Incentivized Collaborative Care to Desseminate Contingency Management

激励性协作护理以普及应急管理

• 批准号: 10765107
• 负责人: Anthony DeFulio
• 金额: $ 81.91万
• 依托单位: DYNAMICARE HEALTH, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10765107
• 关键词: Incentivized; Collaborative; Care; Desseminate; Contingency

ABSTRACT Contingency management, an incentive-based intervention, boasts a massive research base and has been demonstrated efficacy in increasing drug abstinence and medication adherence in people with opioid use disorder. There is a huge gap between the evidence in support of this approach and its dissemination in practice. A digital health program that surmounts most of the barriers to dissemination has been developed that collects all the relevant data and implements all of the contingency management procedures automatically. This program has been shown to be efficacious in several peer-reviewed studies. However, one key barrier to dissemination remains. In order for contingency management to become truly impactful on a national scale, providers must actively engage patients by informing them about it, encouraging them to use it, assisting their enrollment, and then using the data generated by the platform to inform their ongoing care. The best way to surmount this final barrier is to use the motivational technique of contingency management itself; incentivize the necessary provider behaviors. Thus, this SBIR Fast Track application proposes to develop and evaluate a novel incentivized collaborative care model for the delivery of contingency management services for buprenorphine pharmacotherapy patients with opioid use disorders. We believe this model will have the important secondary effect of increasing access to buprenorphine pharmacotherapy, as prescribers will be indirectly incentivized to maximize the number of buprenorphine patients in their practice. Phase I will begin with preparatory activities, including streamlining the enrollment system so that any buprenorphine prescriber can use it, adding data collection systems for provider information, and data display systems that providers can use to easily access the patient data they wish to see. A Phase I feasibility study (n = 10) will follow. The milestones require the potential of the incentivized collaborative care model in disseminating contingency management to be demonstrated. If successful, the feasibility study will pave the way for a randomized controlled trial (RCT). This RCT will be the primary activity of Phase II of this SBIR award, and is designed to evaluate the efficacy of incentivized collaborative care in the dissemination of contingency management. Primary outcome measures will include the engagement in collaborative care in relation to the contingency management intervention, as well as buprenorphine prescribing trends. Secondary analyses will be designed to assess the economic effect of DynamiCare on providers. The RCT will also include exploratory analyses of patient outcomes. Overall, this project is highly consistent with current ONDCP priorities to, “Identify and address policy barriers related to contingency management interventions (motivational incentives),” and “Explore reimbursement for motivational incentives and digital treatment for addiction.” If successful, this project could lead to rapid dissemination of contingency management and improved access to buprenorphine pharmacotherapy to people with opioid use disorder throughout the United States.

抽象的 应急管理是一种基于激励的干预措施，拥有庞大的研究基础，并已被广泛应用。 已证明可有效提高阿片类药物使用人群的戒毒和药物依从性 紊乱。支持这种方法的证据与其传播范围之间存在巨大差距 实践。克服了大部分传播障碍的数字健康计划已经制定 收集所有相关数据并实施所有应急管理程序 自动地。多项同行评审研究表明该计划是有效的。然而，一 传播的主要障碍仍然存在。为了使应急管理真正发挥作用 在全国范围内，提供者必须通过向患者通报信息、鼓励他们使用它来积极吸引患者， 协助他们注册，然后使用平台生成的数据来告知他们正在进行的护理。这 克服这个最后障碍的最佳方法是使用应急管理本身的激励技术； 激励必要的提供者行为。因此，该 SBIR 快速通道申请建议开发和 评估用于提供应急管理服务的新型激励协作护理模式 用于丁丙诺啡药物治疗患有阿片类药物使用障碍的患者。我们相信这个模型将具有 增加丁丙诺啡药物治疗的可及性的重要副作用，因为处方者将 间接激励他们在实践中最大限度地增加丁丙诺啡患者的数量。第一阶段将开始 开展准备活动，包括简化登记系统，以便任何丁丙诺啡 处方者可以使用它，添加提供者信息的数据收集系统和数据显示系统 提供者可以使用它轻松访问他们希望查看的患者数据。第一阶段可行性研究（n = 10）将 跟随。这些里程碑需要激励协作护理模式在传播方面的潜力 应急管理有待论证。如果成功，可行性研究将为 随机对照试验（RCT）。该 RCT 将是 SBIR 奖项第二阶段的主要活动， 旨在评估激励协作护理在传播突发事件中的有效性 管理。主要结果指标将包括参与与以下方面相关的协作护理： 应急管理干预，以及丁丙诺啡处方趋势。二次分析将 旨在评估 DynamiCare 对提供商的经济影响。 RCT 还将包括探索性 分析患者的结果。总体而言，该项目与当前 ONDCP 的优先事项高度一致， “识别并解决与应急管理干预措施相关的政策障碍（激励措施） 激励）”和“探索激励激励的报销和成瘾的数字治疗”。如果 如果该项目取得成功，可以迅速传播应急管理并改善获得服务的机会 丁丙诺啡对美国各地阿片类药物使用障碍患者进行药物治疗。