Tailored Retention and Engagement for Equitable Treatment of OUD and Pain (TREETOP)

为公平对待 OUD 和疼痛而量身定制的保留和参与 (TREETOP)

• 批准号: 10876692
• 负责人: Megan Hamm
• 金额: $ 274.2万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10876692
• 关键词: Tailored; Retention; Engagement; Equitable; Treatment

PROJECT SUMMARY/ABSTRACT: The Tailored Retention and Engagement for Equitable Treatment of OUD and Pain (TREETOP) clinical research center at the University of Pittsburgh (Pitt) is part of the NIH IMPOWR network. TREETOP draws on the NIDA Clinical Trials Network Appalachian (Pennsylvania & West Virginia) and Western States (Oregon) Nodes and the Community-based OUD and Pain Enhanced treatment (COPE) collaborative (Baltimore, Maryland) to develop effective, equitable, and sustainable interventions for chronic pain and OUD. Our overall goal is to improve treatment for comorbid chronic pain and OUD across the OUD Treatment Cascade, prioritizing two disproportionately impacted communities for whom equitable implementation of effective interventions can be challenging: rural and Black communities. We will achieve our overall goal through the integrated contributions of 5 center components as follows: 1) Research Site Overview, Management, and Operations - Our diverse multidisciplinary team has extensive experience with multisite clinical trials as well as in TREETOP’s two emphasis areas, health equity and implementation science. 2) Engagement and Outreach - Our TREETOP Stakeholder Consultation Board (SCB) includes representatives with a variety of perspectives and lived experiences from each clinic and community partnering in our studies and will serve as active participants on the research team. 3) Engagement/Retention Research Projects - Both projects share the central premise that treating chronic pain improves pain and OUD outcomes, tailor a pain self-management (PSM) intervention to patients with co-morbid chronic pain and OUD, and evaluate both the intervention effectiveness and the barriers and facilitators to equitable and sustained implementation of the intervention through the Health Equity Implementation Framework. Specifically, the Engagement research project investigates whether PSM can improve pain and engage primary care patients in medication treatment for OUD, while the Retention project investigates whether PSM and/or flexibly dosed buprenorphine/naloxone can improve pain and retention in treatment among patients who have already initiated care in office-based addiction treatment programs. 4) Data Collection, Management, and Harmonization - The Data Core will be led by investigators with a track record of success in the measurement and analysis of patient-reported outcomes and in leading clinical trials and data coordinating centers, and includes national leaders in the PROMIS Health Organization. 5) Pilot Projects - Our Pilot program includes 3 initial studies on pain measurement, chronic pain/OUD treatment implementation in specialty settings, and chronic pain and OUD stigma, and then follows a standard protocol for soliciting and reviewing future pilot projects addressing health equity and implementation science. Overall Impact: Our TREETOP investigators and SCB will collaborate to advance the science of sustainably and equitably managing chronic pain and OUD, prioritizing disproportionately impacted rural and Black communities.

项目摘要/摘要：为 OUD 的公平待遇而量身定制的保留和参与 匹兹堡大学 (Pitt) 的疼痛与疼痛 (TREETOP) 临床研究中心隶属于 NIH IMPOWR 网络。 TREETOP 利用 NIDA 临床试验网络阿巴拉契亚（宾夕法尼亚州和西弗吉尼亚州） 和西部各州（俄勒冈州）节点以及基于社区的 OUD 和疼痛增强治疗 (COPE) 合作（马里兰州巴尔的摩）制定有效、公平和可持续的慢性病干预措施 疼痛和 OUD。我们的总体目标是改善整个 OUD 中慢性疼痛和 OUD 合并症的治疗 级联治疗，优先考虑两个受到不成比例影响的社区，为他们提供公平的治疗 在农村和黑人社区，实施有效的干预措施可能具有挑战性。我们将实现我们的 通过 5 个中心组成部分的综合贡献，总体目标如下： 1) 研究基地 概述、管理和运营 - 我们多元化的多学科团队在以下方面拥有丰富的经验： 多中心临床试验以及 TREETOP 的两个重点领域：健康公平和实施 科学。 2) 参与和外展 - 我们的 TREETOP 利益相关者咨询委员会 (SCB) 包括 来自每个诊所和社区合作伙伴的具有不同观点和生活经验的代表 参与我们的研究，并将作为研究团队的积极参与者。 3) 参与度/保留率研究 项目——两个项目都有一个共同的中心前提：治疗慢性疼痛可以改善疼痛和 OUD 为患有慢性疼痛和 OUD 共病的患者量身定制疼痛自我管理 (PSM) 干预措施， 评估干预措施的有效性以及公平和可持续的障碍和促进因素 通过健康公平实施框架实施干预措施。具体来说， 参与研究项目调查 PSM 是否可以改善疼痛并吸引初级保健患者 在 OUD 的药物治疗中，而保留项目则调查 PSM 和/或灵活剂量是否 丁丙诺啡/纳洛酮可以改善已经接受过治疗的患者的疼痛和治疗保留 启动基于办公室的成瘾治疗计划的护理。 4) 数据收集、管理和 协调——数据核心将由具有测量成功记录的调查人员领导 对患者报告的结果以及领先的临床试验和数据协调中心的分析，以及 包括 PROMIS 卫生组织的国家领导人。 5) 试点项目 - 我们的试点计划包括 3 个 关于疼痛测量、专业环境中慢性疼痛/OUD 治疗实施的初步研究，以及 慢性疼痛和 OUD 耻辱，然后遵循征求和审查未来试点的标准协议 解决健康公平和实施科学的项目。总体影响：我们的 TREETOP 调查员 和 SCB 将合作推进可持续和公平管理慢性疼痛和 OUD 的科学， 优先考虑受影响最大的农村和黑人社区。