Characteristics and outcomes for hospitalized patients with methamphetamine and opioid co-use: Identifying opportunities for hospital-based addiction services tailored to co-use

甲基苯丙胺和阿片类药物同时使用的住院患者的特征和结果：确定针对共同使用的医院成瘾服务的机会

• 批准号: 10677138
• 负责人: Riley Shearer
• 金额: $ 4.08万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677138
• 关键词: Accounting; Address; Administrator; Admission activity; Advocacy; Age; Ambulatory Care; Automobile Driving; Cessation of life; Characteristics; Clinical; Clinical Medicine; Communication; Communities; Community Hospitals; Complex; Consult; Consultations; Cox Proportional Hazards Models; Data; Death Certificates; Death Rate; Development; Educational process of instructing; Effectiveness; Electronic Health Record; Ethnic Origin; Evaluation; Fellowship; Frontline worker; Funding; Future; Gender; Goals; Health; Health Services Accessibility; Health Services Research; Hospital Mortality; Hospitalization; Hospitals; Individual; Inpatients; Insurance Coverage; Intervention; Interview; Lead; Length of Stay; Link; Location; Logistics; Medicine; Methamphetamine; Methods; National Research Service Awards; Nurses; Opioid; Outcome; Overdose; Patient Care; Patients; Pattern; Pharmaceutical Preparations; Physicians; Provider; Race; Readiness; Research; Research Methodology; Research Personnel; Resources; Risk Reduction; Sampling; Services; Shapes; Social Workers; Structure; Substance Use Disorder; Surveys; Time; Training; United States; Work; addiction; comorbidity; demographics; design; experience; hospital readmission; improved; individualized medicine; medication for opioid use disorder; methamphetamine use; mortality; opioid use; overdose death; polysubstance use; prevent; programs; readmission rates; readmission risk; response; skills; social stigma; sociodemographics; substance use; treatment services

PROJECT SUMMARY/ABSTRACT Drug overdose deaths continue to rise in the United States, accounting for over 100,000 deaths in 2021 alone. Methamphetamine and opioid co-use are largely fueling the most recent increase in mortality. In addition, co- use associated hospital admissions increased more than five-fold between 2003 and 2015. Previous research and hospital-based addiction services for substance use have focused on opioid use alone. These addiction medicine services have increased rates of medication for opioid use disorder and improved patient linkage to continuing outpatient treatment. As a result, hospital length of stay and readmission rates have decreased. However, past research indicates individuals with co-use have different sociodemographic and health profiles and are less likely to receive medication for opioid use disorder than individuals who use opioids alone. There is limited evidence of how existing hospital-based addiction services effect patients who co-use methamphetamine and opioids or how these services could be tailored to better treat hospitalized patients with co-use. The overall objective of this Kirschstein-NRSA F30 fellowship is to generate evidence that can guide the eventual development, implementation, and evaluation of hospital addiction medicine treatment services tailored to co-use. The specific aims of this proposal are: 1) to characterize patient demographics and hospitalization characteristics associated with co-use from a nationally representative sample of inpatient hospitalizations, 2) to quantify the risk of re-admission and mortality following hospital discharge, by substance use profile, and whether differences vary by the receipt of hospital-based addiction services and 3) to identify barriers and facilitators to providing hospital-based addiction services tailored for patients with co-use. The proposed mixed methods project is based on a sequential explanatory approach. It includes training in both quantitative (Aims 1 & 2) and qualitative (Aim 3) research methodologies. Through this work and a thoughtfully designed training plan, the trainee will achieve the following goals: 1) develop health services research expertise, 2) advance the substance use research field as it relates to polysubstance use, 3) integrate research, clinical, and advocacy activities in the field of addiction medicine. This supports his long-term goal of bridging health services research and clinical medicine to support patients with substance use disorders as a physician-researcher.

项目摘要/摘要 药物过量死亡在美国继续增加，仅在2021年就会占100,000多人死亡。 甲基苯丙胺和阿片类药物共同使用在很大程度上助长了死亡率的最新增长。另外，共同 在2003年至2015年期间，使用相关的医院入院增加了五倍以上。 以前的研究和基于医院的吸毒服务仅针对阿片类药物使用。 这些成瘾医学服务具有增加阿片类药物使用障碍的药物率，并改善了 患者与继续门诊治疗的患者联系。结果，住院时间和再入院率 减少了。但是，过去的研究表明有共同使用的人具有不同的社会人口统计学 和健康状况，与使用的人相比，接受阿片类药物使用障碍的药物不太可能 仅阿片类药物。有限的证据表明现有基于医院的成瘾服务如何影响患者 共同使用甲基苯丙胺和阿片类药物或这些服务如何量身定制以更好地治疗住院治疗 共同使用的患者。 这个Kirschstein-NRSA F30奖学金的总体目标是产生可以指导的证据 医院成瘾医学治疗服务的最终开发，实施和评估 量身定制为共同使用。该提案的具体目的是：1）表征患者人口统计和 与全国代表性住院样本相关的住院特征 住院，2）量化出院后重新入院和死亡率的风险 使用个人资料，以及差异是否因收到基于医院的成瘾服务而有所不同，3） 提供为有共同使用的患者量身定制的基于医院的成瘾服务的障碍和促进者。 提出的混合方法项目基于一种顺序解释方法。它包括培训 定量（目标1和2）和定性研究方法。通过这项工作和 经过精心设计的培训计划，学员将实现以下目标：1）开发医疗服务 研究专业知识，2）促进与多物质使用有关的物质使用研究领域，3）整合 成瘾医学领域的研究，临床和倡导活动。这支持了他的长期目标 桥接健康服务研究和临床医学，以支持药物使用障碍患者作为一种 医师研究者。