HEAL Initiative: Research to Foster an Opioid Use Disorder Treatment System Patients Can Count On

0BPROJECT摘要/摘要 2021年，阿片类药物过量死亡人数达到历史最高水平。治疗阿片类药物使用障碍的药物 (Moud)如果服用足够长的时间，可以显著降低过量服药的风险。超过65万人 每年接受Moud的阿片类药物治疗计划(OTP)。不幸的是，平均而言，只有不到一半的人 患者在阿片类药物使用障碍(OUD)治疗中停留至少一年的推荐时间。动态口令 保留和结果质量措施(即“审计和反馈”)可提高治疗保留率。 和结果。质量措施还可以帮助监测新的OTP报销和监管的效果 政策。最终，OTP质量措施可以纳入联邦政府的公共部门 面向医疗保健提供者比较网站。然而，需要研究来确定如何最大限度地 有效创建和传播OTP质量措施。关于审计和反馈的文献指出 影响措施将导致质量改进的概率的三个特征：(1) 措施和基准的特点，(2)提供者对如何 改进措施，以及(3)提供者对改善 测量。这项研究将测试优化这些因素的方法。 NIDA RFA-DA-23-046支持多项目的质量测量和管理研究 将研究人员与合作组织配对的中心，这些组织拥有OUD质量测量和 研究可以推进的管理战略。RTI国际，加州大学洛杉矶分校， 和康涅狄格州Beacon Health是领导这项研究的研究组织。他们正在与 需要开发有效的OTP质量测量和管理系统的两个组织： 贝马克卫生服务和洛杉矶县药物滥用预防和控制分部。 该小组正在实施三个相互关联的研究项目，总体目标如下： 总体目标1.创建和心理测量学测试保留、过量用药的紧急情况下的OTP措施 科室就诊、过量住院和死亡率，基准和工具包描述了 口服避孕药可以提高保持率。 总体目标2.测试给予OTPS质量措施的效果和如何改进的信息 保留(一个保留工具包)，包括质量改进培训和不进行质量改进培训 随机试验，分配OTP接受：(1)工具包的保留和结果测量；或 (2)工具包的保留和成果指标以及质量改进(QI)培训(即NIATx) (臂2)或(3)照常治疗(控制臂)。 总体目标3.检验OTP水平和LA县人口水平统一的措施对 与加州其他县相比，洛杉矶县的留存率和结果。

0BPROJECT SUMMARY/ABSTRACT Opioid overdose deaths reached the highest level ever in 2021. Medications to treat opioid use disorder (MOUD) can markedly reduce overdose risks when taken for long enough. More than 650,000 people receive MOUD in Opioid Treatment Programs (OTPs) annually. Unfortunately, on average, less than half of patients stay in opioid use disorder (OUD) treatment for the recommended minimum 1 year of time. OTP retention and outcome quality measures (i.e., “audit and feedback”) may improve treatment retention rates and outcomes. Quality measures can also help monitor the effect of new OTP reimbursement and regulatory policies. Eventually, OTP quality measures could be incorporated into the Federal government’s public facing healthcare provider Compare website. However, research is needed to determine how to most effectively create and disseminate OTP quality measures. The literature on audit and feedback points to three features that influence the probability that measures will result in improved quality: (1) the characteristics of the measures and benchmarks, (2) the knowledge that providers have about how to improve the measures, and (3) the control that providers have over the factors that matter to improve the measure. This study will test approaches for optimizing each of these factors. NIDA RFA-DA-23-046 is supporting multi-project OUD Quality Measurement and Management Research Centers that pair researchers with partner organizations that have an OUD quality measurement and management strategy that research could advance. RTI International, University of California Los Angeles, and Beacon Health Connecticut are the research organizations leading this study. They are partnering with two organizations that need to develop an effective OTP quality measurement and management system: BayMark Health Services and the Los Angeles County Division of Substance Abuse Prevention and Control. The team is implementing three inter-related research projects with the following overall aims: Overall Aim 1. Create and psychometrically test OTP measures of retention, overdose emergency department visits, overdose hospitalizations, and mortality with benchmarks and toolkits describing how OTPs can improve retention. Overall Aim 2. Test the effect of the giving OTPs quality measures and information on how to improve retention (a retention toolkit), with and without quality improvement training, by conducting a clustered randomized trial that assigns OTPs to receive either: (1) retention and outcome measures with the toolkit; or (2) retention and outcome meaures with the toolkit as well as quality improvement (QI) training (i.e., NIATx) (Arm 2), or (3) treatment as usual (Control Arm). Overall Aim 3. Test the effect of aligning OTP-level and LA county population-level OUD measures on retention and outcomes in LA county relative to other counties in California.