Prediction of Return to Opioid Use During Immediate Community Reintegration

在立即重新融入社区期间恢复阿片类药物使用的预测

• 批准号: 10711730
• 负责人: Nicole Holland Weiss
• 金额: $ 26.01万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10711730
• 关键词: Biometry; Centers of Research Excellence; Community Integration; Coupled; Data; Ecological momentary assessment; Environmental Monitoring; Galvanic Skin Response; Health; Hour; Individual; Inpatients; Life; Methods; Opioid; Overdose; Persons; Physiology; Post-Traumatic Stress Disorders; Research; Risk; Severities; Symptoms; Testing; Time; Work; community reintegration; contextual factors; evidence base; heart rate variability; high risk; innovation; opioid use; opioid use disorder; prevent; preventive intervention; return to use; tool; wearable sensor technology

PROJECT SUMMARY/ABSTRACT Nearly 400,000 people with an opioid use disorder (OUD) receive OUD treatment each year, or 19.7% of all people with an OUD. Community reintegration following residential OUD treatment is a critically vulnerable time, with most inpatients returning to use within 30 days. Given the extremely brief window of opportunity for prevention intervention, evaluating time-sensitive proximal predictors of return to opioid use during community reintegration is essential. Risk for return to use fluctuates substantially-even within timescales of hours-with some people displaying higher variability than others. Identifying predictors of return to opioid use thus requires methods that can track return to use closely over time, rather than relying on retrospective or cross-sectional assessments. Ecological monitoring tools can accurately record severity and variability of return to opioid use in daily life, proximally to when they occur. Yet, application of this work during the extremely high-risk period of community reintegration is scarce. The proposed study will assess time-varying, longitudinal changes in posttraumatic stress disorder (PTSD) symptoms on risk for return to opioid use during community reintegration. Further, the influence of physiology (heart rate variability [HRV] and electrodermal response [EDA]) on risk for return to opioid use-including when coupled with PTSD symptoms-will be explored. These findings will inform evidence-based tools to prevent and/or delay return to opioid use during community integration. This study advances research by using ecological momentary assessment (EMA) and a wearable biosensor (Empatica) to test proximal relations between PTSD symptoms and return to opioid use-and the influence of physiology-in the 30 days immediately following residential OUD treatment (N=150). EMA and biometrics capture data frequently (or, for the Empatica E4, continuously), naturalistically, and in near real-time, allowing for explication of within-person, proximal relations, as well as contextual factors underlying risk. Aim 1 determines the influence of PTSD on return to opioid use during immediate community reintegration of OUD inpatients. Aim 2 evaluates the utility of passively collected physiology to detect return to opioid use during immediate community reintegration of OUD inpatients. The proposed research fills important gaps regarding time-sensitive proximal predictors of return to opioid use during the high-risk and understudied period of community reintegration. This work is important, timely, and innovative. Developing evidence-based tools to prevent and delay return to opioid use during community reintegration has important implications for the health of individuals in our nation.

项目 总结/摘要 每年有近40万阿片类药物使用障碍（OUD）患者接受OUD治疗，占总人数的19.7%。 所有的人都有OUD。社区重新融合后，住宅OUD治疗是一个非常脆弱的 大多数住院患者在30天内恢复使用。鉴于极其短暂的机会之窗， 预防干预，评估社区期间恢复阿片类药物使用的时间敏感的近端预测因素 重返社会至关重要。恢复使用的风险波动很大-即使在几小时的时间尺度内-有些 表现出更高变异性的人因此，确定阿片类药物使用回归的预测因素需要 方法，可以跟踪返回使用密切随着时间的推移，而不是依赖于回顾性或横截面 评估。生态监测工具可以准确记录阿片类药物复吸的严重程度和变异性， 日常生活中，接近他们发生的时候。然而，这项工作在极高风险时期的应用， 重新融入社区的情况很少。拟议的研究将评估时间变化，纵向变化， 创伤后应激障碍（PTSD）症状对重返社区期间阿片类药物使用风险的影响。 此外，生理学（心率变异性[HRV]和皮肤电反应[EDA]）对 将探讨阿片类药物使用的回归，包括与PTSD相关的回归。这些发现将为我们提供信息 以证据为基础的工具，以防止和/或延迟在社区融合期间重新使用类阿片。 本研究通过使用生态瞬时评估（EMA）和可穿戴生物传感器推进研究 （Empatica）测试PTSD症状和恢复阿片类药物使用之间的近端关系-以及 生理学-在住宅OUD治疗后30天内（N=150）。EMA和生物特征捕获 数据频繁（或者，对于Empatica E4，连续），自然，并且接近实时，允许 解释人内、近端关系以及潜在风险的背景因素。目标1确定了 创伤后应激障碍对OUD住院患者立即重返社区期间恢复阿片类药物使用影响目的2 评估被动收集生理学检测阿片类药物返回的效用 在OUD住院患者立即重返社区期间使用。 拟议的研究填补了关于阿片类药物回归的时间敏感近端预测因素的重要空白 在重返社区的高风险和未充分研究期间使用。这项工作是重要的，及时的， 新颖啊开发循证工具，以预防和延迟社区期间恢复使用阿片类药物 重返社会对我国个人的健康具有重要影响。