HEALing Measurement Center: Enhancing Opioid Use Disorder Recovery through Measurement Based Care

HEALing 测量中心：通过基于测量的护理促进阿片类药物使用障碍的康复

基本信息

批准号：
10774377
负责人：
Arnie Paul Aldridge
金额：
$ 151.3万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-30 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10774377
关键词：
Address Alcohols Caring Charge Clinical Clinical effectiveness Collection Communication Communities Community Health Community Healthcare Complex Contract Services Data Data Analytics Data Collection Data Sources Death Rate Diagnosis Disease remission Documentation Dropout Effectiveness Environment Equity Evaluation Evidence based intervention Evidence based treatment Face Fostering Goals Grant Health Benefit Health Services Health Services Accessibility Human Hybrids Improve Access Individual Informatics Infrastructure Intervention Lead Leadership Literature Measurement Measures Mental Health Mental disorders Opioid Outcome Patient Care Patient Monitoring Patient-Focused Outcomes Patients Pennsylvania Pharmaceutical Preparations Policy Maker Program Evaluation Protocols documentation Provider Public Health Quality of life Recovery Reporting Research Research Project Grants Risk Role Services Site Substance abuse problem Symptoms System Testing Time Training Universities acceptability and feasibility behavioral health care systems dashboard design effectiveness/implementation hybrid effectiveness/implementation trial healing health organization implementation strategy implementation tool improved innovation learning network medical schools medication for opioid use disorder meetings operation opioid treatment program opioid use disorder overdose death patient retention programs substance use tool

项目摘要

Abstract Opioid use disorder (OUD) remains a critical public health crisis in Pennsylvania. The Pennsylvania Centers of Excellence have been charged with providing opioid treatment, including medication for opioid use disorder (MOUD), to enhance treatment access, promote recovery, and reduce the impact of fatal overdose throughout the state. Despite efforts to improve access to evidence-based treatments for OUD such as medications and integrated behavioral health services, national OUD and opioid involved overdose death rates remain alarmingly high. Current MOUD interventions primarily targeting reduction in OUD symptoms have significant dropout rates (20-50%) and result in remission of OUD for ~36 percent of individuals. The patients with co- occurring substance use and mental health disorders are at greater risk for poor outcomes, often because they have more complex treatment needs that are hard to identify, track, and respond to in real time. To potentially improve OUD intervention outcomes, the overarching goal of the HEALing Measures Center at University of Pittsburgh is to enhance the measurement, quality, and equity of care delivered in community opioid treatment programs (OTPs) through sustained implementation of measurement-based care (MBC). Specifically, the three proposed projects were designed to address the immediate concerns expressed by our partners while simultaneously meeting critical research gaps. Research Plan 1 will develop an MBC Implementation Blueprint including technical assistance, learning networks, and paperwork reduction strategies. Research Plan 2 will demonstrate the fidelity and effectiveness of implementing enhanced MBC implementation (MBC+) versus measurement as usual (MAU) via a stepped-wedge, hybrid type II effectiveness-implementation trial. Research Plan 3 will demonstrate the clinical effectiveness of MBC+ relative to MAU for patients with co-occurring OUD and mental health diagnoses. The proposed study will provide critical preliminary evidence regarding the role and significance of capitalizing on MBC in OUD interventions, enhanced implementation of a sustainable, equitable, and effective MBC intervention via implementation strategies that are co-designed with stakeholders (policymaker, payer, and OTP), and alternative avenues to potentially enhance symptom-related outcomes and treatment retention of OUD interventions with downstream societal, psychological, and public health benefits.

抽象的阿片类药物使用障碍（OUD）仍然是宾夕法尼亚州的关键公共卫生危机。宾夕法尼亚州的中心卓越已被指控提供阿片类药物治疗，包括阿片类药物使用障碍的药物（MOUD），以增强治疗访问，促进恢复并减少整个致命过量的影响国家。尽管努力改善了对OUD的基于证据的治疗的机会，例如药物和综合行为卫生服务，国家奥德和阿片类药物涉及的过量死亡率仍然存在令人震惊的高。当前的MOUD干预措施主要针对降低OUD症状的干预措施显着辍学率（20-50％），并导致约36％的个体减轻OUD。共同患者发生的药物使用和心理健康障碍的预后不良风险更大，通常是因为它们拥有更复杂的治疗需求，这些需求很难实时识别，跟踪和响应。潜在改善OUD干预结果，这是大学康复措施中心的总体目标匹兹堡将增强社区阿片类药物治疗中提供的测量，质量和公平性通过持续实施基于测量的护理（MBC）的计划（OTP）。具体来说，旨在解决我们合作伙伴表达的直接关注的三个拟议项目同时满足关键的研究差距。研究计划1将制定MBC 实施蓝图，包括技术援助，学习网络和减少文书工作策略。研究计划2将证明实施增强的MBC的忠诚度和有效性像往常有效实施试验。研究计划3将证明MBC+的临床有效性相对于共同发生OUD和心理健康诊断患者的MAU。拟议的研究将提供有关在OUD中资本化MBC的作用和意义的关键初步证据干预措施，增强了可持续，公平且有效的MBC干预与利益相关者（决策者，付款人和OTP）共同设计的实施策略，以及替代途径可能会增强与症状相关的结局和OUD的治疗保留率下游社会，心理和公共卫生益处的干预措施。