Pilot Implementation of Measurement-Based Care in Community Opioid Treatment Programs

在社区阿片类药物治疗计划中试点实施基于测量的护理

• 批准号: 10691007
• 负责人: Kelli Scott
• 金额: $ 18.64万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-25 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10691007
• 关键词: Abstinence; Alcohols; Appointment; Area; Behavior Therapy; Caring; Censuses; Centers for Disease Control and Prevention (U.S.); Cessation of life; Client; Clinical; Collection; Communities; Complement; Computerized Medical Record; Consolidated Framework for Implementation Research; Counseling; Data; Data Collection; Data Reporting; Development; Development Plans; Dissemination and Implementation; Documentation; Effectiveness; Epidemic; Ethnography; Evidence based intervention; Evidence based treatment; Frequencies; Goals; Gold; Group Therapy; Guidelines; Health Personnel; Helping to End Addiction Long-term; Hybrids; Intervention; Interview; Measurement; Measures; Melissa; Mentors; Mentorship; Methods; Modeling; Monitor; National Institute of Drug Abuse; New England; Opiate Addiction; Opioid; Outcome; Overdose; Patient Self-Report; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacotherapy; Phase; Policies; Prescription drug overdose; Procedures; Process; Program Development; Protocols documentation; Provider; Public Health; Recommendation; Recording of previous events; Reporting; Research; Research Activity; Research Personnel; Research Proposals; Site; Site Visit; Strategic Planning; Structure; Surveys; Testing; Training; Training Activity; Training Support; United States; United States Department of Veterans Affairs; Universities; Urine; Work; addiction; base; burden of illness; career; career development; cognitive interview; community based participatory research; community engaged research; community partnership; community setting; design; effectiveness implementation study; effectiveness implementation trial; effectiveness outcome; evidence base; experience; flexibility; group counseling; implementation outcomes; implementation science; improved; mentoring community; multidisciplinary; opioid misuse; opioid overdose; opioid treatment program; opioid use disorder; overdose death; pilot trial; programs; psychosocial; public health emergency; rapid technique; research and development; scale up; substance use treatment; tool

PROJECT SUMMARY Opioid overdose has been recognized as a public health emergency, as lethal drug overdoses have become the leading cause of accidental death in the United States. The gold standard, evidence-based intervention for opioid use disorder is pharmacotherapy, but abstinence rates following pharmacotherapy are sub-optimal. Measurement-based care (MBC), the systematic use of client self-report data to inform and enhance treatment, is an evidence-based intervention that could be uniquely well suited to complement pharmacotherapy for OUD. Unfortunately, very few community opioid treatment programs (OTPs) offer psychosocial interventions to complement pharmacotherapy due to the high volume of patients served and a reliance on group therapy models to accommodate this large census. There is a pressing need for flexible psychosocial intervention structures for use in OTPs that are not associated with typical barriers found in full package, manualized interventions. The training and research activities in this proposal seek to enhance the provision of MBC in community OTPs through two research phases bolstered by four training aims. In Phase 1 of the research plan, the candidate, supported by the experienced mentorship team, will work with 8 OTPs to develop community-engaged research partnerships, complete site visits, and engage treatment providers, leaders, staff, and patients in qualitative interviews and quantitative surveys. Phase 1 outcomes will be used to inform site selection for MBC implementation and to facilitate adaptation of an MBC assessment protocol for use in OTPs. Phase 2 will involve a pilot type I hybrid effectiveness-implementation study with four OTPs. The candidate will work with the OTPs to integrate MBC into electronic medical record documentation procedures. Treatment providers will also receive MBC training and ongoing support, and preliminary MBC effectiveness and implementation data will be collected. To conduct this research, the candidate requires training in four key areas: 1) development and management of community-engaged partnerships to support effectiveness and implementation trials in addiction treatment; 2) training in evidence-based assessment and intervention methods for OUD; 3) training in mixed methods data collection using rapid ethnography; and 4) training in measure design and adaptation. These training aims will be supported by the Brown University Center for Alcohol and Addiction Studies as well as by the candidate’s mentorship team. The mentorship team will be led by Primary Mentor Dr. Sara Becker, an expert in implementation science and community partnership development in substance use treatment settings. The proposal will also be supported by Dr. Francesca Beaudoin, Dr. Lawrence Palinkas, and Dr. Melissa Clark, experts in OUD intervention, rapid mixed methods data collection, and measure design, respectively. Taken together, this research and career development plan will advance a significant public health issue by enhancing the quality of OUD care while launching the independent career of the candidate in the implementation of MBC in OTPs.

项目摘要 阿片类药物过量已被视为公共卫生紧急情况，因为致命药物过量已成为 是美国意外死亡的主要原因黄金标准，基于证据的干预， 阿片类药物使用障碍是药物治疗的一种有效方法，但药物治疗后的戒断率并不理想。 测量为基础的护理（MBC），系统地使用客户自我报告数据，以告知和提高 治疗，是一种基于证据的干预措施，可以非常适合补充 药物治疗OUD。不幸的是，很少有社区阿片类药物治疗计划（OTP）提供 心理社会干预，以补充药物治疗，由于大量的病人服务和 依靠团体治疗模式来适应这一大规模的人口普查。迫切需要灵活的 在OTP中使用的心理社会干预结构与全面调查中发现的典型障碍无关 一揽子、手动干预。本建议中的培训和研究活动旨在加强 通过两个研究阶段，在四个培训目标的支持下，在社区OTP中提供MBC。在阶段1中 在研究计划中，候选人将在经验丰富的导师团队的支持下，与8名OTP合作， 发展社区参与的研究伙伴关系，完成现场访问，并与治疗提供者接触， 领导者、工作人员和患者进行定性访谈和定量调查。第1阶段的结果将用于 为实施《生物多样性公约》进行知情选址，并促进《生物多样性公约》评估议定书的调整， 使用OTP。第二阶段将涉及一个试点I型混合的有效性-实施研究与四个OTP。的 候选人将与OTP合作，将MBC整合到电子病历文件程序中。 治疗提供者还将获得MBC培训和持续支持，以及初步的MBC效果 并将收集执行数据。为了进行这项研究，候选人需要接受四个关键方面的培训 （1）发展和管理社区参与的伙伴关系，以支持有效性， 成瘾治疗的实施试验; 2）循证评估和干预培训 OUD的方法; 3）使用快速人种志进行混合方法数据收集的培训;以及4） 措施设计和调整。这些培训目标将得到布朗大学中心的支持， 酒精和成瘾研究以及候选人的导师团队。导师团队将由 由主要导师Sara Becker博士，实施科学和社区伙伴关系专家 在物质使用治疗环境中的发展。该提案也将得到弗朗西斯卡博士的支持 Beaudoin，Lawrence Palinkas博士和Melissa Clark博士，OUD干预专家，快速混合方法 数据收集和测量设计。总的来说，这项研究和职业发展计划 将通过提高OUD护理质量，同时推出 候选人在OTP中实施MBC的独立职业生涯。