Impact of the COVID-19 pandemic on patient outcomes, telehealth care delivery, and treatment for unhealthy alcohol use in vulnerable patients with advanced liver disease across two healthcare systems

项目总结(补编) 本行政补充申请旨在申请额外拨款，以符合 NOT-AA-19-020，《关于NIAAA人类受试者资助研究数据共享政策的通知》 由国家酒精滥用和酒精中毒研究所(NIAAA)资助。正如在 通知，NIAAA要求NIAAA资助的包括人类受试者的研究提交 识别的数据进入NIAAADA，这是由NIMH托管和管理的NIAAA数据存储库 数据存档(NDA)，通过广泛的数据共享来增加研究的价值。 这项补充请求的目标是确保预算支助，以满足以下要求 保密协议。通过本附录提交的数据将包括家长研究数据 与新冠肺炎期间晚期慢性肝病患者的护理相关 两个卫生系统的肝病实践中的流行病，一个公共安全网系统和 退伍军人事务部医疗保健系统。在母公司的研究中，我们将：1)评估 新冠肺炎大流行对晚期慢性阻塞性肺病患者临床转归的影响 肝病实践中的护理，在自然实验中；2)评估患者报告的经验 使用远程医疗应对大流行，以提供肝病专科护理 晚期慢性阻塞性肺疾病患者；3)进行随机对照试验评估疗效 以及利用远程医疗对不健康的酒精使用进行阶梯式酒精治疗的可行性 与平时相比，酒精性CLD患者在肝科接受护理 关心。完成这些研究目标的数据将包括在数据存档中，以 由本行政副刊提供支持。

PROJECT SUMMARY (SUPPLEMENT) This administrative supplement application is to request additional funds in order to comply with NOT-AA-19-020, “Notice of NIAAA Data-Sharing Policy for Human Subjects Grants Research Funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).” As stated in the Notice, the NIAAA requires NIAAA-funded studies that include human subjects to submit de- identified data into the NIAAADA, a NIAAA data repository hosted and managed by the NIMH Data Archive (NDA), in order to increase value to research through widespread data sharing. The goal of this supplement request is to ensure budgetary support to fulfill the requirements of the NDA. The data to be submitted through this supplement will include parent study data relevant to the care of patients with advanced chronic liver disease (CLD) during the COVID-19 pandemic within hepatology practices in two health systems, a public safety net system and Veterans Affairs healthcare systems. In the parent study we will: 1) evaluate the impact of the COVID-19 pandemic on clinical outcomes of vulnerable patients with advanced CLD receiving care in hepatology practices, in a natural experiment; 2) Evaluate patient-reported experiences with use of telemedicine in response to the pandemic to deliver hepatology specialty care in those with advanced CLD; and 3) Conduct a randomized controlled trial evaluating the efficacy and feasibility of a stepped alcohol treatment using telemedicine on unhealthy alcohol use in patients with alcohol-related CLD receiving care in hepatology practices, compared with usual care. Data from the completion of these study objectives will be included in the data archiving to be supported by this administrative supplement.