Chronic Disease and Health Outcomes of Older Adults with Opioid Use Disorders

患有阿片类药物使用障碍的老年人的慢性病和健康结果

• 批准号: 10271007
• 负责人: Benjamin Hyun Han
• 金额: $ 18.15万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-28 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10271007
• 关键词: Accident and Emergency department; Acute; Address; Admission activity; Adult; Aging; Alcohol or Other Drugs use; Area; Attitude; Award; Awareness; Caring; Cessation of life; Chronic; Chronic Care; Chronic Disease; Clinical Trials; Code; Complement; Complex; Comprehensive Health Care; Data; Data Reporting; Data Set; Development; Development Plans; Diagnosis; Disease Management; Elderly; Epidemic; Epidemiologic Methods; Foundations; Future; Generations; Geriatric Assessment; Goals; Health; Health Care Costs; Health Services Research; Health Status; Healthcare; Hospitals; Individual; Inpatients; Integrated Health Care Systems; Intervention; Interview; Knowledge; Lead; Longitudinal cohort study; Matched Case-Control Study; Medical; Medical Care Costs; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Modeling; National Institute of Drug Abuse; New York; New York City; Nurses; Older Population; Opiate Addiction; Outcome; Outcome Measure; Patients; Pattern; Pharmacotherapy; Phase; Population; Prevalence; Provider; Public Health; Qualitative Research; Quality of Care; Quality of life; Research; Research Personnel; Risk; Risk Factors; Service delivery model; Strategic Planning; Substance Use Disorder; Supervision; System; Testing; Training; Vulnerable Populations; acute care; addiction; aged; baby boomer; barrier to care; base; burden of illness; career; career development; chronic care model; clinical care; cohort; comorbidity; cost; design; evidence base; experience; falls; frailty; functional decline; health care service utilization; hospital readmission; improved; improved functioning; improved outcome; mortality; multidisciplinary; multiple chronic conditions; older patient; opioid abuse; opioid treatment program; opioid use disorder; patient oriented; practice setting; premature; prescription opioid misuse; skills; social; social exclusion; theories; therapy development; treatment program

! Project Summary/Abstract: This project is a revised application for a Mentored Patient-Oriented Research Career Development Award. My long-term goal is to be a leader in aging and addiction research with expertise in developing chronic care delivery models coordinated within substance use treatment for older adults. This career award will provide additional training and facilitate the completion of the proposed mentored research to continue my career development into an independent clinician investigator. The proposed research addresses a critical knowledge gap in the setting of an epidemic of older adults with substance use disorders. Although it is recognized that older adults with opioid use disorders (OUD) are often medically and socially complex, very little is known regarding their specific health status and needs of this vulnerable population. My proposed career development plan will allow me to address this knowledge gap by working with a team of mentors as well as with the New York City Department of Health and Mental Hygiene and the New York City Health + Hospitals' integrated healthcare system who will supervise and collaborate on the following training goals: (1) to achieve expertise in advanced quantitative methods as applied to large administrative datasets for addiction health services research; (2) to develop skills in qualitative research theory and practice; and (3) to attain proficiency and experience in the development of a care intervention. I will attain these training goals with guidance from my mentorship team complemented by formal coursework and seminars, and by conducting a research agenda that uses a mixed methods approach with the following specific aims: (1) describe the prevalence and risk factors for high utilization of acute healthcare, high medical costs, multiple chronic conditions, and mortality among older adults with OUD; (2) examine staff and patient attitudes, acceptance, and barriers regarding the integration of geriatric models of care into opioid treatment programs; (3) develop and pilot for feasibility, a geriatric-based care model for geriatric conditions and chronic disease management for older adults with OUD to be tested in an R01. This proposal is directly aligned with the priorities of the National Institute on Drug Abuse’s strategic planning workgroup on the "Complexity of Substance Use Disorders and the Continuum of Substance Use Problems" to better understand substance use among individuals with complex conditions. This research will set a future research agenda for widely integrating an evidence-based model of geriatric- based chronic disease assessment and management into existing substance use treatment programs. !

呢 项目摘要/摘要： 该项目是一个经过修订的申请，申请了受到指导的面向患者的研究职业发展奖。我的 长期目标是成为衰老和成瘾研究领域的领导者，并在发展慢性护理方面具有专业知识 递送模型在受试者中协调的老年人使用治疗。该职业奖将提供 额外的培训并支持拟议的Mendored研究的完成，以继续我的职业生涯 发展成独立的临床研究者。拟议的研究涉及关键知识 在患有药物使用障碍的老年人流行病的情况下，差距。虽然认识到 阿片类药物使用障碍（OUD）的老年人通常在医学和社会上很复杂，鲜为人知 关于他们的特定健康状况和这个脆弱人群的需求。我提出的职业 发展计划将使我能够通过与一组导师一起解决这一知识差距 纽约市卫生与精神卫生部和纽约市健康 +医院 综合医疗系统将监督和合作以下培训目标：（1）实现 用于成瘾健康的大型行政数据集的高级定量方法的专业知识 服务研究； （2）发展定性研究理论和实践的技能； （3）达到熟练程度 和开发护理干预的经验。我将在 我的训练团队由正式的课程和半手赛完成，并进行了研究 使用以下特定目的使用混合方法方法的议程：（1）描述患病率和 高利用急性医疗保健，高医疗费用，多种慢性病和死亡率的危险因素 在老年人中； （2）考试人员和患者参与者，接受和障碍 将老年护理模型整合到阿片类药物治疗计划中； （3）可行性的发展和飞行员， 老年人的老年疾病的老年护理模型 在R01中进行测试。该提议与国家毒品研究所的优先事项直接一致 滥用对“物质使用障碍的复杂性和连续性的复杂性”的战略规划工作组 物质使用问题“可以更好地理解具有复杂条件的个体的物质使用。 这项研究将设定未来的研究议程，以广泛整合一种基于证据的老年医学模型 基于慢性疾病评估和管理中的现有药物使用治疗计划。 呢