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

项目概要/摘要：为公平对待OUD量身定制的保留和参与 匹兹堡大学（皮特）的TREETOP临床研究中心是NIH IMPOWR的一部分 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（科普） 协作（巴尔的摩，马里兰州），以制定有效，公平和可持续的干预措施， 疼痛和OUD。我们的总体目标是改善OUD中慢性疼痛和OUD共病的治疗 治疗级联，优先考虑两个受到不成比例影响的社区， 实施有效的干预措施可能具有挑战性：农村和黑人社区。我们将实现我们的 通过以下5个中心组成部分的综合贡献实现总体目标：1）研究中心 概述、管理和运营-我们多元化的多学科团队拥有丰富的经验， 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)参与和推广-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各种观点和生活经验的代表 在我们的研究中，并将作为研究团队的积极参与者。3)参与/保留研究 项目-两个项目都有一个共同的中心前提，即治疗慢性疼痛可以改善疼痛和OUD 结果，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， 并评估干预的有效性以及公平和持续的障碍和促进因素 通过卫生公平实施框架实施干预措施。具体而言是 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 在药物治疗OUD，而保留项目调查是否PSM和/或灵活给药 丁丙诺啡/纳洛酮可以改善已经接受治疗的患者的疼痛和保留 在以办公室为基础的成瘾治疗方案中启动护理。4)数据收集、管理和 协调-数据核心将由具有成功测量记录的研究者领导 和患者报告结局的分析，以及领先的临床试验和数据协调中心，以及 包括PROMIS卫生组织的国家领导人。5)试点项目-我们的试点项目包括3个 疼痛测量的初步研究，慢性疼痛/OUD治疗在专业环境中的实施，以及 慢性疼痛和OUD耻辱，然后遵循标准协议征求和审查未来的试点 涉及卫生公平和实施科学的项目。总体影响：我们的TREETOP调查人员 和SCB将合作推进可持续和公平管理慢性疼痛和OUD的科学， 优先考虑受影响不成比例的农村和黑人社区。

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.