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Reducing Unused Prescribed Opioids After Cesarean Birth

减少剖腹产后未使用的处方阿片类药物

基本信息

批准号：
10671569
负责人：
Sarah Scheiderich Osmundson
金额：
$ 16.88万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-01 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10671569
关键词：
Abdomen Accidents Acute Analgesics Anesthesiology Attention Award Biometry Birth Calibration Caring Cesarean section Cessation of life Characteristics Clinical Clinical Investigator Clinical Trials Conduct Clinical Trials Development Development Plans Discipline of obstetrics Electronic Health Record Electronics Emotional Epidemiology Family Family member Feeling Flushing Foundations Friends Goals Guidelines Gynecology Habits Health system Heroin Hospitals Individual Infant Interdisciplinary Study Interview K-Series Research Career Programs Leadership Legal Location Mental Depression Mentors Methods Minority Mothers National Institute of Drug Abuse Operative Surgical Procedures Opioid Overdose Pain Pain Measurement Pain management Parameter Estimation Patient Outcomes Assessments Patients Pattern Persons Pharmaceutical Preparations Postoperative Pain Provider Public Health Randomized, Controlled Trials Readiness Recommendation Reporting Research Research Personnel Research Training Risk Role Safety Sampling Scholarship Site Smoking Testing Time Training United States United States Food and Drug Administration Woman Work career career development chronic pain clinical decision support clinically significant data tools effectiveness study experience illicit opioid improved innovation instrument multidisciplinary nonmedical use opioid abuse opioid disposal opioid epidemic opioid misuse opioid mortality opioid overdose opioid use overdose death pain outcome pain relief pain score postcesarean section predictive modeling predictive tools prescription opioid programs randomized, clinical trials satisfaction skill acquisition standard care support tools tool treatment as usual trial comparing

项目摘要

PROJECT SUMMARY/ABSTRACT Over the past 15 years, the United States has seen the emergence of an opioid epidemic with drug overdose ranking as the most common cause for accidental death. The rise in drug overdose deaths mirrors the rise in legal opioid prescribing. Unfortunately, most persons using opioids for non-medical purposes obtain them from a family member or friend who was legitimately prescribed opioids. While significant attention has been devoted to prescribing recommendations for individuals with chronic pain and for acute post-surgical pain, much less attention has been given to post-surgical opioid prescribing after hospital discharge. As the most common abdominal surgery in the United States, cesarean birth is the ideal setting to examine methods to reduce unused prescribed opioids. My preliminary work demonstrates that most women have unused opioids after cesarean birth, however a significant proportion of women use all opioids and have unmet pain needs. In addition, current opioid prescribing practices appear to be largely based on prescriber habits rather than patient need. This body of work endeavors to 1) characterize post-discharge opioid use patterns and identify demographic and obstetric variables associated with differential use 2) create and validate a clinical decision support tool that predicts customized post-discharge opioid need and 3) conduct a pilot randomized clinical trial comparing prescribing guided by the CDS tool to standard care to test whether this tool reduces unused opioids without increasing unmet pain after cesarean birth. The overarching objective of this mentored career development experience is to emerge as an independent clinical investigator leading a multidisciplinary research program to improve opioid prescribing after hospital discharge. To accomplish this goal, I will augment my prior research training with advanced coursework and skills development in predictive modeling and conducting clinical trials as well as leadership training focused on opioid prescribing and maternal and infant public health systems. Throughout the award period, the I will work closely with a multidisciplinary team of mentors and advisors—including experts in obstetrics and gynecology, biostatistics, anesthesiology, public health, and epidemiology—to carry out my stated career objectives and specific aims.

项目总结/文摘