Midwestern changes in substance use and treatment during the COVID-19 pandemic

COVID-19 大流行期间中西部物质使用和治疗的变化

• 批准号: 10449194
• 负责人: LISA M MCFADDEN
• 金额: $ 24.9万
• 依托单位: SANFORD RESEARCH/USD
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10449194
• 关键词: Alcohol consumption; American Indians; Buprenorphine; COVID-19 pandemic; Classification; Computerized Medical Record; County; Drug usage; Economics; Health Policy; Measures; Midwestern United States; Overdose; Patients; Pharmaceutical Preparations; Provider; Research; Role; Rural; Rural Population; Substance Use Disorder; Time; United States Department of Agriculture; Use Effectiveness; buprenorphine treatment; effectiveness evaluation; opioid use; opioid use disorder; population health; precision medicine; rural area; stimulant use disorder; substance use; substance use treatment; telehealth; trend; urban area

The SAR-CoV-2 pandemic has contributed to widespread health and healthcare policy changes, including that surrounding substance use disorders. Early indicators suggest that substance use may be increasing, but healthcare policy changes may help counter this increase. Restrictions on telehealth use for the treatment of substance use disorders and the dispensing of drugs to treat opioid use disorder have been eased. This change may be particularly helpful in rural areas where local providers are sparse. The current proposal will investigate changes in substance use and evaluate telehealth's use and effectiveness for the treatment of substance use disorders while exploring the role of rural or urban locations in these trends. The proposed studies will be accomplished through three aims. In the first aim, electronic medical records will be queried to identify patients with alcohol, opioid, or stimulant use disorder or overdoses during the time period encompassing March 2019-April 2021 in the Midwest. Demographic variables, economic variables, and USDA rural/urban classification will be included in the analysis. This aim will help determine trends in drug use measures across the rural/urban spectrum during a period of dynamic change. In the second aim, the use and effectiveness of telehealth for the treatment of substance use disorders will be evaluated. Given the proximity to providers is often cited as barriers to substance use treatment in rural locations, this aim will evaluate the effectiveness of telehealth across the rural/urban continuum. In the third aim, changes in buprenorphine treatment for opioid use disorder will be investigated. Given the sparsity of licensed buprenorphine providers in the rural Midwest, this aim will also examine the use and effectiveness of telehealth for delivering buprenorphine treatment in underserved counties. The resulting findings will provide a better understanding of substance use disorders across the urban and rural continuum while providing critical information to guide healthcare policies related to telehealth usage to treat substance use disorders. The resulting findings will be crucial in developing precision medicine to treat substance use disorder in urban and rural locations.

SARS-CoV-2大流行促进了广泛的卫生和医疗保健政策变化，包括周围的物质使用障碍。早期指标表明，物质使用可能正在增加，但医疗保健政策的变化可能有助于抵消这一增长。对远程保健用于治疗药物使用障碍和分发治疗阿片类药物使用障碍的限制已经放宽。这一变化在当地供应商稀少的农村地区可能特别有帮助。目前的提案将调查物质使用的变化，评估远程保健在治疗物质使用障碍方面的使用和有效性，同时探索农村或城市地点在这些趋势中的作用。拟议的研究将通过三个目标完成。在第一个目标中，将查询电子医疗记录，以识别中西部地区在2019年3月至2021年4月期间患有酒精、阿片类药物或兴奋剂使用障碍或过量的患者。分析将包括人口变量、经济变量和美国农业部城乡分类。这一目标将有助于确定在动态变化时期整个城乡范围内的药物使用措施的趋势。在第二个目标中，将评估远程保健在治疗药物使用障碍方面的使用和效果。鉴于接近提供者经常被认为是农村地区药物使用治疗的障碍，这一目标将评估农村/城市连续统一体的远程保健的有效性。在第三个目标中，将调查丁丙诺啡治疗阿片类药物使用障碍的变化。考虑到许可的稀缺性 为了在中西部农村地区提供丁丙诺啡，这一目标还将审查远程保健在服务不足的县提供丁丙诺啡治疗的使用和有效性。由此产生的发现将提供更好地了解整个城市和农村的物质使用障碍，同时提供关键信息，以指导与远程保健使用相关的医疗政策，以治疗物质使用障碍。这一结果将对开发治疗城乡药物使用障碍的精准医学至关重要。