射吸毒者的治疗机会(PWID)。 为了实现他的长期目标，卡帕迪亚博士将获得评估护理提供模式的技能，这些模式 将医疗保健和行为保健结合起来，特别是药物使用障碍的护理。他会学到 政策研究的方法论途径，包括自然的实验设计和分析 管理/索赔数据，进行混合方法研究，并使用模拟模型预测 公共卫生干预措施的影响。他将通过正式的组合实现这些培训目标 课程作业、在不同护理环境中的轮换、指导和实践研究经验。他会成为 由布鲁斯·沙克曼博士(小学)、包玉华博士、大卫·帕尔曼博士、克里斯汀·马克斯博士和鲍玉华博士指导。 埃里卡·马丁，以及一个专家顾问团队。加在一起，这些人在所有 卡帕迪亚博士在本授奖期间寻求发展的培训领域。 卡帕迪亚博士将在拟议的职业发展期间研究的人口健康问题 奖励是需要改善PWID患者获得丙型肝炎病毒治疗的机会，重点是纽约州。已扩展 需要获得治疗，以防止肝病的长期发病率和死亡率，并有可能 消除丙型肝炎病毒传播。将丙型肝炎病毒治疗纳入初级保健和药物使用治疗 环境可能有助于减少扩大治疗的障碍。在他提议的研究中，卡帕迪亚博士将使用数据 来自纽约州医疗补助计划，以研究初级保健中丙型肝炎治疗吸收的趋势(目标1)。他会的 进行访谈，将这些量化结果与背景联系起来，并得出进一步支持的因素 将治疗纳入初级保健、药物使用治疗和注射器服务计划。(目标2)。他 然后，我将根据这些发现开发一个模拟模型，以预测综合护理模型的影响 关于纽约州PWID的丙型肝炎治疗(目标3)。 拟议的研究将测试综合丙型肝炎病毒护理是否得到有效利用，描述 实现这一目标的障碍，并分析其对丙型肝炎病毒感染者，特别是PWID感染者健康的影响。它 将与决策者和公共卫生从业者相关。此外，卡帕迪亚博士将掌握的技能 通过完成此指导研究和培训计划而获得的收益将使他能够寻求未来的R01 资助并实现他成为一名独立调查员的目标。

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.