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Beyond Treatment Initiation: Enhancing Opioid Use Disorder Care Transitions Across Health System Touchpoints

除了治疗启动之外：加强阿片类药物使用障碍护理在卫生系统接触点的转变

基本信息

批准号：
10592062
负责人：
Noa Krawczyk
金额：
$ 18.18万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-03-15 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10592062
关键词：
Accident and Emergency department Active Learning Address Award Buprenorphine Caring Case Study Characteristics Classification Clinical Communities Competence Comprehension Data Data Collection Data Set Dedications Discharge Plannings Effectiveness Electronic Health Record Ensure Epidemic Epidemiology Equity Evidence based practice Evidence based treatment Frequencies Future Goals Grant Harm Reduction Health Health Services Health Services Research Health system Healthcare Hospital Referrals Hospitalization Hospitals Improve Access Individual Inpatients Institution Intervention Intervention Studies Interview Knowledge Life Link Medicaid Mentored Research Scientist Development Award Mentorship Methadone Methods Modeling Morbidity - disease rate Naltrexone National Institute of Drug Abuse Nature Opioid Outcome Overdose Overdose reduction Participant Patients Perception Persons Pharmaceutical Preparations Policies Provider Public Hospitals Qualitative Methods Questionnaires Reporting Research Research Personnel Review Literature Role Series Services Structure Substance Use Disorder Surveys Taxonomy Training Treatment outcome Wages Work Writing acute care addiction care systems career clinical practice cognitive interview community barrier diverse data evidence base follow-up health care settings high risk implementation research improved integrated care medical schools medication for opioid use disorder meetings mortality multilevel analysis opioid epidemic opioid overdose opioid use disorder overdose risk patient-level barriers prevent programs provider-level barriers rapid growth skills sociodemographics standard care substance use treatment success symposium treatment services uptake virtual

项目摘要

7. PROJECT SUMMARY/ABSTRACT The opioid epidemic continues to rage, taking a vast toll on morbidity and mortality across the U.S. Despite efforts to expand availability of life-saving medications for opioid use disorder (MOUD), a significant gap re- mains in access to and continuity in these treatments. Given the high frequency of encounters with acute-care settings among patients with opioid use disorder (OUD), emergency departments and hospitals are increas- ingly seen as ‘touchpoints’ to promote initiation of MOUD treatment. Growing evidence around the efficacy of initiating MOUD in the hospital and linking people to community treatment has led to a rapid growth of such hospital-based interventions. However, little is known about the nature or success of strategies used to transi- tion patients from hospital settings to community-based MOUD treatment. Knowing which transition strategies are most effective in improving engagement in MOUD treatment post-hospitalization is critical to supporting patients through the ‘OUD Cascade of Care’ towards reduced overdose risk and improved health. The goal of this K01 Award is to address these gaps while advancing the candidate’s career goal of becom- ing an independent investigator who works at the interface of intervention and implementation research, epide- miology, and policy to advance knowledge on strategies to improve access to, uptake and sustainability of evi- dence-based services for opioid and other substance use disorders. Through coursework, scientific confer- ences, experiential learning, and close mentorship from experts in addiction, health services research and qualitative and quantitative methods at the NYU Grossman School of Medicine and partner institutions, Dr. Krawczyk will develop competency in the delivery of addiction services and acute care interventions; mixed methods for collecting and analyzing data on healthcare practices and their implementation; analysis of multi- level healthcare data from diverse datasets; and professional skills for grant writing and research partnerships. The proposed research will employ quantitative and qualitative methods to study the nature and role of transition strategies used to link OUD patients from hospitals to ongoing MOUD engagement in the community using a case study of 11 public hospitals in NYC. Research aims are to (1) Develop a taxonomy and subse- quent survey of hospital OUD care transition strategies via review of the literature and input from an expert Delphi panel; (2) Conduct in-depth interviews with provider and patient stakeholders regarding primary barriers and facilitators to effective transitions, and; (3) Explore multi-level associations between patient characteristics, hospital transition strategies, and post-discharge MOUD engagement outcomes. This work is in line with NIDA’s goals to conduct research that addresses real-world complexities, explores sustainable implementation of evidence-based practices for substance use treatment, and studies the integration of treatment services in diverse health care settings. By providing salary support, training, and a formal mentorship structure, this award will facilitate Dr. Krawczyk’s transition to an independent career in addiction health services research.

7. 项目总结/文摘