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 慢性疼痛管理和 OUD 促进整体康复 – 耶鲁大学和组织联合 (IMPOWR- 你）。 IMPOWR-YOU 是一个多学科中心，由具有专业知识的知名研究人员领导 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。我们在一般医疗环境（初级保健、医院）中进行研究 专业（阿片类药物治疗计划（OTP）），重点是支持职业发展 早期研究人员和传统上在研究中代表性不足的群体（URG）。 IMPOWR-YOU 由 5 个核心组成（运营、利益相关者/PWLE、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 研究以我们的调查人员和利益相关者之前的工作为基础，解决了以下关键问题： 面对整个医疗保健系统的从业者。拟议的研究包括： 1) 在初级保健中，比较 药剂师主导的协作护理方法对长期处方患者的有效性 具有 CP 和 OUD/滥用的阿片类药物与药剂师计划以及通过电话转诊的患者 - 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，其中包括 接受美沙酮或治疗的患者照常接受 CBT、运动和压力管理治疗 丁丙诺啡； 3. 在第一年进行试点，修改阿片类药物管理计划，以解决 CP和OUD住院患者的需求并评估其初步疗效。所有研究 包括与疼痛、OUD、饮酒、焦虑、抑郁症状、睡眠问题相关的结果 一些评估压力、耻辱和恢复资本。我们的试点项目核心将监督选择 在第 2-5 年进行试点，以支持早期研究人员以及与利益相关者/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之上 利益相关者，包括 PWLE、早期研究人员、URG、卫生系统和组织 制定 CP 和 OUD/滥用指南。 IMPOWR-YOU 拥有理想的研究人员组合， 包括初级保健、成瘾医学/精神病学、心理学专业护理、临床 试验、定性研究和实施科学；与利益相关者建立关系，并 PWLE；创新、领导力、协作和卓越生产力的记录，创造了一个 该中心将致力于满足 CP 和 OUD/滥用患者的独特需求。

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.