Building and Implementing Best Practices for Buprenorphine Initiation in the Setting of Fentanyl Use
Building and Implementing Best Practices for Buprenorphine Initiation in the Setting of Fentanyl Use
在芬太尼使用情况下建立和实施丁丙诺啡起始的最佳实践
批准号：
10721763
负责人：
Elenore Bhatraju
金额：
$18.8万
依托单位：
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
项目状态：
未结题
起止时间：
2023-08-15 至 2028-07-31
关键词：
Absence of pain sensationAwardAwarenessBuprenorphineCaringCertificationCessation of lifeClinicalCommunitiesComplexConsensusCounselingCountryDataData CollectionDoseEffectivenessEnrollmentFDA approvedFailureFeedbackFentanylFundingFutureGoalsHospitalsIndividualInpatientsInterviewLifeLiteratureMedical centerMethadoneMethodsMorbidity - disease rateNaltrexoneNatureOpioidOpioid agonistOutcomeOutpatientsPatient CarePatientsPenetrationPersonsPharmaceutical PreparationsPhasePhysiciansPilot ProjectsPractice GuidelinesPreparationPrevalenceProceduresProcessProviderQualitative MethodsQualitative ResearchRandomizedReactionResearchResearch MethodologyResearch PersonnelResearch SupportResearch TrainingReview LiteratureRiskRuralSafetySecondary toSubstance Use DisorderTimeTrainingTreatment FailureVentilatory DepressionWaiting ListsWithdrawalWorkaddictioncareereffectiveness/implementation studyevidence baseexperiencefeasibility testingfentanyl useimplementation barriersimplementation evaluationimplementation facilitatorsimplementation scienceimprovedimproved outcomeinnovationlipophilicitymedication for opioid use disordermortalitymultidisciplinarynovelopioid useopioid use disorderoverdose deathpreferenceprovider factorsrecruitrelative effectivenessresponsesafety nettoolvirtual
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PROJECT SUMMARY
Morbidity and mortality related to opioid use continue to rise, with fentanyl now the most
common opioid involved in overdose death. Despite three FDA approved medications for opioid
use disorder (MOUD)—methadone, buprenorphine, and naltrexone--as many as 3 out of 4
people with OUD are not on any of these lifesaving medications, which speaks to failures in
implementation. The penetration of fentanyl into the opioid supply has made strategies for
initiation of buprenorphine even more complex. Growing literature describes increased
precipitated withdrawal at the time of buprenorphine initiation, thought to be secondary to the
lipophilic nature of fentanyl. There is an urgent need to better understand how we can
successfully engage more people in treatment that we know decreases morbidity and mortality
related to OUD. The work proposed in this K23 application will investigate the initiation of
buprenorphine in the setting of fentanyl use from both the patient and provider perspectives. We
will utilize novel methods to develop a buprenorphine initiation toolkit and then will pilot the
implementation of this new tool. The specific aims of the research are to: 1. Use qualitative
methods to explore the experience of both patients and providers initiating buprenorphine for
OUD in the setting of fentanyl use. 2a. Conduct a modified Delphi process to investigate expert
consensus regarding buprenorphine initiation in the setting of fentanyl. 2b. Work with a
multidisciplinary group to develop a buprenorphine initiation toolkit, and 3: Conduct a pilot study
to evaluate the acceptability, feasibility and effectiveness of the buprenorphine initiation toolkit.
Along with the multipronged training plan, this research will support my overarching goal of
becoming an independent physician researcher focused on improving outcomes for people with
substance use disorders through innovative implementation approaches.
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