Project-007

阿片类药物过量死亡和表明阿片类药物发展的有问题的阿片类药物使用模式的上升 在美国，使用障碍(OUD)已经达到了危机水平。对OUD和其他物质的最高风险 使用障碍(SODS)与14岁之前鼓动使用有关。毒药中心网络 2000-2017年间，德克萨斯州报告了102,940次与阿片类药物有关的暴露，包括21,723次暴露 对青少年来说。1999-2015年间，死于阿片类药物的人数为16843人，其中2200人死于阿片类药物 范围为15-24年，在这段时间内稳步上升。虽然德克萨斯州在各州中名列前茅 据报道，2015年至2016年期间，人均阿片类药物超标率最低，增长了7.4%。这个 翻译生态系统优化(EOT)可选功能将利用我们丰富的信息技术和 卓越的临床和研究创建了一个项目ECHO(社区医疗保健成果的延伸) 网络。UTMB在农村和服务不足的社区的网络历史上很强大，这次经历是一种 EOT目标的核心力量是解决SUDS/OUD在综合护理方面的现有差距。最初的焦点 因为TeleECHO网络建立在与14个家庭医学的社区医生现有关系的基础上 在农村和服务不足的得克萨斯州县设立诊所，以促进OUD/SUD和精神健康服务的整合 进入家庭医学实践。远程医疗将在医护人员中创建一个实践社区 (医生、教职员工、住院医生、学生)促进以病例为基础的学习并传播最佳做法 OUD/SUD护理，提高患者护理质量，并建立开展研究所需的关系 农村和服务不足的社区。与德克萨斯州地区CTSA联盟(TRCC)合作，EOT将 与UTMB区域妇幼保健计划(RMCHP)31家诊所网络合作，以加强 基于OUD/当代知识的有针对性、以妇女和怀孕为中心的主题的TeleECHO 肥皂水和精神健康障碍。这一合作伙伴关系将获取一种量化和分类的电子健康 阿片类药物、其他危险因素及其影响因素的流行病学监测和临床研究记录数据库 孕产妇-围产儿死亡率和发病率的相互作用。为了更好地利用当代知识， TeleECHO网络将通过实践社区以青少年为中心的主题进行扩展 与学校的教师和医疗保健提供者合作。与这些学校和社区合作，我们将翻译 我们以证据为基础的调查结果通过覆盖、有效性、采用、实施、维护 (Re-AIM)方法侧重于以证据为基础的药物使用和暴力预防方案。EOT是 强调以我们的集体力量为基础，将我们推向这样一个未来，在这个未来， 对艾滋病/肥胖症的保健以及以证据为基础、对文化敏感的教育和预防战略 在德克萨斯州不同的城市和农村社区发布，并最终在CTSA全国网络中发布 他们的人口服务于。

Opioid overdose deaths and the rise in problematic opioid use patterns that indicate the development of opioid use disorder (OUD) have reached crisis levels in the United States. The highest risk for OUD and other substance use disorders (SUDs) associates with use instigated before 14 years of age. The Poison Center Network reported 102,940 opioid-related exposures in Texas from 2000-2017, including 21,723 exposures attributed to adolescents. Deaths attributed to opioids numbered 16,843 from 1999-2015, with 2,200 deaths in the age range of 15-24 years, tracking with a steady escalation over this period. While Texas ranks among the states with the lowest rate of opioid overdoses per capita, a 7.4% increase was reported between 2015 and 2016. The Ecosystem Optimization for Translation (EOT) optional function will harness our rich information technology and clinical and research excellence to create a Project ECHO (Extension for Community Healthcare Outcomes) network. UTMB’s networking in rural and underserved communities is historically strong and this experience is a central strength of the goal of the EOT to address existing gaps in integrated care in SUDs/OUD. The initial focus for the teleECHO network builds on the existing relationship with community physicians in 14 family medicine clinics in rural and underserved Texas counties to promote integration of OUD/SUD and mental health services into family medicine practices. Telementoring will create a community of practice across healthcare workers (physicians, faculty, residents, students) to facilitate case-based learning and disseminate best practices in OUD/SUD care, improve quality of care of patients, and build the relationships required to conduct research in rural and underserved communities. Partnering with the Texas Regional CTSA Consortium (TRCC), the EOT will work with the UTMB Regional Maternal and Child Health Program (RMCHP) network of 31 clinics to enhance teleECHO with targeted, women- and pregnancy-centered topics based upon contemporary knowledge of OUD/ SUDs and mental health disorders. This partnership will capture a quantitative and categorized electronic health record database for epidemiological surveillance and clinical research in opioids, other risk factors and their interactions in maternal-perinatal mortality and morbidity. To inform the use of contemporary knowledge, the teleECHO network will be expanded with adolescent-centered topics, delivered through a community of practice with teachers and healthcare providers in schools. Working with these schools and communities, we will translate our evidence-based findings into practice via a Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) approach focused on evidence-based substance use and violence prevention programs. The EOT is a pivot in emphasis grounded in our collective strengths to move us to a future in which the best practices of health care for OUD/SUDs, and evidence-based, culturally sensitive education and prevention strategies are promulgated across diverse urban and rural communities in Texas, and ultimately the national network of CTSAs and their populations served.