Researching Effective Strategies to Prevent Opioid Death (RESPOND)

研究预防阿片类药物死亡的有效策略（RESPOND）

• 批准号: 10369647
• 负责人: Benjamin P. Linas
• 金额: $ 68.65万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2023-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10369647
• 关键词: Age; American; Caring; Cessation of life; Clinical Research; Cost Sharing; Costs and Benefits; Coupled; Criminal Justice; Data; Data Set; Data Sources; Economic Factors; Epidemic; Epidemiologic Factors; Evidence based treatment; Exercise; FDA approved; Funding; Goals; Gold; Health Care Costs; Health Policy; Insurance; Insurance Coverage; Intervention; Knowledge; Life Expectancy; Literature; Massachusetts; Medical; Medicine; Methadone; Modeling; Morals; Naltrexone; Operating System; Opioid; Outcome; Overdose; Patients; Persons; Pharmaceutical Preparations; Policies; Policy Maker; Population; Positioning Attribute; Process; Public Health; Records; Registries; Regulation; Research; Research Personnel; Resources; Social Functioning; Societies; Suboxone; Substance Use Disorder; Symptoms; System; Thinking; Time; Translating; Work; addiction; care delivery; cost; cost effective; experience; fight against; health economics; illicit opioid; improved; innovation; models and simulation; mortality; multiple data sources; opioid mortality; opioid overdose; opioid use; opioid use disorder; population health; premature; prevent; prior authorization; programs; public health emergency; simulation; skills; standard of care; stem; symposium; synergism

PROJECT SUMMARY The misuse of and addiction to opioids is an epidemic in the U.S. that now reduces U.S. life expectancy. Overdose is the leading cause of premature death among Americans under the age of 50. More than 2 million Americans struggle with an opioid use disorder (OUD). Buprenorphine-naloxone, naltrexone, and methadone are all FDA-approved medications for OUD (MOUDs) that decrease opioid use and mortality and are the gold- standard of care. At this time, however, fewer than 20% of patients with OUD receive those treatments. We do not have a functioning system to treat OUD. Innovation to the way that we deliver OUD treatment could provide the OUD care we now need. Our team works with colleagues at Massachusetts Department of Public Health to investigate the OUD epidemic in MA and also recently convened a national stakeholder conference to identify feasible action plans for the OUD epidemic. What is clear is that state policy makers seek evidence to inform system-level change. System-level thinking investigates how systems operate and how they can be modified to produce desired outcomes. At this time, system-level data about OUD treatment are very limited and inconsistent. Simulation models integrate data from multiple sources to translate outcomes from clinical studies to policy-relevant data about population health and cost. A model that simulates the population with OUD in a state can be used to investigate delivery system innovations and project the impact on public health outcomes and cost and will be invaluable in the fight against OUD. Our goal is to inform state-level innovation for low- barrier access to MOUDs. Our objective is a five-year research program, Researching Effective Strategies to Prevent Opioid Death (RESPOND), that will develop a simulation model of OUD treatment and use it to inform system-level change. Our specific aims are: Aim 1: To develop and validate a state-level, population simulation model of OUD treatment and OUD care delivery. To build the simulation, we will leverage the MA “chapter 55” dataset, a first-in-the-nation administrative records registry to study OUD. Aim 2: To develop priorities for delivering low-barrier access to MOUDs and identify epidemiologic and economic factors that should drive priorities at the state-level. We will investigate the benefits and cost of six models for implementing low-barrier access to MOUDs. We will identify innovations that provide the greatest benefit given available resources, and thereby develop priorities for policy. Aim 3: To simulate state-level regulations that govern insurance coverage for MOUDs to investigate how regulatory change could be coupled to innovation in OUD care delivery. We will simulate changes including requiring payers to reimburse MOUD treatment, prohibiting cost-sharing, and eliminating prior-authorization. Our team assembles national leaders in addiction medicine, simulation modeling, healthcare policy, and health economics to apply the power of simulation models to the OUD epidemic. Our innovative work will make RESPOND a national resource to inform a new kind of OUD care.

项目摘要 阿片类药物的滥用和成瘾在美国是一种流行病，现在降低了美国人的预期寿命。 药物过量是50岁以下美国人过早死亡的主要原因。超过2百万 美国人患有阿片类药物使用障碍（OUD）。丁丙诺啡-纳洛酮、纳洛酮和美沙酮 是FDA批准的所有OUD药物（MOUD），可减少阿片类药物的使用和死亡率，是黄金- 护理标准。然而，目前只有不到20%的OUD患者接受这些治疗。我们 没有一个有效的系统来治疗OUD。我们提供OUD治疗的创新方式可以提供 我们现在需要的OUD护理。我们的团队与马萨诸塞州公共卫生部的同事合作， 调查MA的OUD流行情况，最近还召开了一次全国利益相关者会议， 针对OUD流行病的可行行动计划。很明显，国家政策制定者寻求证据， 系统级的变化。系统级思维研究系统如何运行，以及如何修改它们， 产生预期的结果。目前，关于OUD治疗的系统级数据非常有限， 前后矛盾模拟模型集成了来自多个来源的数据，以转化临床研究的结果 与人口健康和成本相关的政策数据。一个模型，模拟人口与OUD在 国家可用于调查交付系统创新并预测对公共卫生结果的影响 和成本，并将在打击OUD的宝贵。我们的目标是为低水平的国家创新提供信息- 进入MOUD的障碍。我们的目标是一个为期五年的研究计划，研究有效的战略， 预防阿片类药物死亡（RESPOND），将开发OUD治疗的模拟模型，并使用它来告知 系统级的变化。我们的具体目标是：目标1：开发和验证一个国家级的人口模拟 OUD治疗和OUD护理提供模式。为了构建模拟，我们将利用MA“第55章” 数据集，第一个在全国行政记录登记研究OUD。目标2：制定优先事项， 提供低障碍获得MOUD的机会，并确定应推动 国家一级的优先事项。我们将研究实施低壁垒的六种模式的好处和成本 进入MOU。我们将确定在现有资源范围内提供最大效益的创新， 从而制定政策优先事项。目标3：模拟管理保险范围的州级法规 MOUDs调查如何将监管变化与OUD护理服务的创新结合起来。我们将 模拟变化，包括要求付款人偿还MOUD治疗，禁止费用分摊， 取消了事先授权我们的团队聚集了成瘾医学，模拟 建模、医疗保健政策和卫生经济学，将模拟模型的力量应用于OUD 疫情我们的创新工作将使RESPOND成为一个国家资源，为一种新的OUD护理提供信息。