CTN-0121: Integrated Care and Treatment for Severe Infectious Diseases and Substance Use Disorders among Hospitalized Patients

项目总结/摘要 这是NIDA的CTN佛罗里达节点联盟（FNA）21-25年的应用程序。FNA覆盖佛罗里达， 格鲁吉亚和波多黎各，美国的地区，继续遭受高比率的药物过量， 阿片类药物、可卡因和甲基苯丙胺的持续流行。这些地区的治疗需求未得到满足， 在实施循证治疗方面存在差异。FNA旨在建立在我们的 在医疗保健环境中领导和实施试验以及将物质使用纳入 医疗保健的主流。我们建议把家庭及儿童事务局在青少年教育方面的丰富专业知识， 治疗，艾滋病毒和丙型肝炎病毒护理继续在物质使用人群，精神健康共病，电子 健康、数据科学、文化科学、卫生经济学、培训、实施/传播和工作 西班牙裔人口。FNA的研究议程将提供科学的领导，以开发，测试， 对青少年和成年人使用药物的所有方面实施干预措施， 将SU预防/筛查/治疗服务纳入主流青少年和成人卫生保健。 FNA还旨在应用我们在实施科学，数据科学和电子健康使用方面的专业知识 记录（EHR），以促进建立在精准医学原则基础上的学习型医疗保健系统， 实施和改进方法，以预测个人对治疗的反应。建立在 通过双向合作，FNA建议制定、测试和实施干预措施， 在FNA的临床和研究网络中提供连续的服务。这些网络包括SUD 治疗和一般医疗环境，卫生系统，临床研究网络，以及基于实践的 研究网络。为了实现其目标，FNA提出了一个创新的概念研究议程， (1)利用电子技术，在儿科护理中整合行为健康和以家庭为重点的干预措施， (2)在医院环境中为合并SU和HIV的患者提供综合护理模式，（3）解决 精神健康和兴奋剂使用的共病，（4）使用EHR，登记和环境数据，以改善 治疗精确度，以及（5）使用背景和文化来改善治疗结果。FNA建议， 与其他节点合作设计和实施CTN试验，并提供 成功执行研究所需的基础设施和能力。FNA网络合作伙伴 在利用EHR进行护理点试验和研究方面的经验， 索赔数据。迈阿密CTSI大学、佛罗里达CTSI大学和格鲁吉亚CTSA大学将为 CTN是CTSA国家联盟的生物信息学工具。这些综合技术服务协定与 FNA有助于在众多环境中接触1600多万患者的多样化患者人群， 作为初级保健、急诊室、医院、社区卫生服务中心、学校诊所、SUD治疗和减少伤害场所。

PROJECT SUMMARY/ABSTRACT This is an application for years 21-25 of NIDA’s CTN Florida Node Alliance (FNA). The FNA covers Florida, Georgia and Puerto Rico, areas of the US that continue to suffer from high rates of drug overdoses and unceasing opioid, cocaine and methamphetamine epidemics. These areas have unmet treatment needs and experience disparities in the implementation of evidence-based treatments. The FNA aims to build on our record of success in leading and implementing trials in healthcare settings and integrating substance use into mainstream of healthcare. We propose to bring to the CTN the FNA’s considerable expertise in adolescent treatment, the HIV and HCV care continua in substance-using populations, mental health comorbidities, e- Health, data science, culturalized science, health economics, training, implementation/dissemination, and work with Hispanic populations. The FNA’s research agenda will provide scientific leadership to develop, test, and implement interventions for the full spectrum of substance use in adolescents and adults, and strategies for the integration of SU prevention/screening/treatment services into mainstream adolescent and adult health care. The FNA also aims to apply our expertise in implementation science, data science, and use of electronic health records (EHRs) to promote learning health care systems that build on precision medicine principles by implementing and refining methods to predict individual response to treatment. Building on a foundation of bidirectional collaboration, the FNA proposes to develop, test and implement interventions that address the service delivery continuum in the FNA’s clinical and research networks. These networks consist of SUD treatment and general medical settings, health systems, clinical research networks, and practice-based research networks. To achieve its aims, the FNA is proposing an innovative research agenda of concepts that (1) integrate behavioral health and family focused interventions in pediatric care with the use of e-technologies, (2) deliver integrative models of care for comorbid SU and HIV in hospital settings, (3) address the comorbidities of mental health and stimulant use, (4) use EHR, registry and environmental data to improve treatment precision, and (5) use context and culture to improve treatment outcomes. The FNA proposes to collaborate with other Nodes on the design and implementation of CTN trials and by providing the infrastructure and capabilities required for successful study execution. FNA network partners have demonstrated experience in conducting point of care trials and studies that leverage the use of EHR and claims data. The University of Miami CTSI, University of Florida CTSI, and the Georgia CTSA, will bring to the CTN the bioinformatics tools of the CTSA National Consortium. These CTSAs together with partners of the FNA, facilitate access to a diverse patient population of 16+ million patients across a numerous settings such as primary care, EDs, hospitals, FQHCs, school-based clinics, SUD treatment and harm reduction venues.