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Using Default Opioid Prescription Settings to Limit Excessive Opioid Prescribing to Adolescents and Young Adults

使用默认阿片类药物处方设置来限制青少年和年轻人的过量阿片类药物处方

基本信息

批准号：
10608175
负责人：
Kao-Ping Chua
金额：
$ 19.66万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
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：
2019-05-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10608175
关键词：
Address Adenoidal structure Adenoidectomy Adolescent and Young Adult Award Behavior Therapy Blue Cross Blue Shield Characteristics Child Clinical Data Decision Making Dedications Development Plans Doctor of Philosophy Dose Electronic Health Record Environment Excision Future Goals Grant Health Policy Health Services Heterogeneity Institution Insurance Carriers Interruption Intervention Interview Medicaid Mentors Mentorship Methods Michigan Mission National Institute of Drug Abuse Operative Surgical Procedures Opioid Otolaryngologist Pain management Patient Outcomes Assessments Patients Pattern Physicians Pilot Projects Population Postoperative Period Private Hospitals Procedures Provider Regulation Reporting Research Research Methodology Research Personnel Risk Sampling Structure Surveys System Time Series Analysis Tonsil Tonsillectomy Training Universities Vulnerable Populations age group aged career development clinical practice design electronic health record system experience implementation cost implementation research individual patient insight intervention effect intervention refinement meetings opioid misuse opioid use patients who use opioids pediatrician prescription opioid prescription opioid misuse prevent provider behavior substance misuse success therapy design young adult

项目摘要

PROJECT SUMMARY / ABSTRACT Candidate: Kao-Ping Chua, MD, PhD, is a general pediatrician and health services researcher who aims to become a national leader in appropriate opioid prescribing to children and young adults. Research Context: Adolescents and young adults collectively have the highest rates of prescription opioid misuse of any age group, and leftover opioids from prior prescriptions are a key driver of this misuse. Therefore, it is crucial to ensure that quantities in opioid prescriptions match the needs of adolescents and young adults. This proposal will pilot an electronic health record-based intervention using default opioid prescription settings to limit excessive opioid prescribing to adolescents and young adults undergoing tonsillectomy and/or adenoidectomy (removal of the tonsils and/or adenoids), which are common surgeries associated with high rates and quantities of opioid prescribing. In the pilot study, the default settings will be informed by data on baseline patient-reported post-operative opioid consumption, thereby increasing the likelihood that these settings reflect patient need. Specific Aims: 1) To pilot a behavioral intervention using default opioid prescription settings among adolescents and young adults undergoing tonsillectomy and/or adenoidectomy at the University of Michigan; 2) To refine the intervention for future research by assessing providers’ experiences with the default settings; and 3) To identify additional high-priority procedures and conditions for default setting interventions. Research Plan: Dr. Chua will design and implement an intervention using default opioid prescription settings for adolescents and young adults undergoing tonsillectomy and/or adenoidectomy at the University of Michigan. Dr. Chua will use an interrupted time series analysis to evaluate the effect of the intervention on the dosing of the initial post-operative opioid prescription and patient-reported outcomes, and will additionally interview providers to assess their experiences with the intervention. To determine additional potential targets for future default setting interventions in an R01 grant, Dr. Chua will analyze claims from adolescents and young adults insured by Blue Cross Blue Shield of Michigan and Michigan Medicaid to identify other procedures and conditions with high rates and quantities of opioid prescribing. Career Development Plan: Dr. Chua will develop expertise in 1) Qualitative and mixed methods research; 2) Implementation research; and 3) Opioid prescribing and substance misuse. His career development will be supported by close mentorship, advanced coursework, and research meetings/seminars. Environment: The University of Michigan offers the ideal environment for Dr. Chua to pursue this training, with the outstanding guidance of well-established mentors and interdisciplinary institutes dedicated to his success.

项目摘要/摘要