HEAL Initiative: Integrative Management of chronic Pain and OUD for Whole Recovery (IMPOWR): Research Centers

迫切需要对慢性疼痛患者进行高影响力的多学科研究 (CP)和阿片类药物使用障碍(OUD)，在他们接受护理的环境中并与 利益相关者和有生活经验的人(PWLE)。我们建议创建一体化的 慢性疼痛的管理和全面康复-耶鲁大学和组织联合(IMPOWR- 你)。IMPOWR-You是一个多学科中心，由具有专业知识的资深调查人员领导 研究CP和阿片类药物使用障碍/滥用(OUD/滥用)，并与 利益相关者和PWLE。我们在普通医疗环境(初级保健、医院)和 专科(阿片类药物治疗计划(OTP))，重点是支持 早期调查人员和那些传统上在研究中代表性不足的群体(URG)。 IMPOWR-您由5个核心组成(运营、利益相关者/工作人员、职业发展和 多样性、试点项目、数据和测量)、2个研究项目和年度试点项目。我们的 研究建立在我们调查人员和利益相关者之前的工作基础上，解决了以下关键问题 面向整个医疗系统的从业者。建议的研究包括：1)在初级保健方面，比较 药剂师主导的协作式护理方法对长期处方患者的有效性 有CP和OUD/滥用的阿片类药物与药剂师计划和患者转介到电话- 提供基于认知行为疗法(CBT)的疼痛自我管理计划；2)在OTP中 比较分级护理多模式跨学科CP管理的有效性，包括 接受美沙酮或美沙酮治疗的患者按常规进行CBT、运动和压力管理 丁丙诺啡；3.在第一年进行一项试点，修改阿片类药物管理计划，以解决 对CP和OUD住院患者的需求进行调查，并评价其初步疗效。所有研究 包括与疼痛、肥胖、饮酒、焦虑、抑郁症状、睡眠问题有关的结果 一些人评估了压力、耻辱和复苏资金。我们的试点项目核心将监督选择 在2-5年间进行试点，以支持早期调查人员和与利益相关者/PWLE的合作。 IMPOWR-You建立在不同领域之间长期的多学科研究合作基础上 利益相关者，包括PWLE、早期调查人员、URG、卫生系统和以下组织 制定CP和OUD/误用指南。IMPOWR-你拥有调查人员的理想组合， 包括初级保健、成瘾医学/精神病学、心理学专科护理、临床 试验、定性研究和实施科学；与利益攸关方和 PWLE；创新、领导力、协作和卓越工作效率的跟踪记录，以创建 领先的中心，将有助于解决CP患者和OUD/误用患者的独特需求。

There is an urgent need to conduct high impact multidisciplinary research for patients with chronic pain (CP) and opioid use disorder (OUD)in the settings where they receive care and in collaboration with stakeholders and persons with lived experience (PWLE). We propose to create the Integrative Management of chronic Pain and OUD for Whole Recovery– Yale and Organizations United (IMPOWR- YOU). IMPOWR-YOU is a multidisciplinary center led by established investigators with expertise studying CP and opioid use disorder/misuse (OUD/misuse) and working in partnership with stakeholders and PWLE. We conduct research in general medical settings (primary care, hospital) and specialty (opioid treatment programs (OTPs)) with a focus on supporting the career development of early stage investigators and those from groups traditionally underrepresented in research (URG). IMPOWR-YOU is comprised of 5 cores (Operations, Stakeholder/PWLE, Career Development and Diversity, Pilot Projects, Data and Measurement), 2 research projects, and annual Pilot Projects. Our research, built on previous work of our investigators and stakeholders, addresses critical issues that face practitioners across the healthcare system. Proposed studies include: 1) In primary care, compare the effectiveness of a pharmacist led collaborative care approach for patients prescribed long-term opioids who have CP and OUD/misuse vs. the pharmacist program plus patient referral to a phone- delivered, cognitive behavior therapy (CBT)-based pain self-management program; 2) In an OTP to compare the effectiveness of a stepped care multimodal interdisciplinary CP management that includes CBT, exercise and stress management to treatment as usual in patients receiving methadone or buprenorphine; 3. In Year 1 conduct a pilot to modify an opioid stewardship program to address the needs of hospitalized patients with CP and OUD and evaluate its preliminary efficacy. All studies include outcomes related to pain, OUD, alcohol use, anxiety, depressive symptoms, sleep problems and some assess stress, stigma and recovery capital. Our Pilot Project Core will oversee the selection of pilots in Years 2-5 to support early stage investigators and collaborations with stakeholders/PWLE. IMPOWR-YOU is built on long-standing multidisciplinary research collaborations among diverse stakeholders, including PWLE, early stage investigators, URG, health systems, and organizations that produce guidelines for CP and OUD/misuse. IMPOWR-YOU has the ideal mixture of investigators, including leaders in primary care, addiction medicine/psychiatry, psychology specialty care, clinical trials, qualitative research and implementation science; established relationships with stakeholders and PWLE; a track record of innovation, leadership, collaboration, and outstanding productivity to create a leading Center that will contribute to addressing the unique needs of patients with CP and OUD/misuse.