Chronic Disease and Health Outcomes of Older Adults with Opioid Use Disorders

项目摘要/摘要： 本杰明·韩博士的长期目标是成为衰老和成瘾研究的领先者，拥有 在老年人的物质使用治疗中协调发展慢性护理提供模式。这 职业奖将通过提供额外的培训和完成 建议进行导师研究，以继续他的职业发展，成为一名独立的临床医生研究员。 这项拟议的研究解决了老年人艾滋病流行背景下的一个关键知识缺口 物质使用障碍：当前医疗保健模式、慢性病负担、态度和障碍 阿片类药物使用障碍老年人的慢性病管理(OUD)。尽管它是 认识到患有OUD的老年人通常在医学和社交方面都很复杂，对以下方面了解很少 这一弱势群体的具体健康状况和需求。韩博士提出的职业发展计划 将使他能够通过与导师团队以及 圣地亚哥的行为健康服务部将就以下培训目标进行合作：(1)实现 掌握先进的量化方法和使用大型成瘾健康管理数据集的专门知识 服务研究；(2)培养定性研究的理论和实践技能；(3)熟练掌握 和制定护理干预措施的经验，以及评估可行性的相关技能， 可持续性、计划评估和实施研究。韩博士将通过以下方式实现这些培训目标 来自他的指导团队的指导，辅之以正式的课程和研讨会，并通过开展 使用混合方法方法的研究议程具有以下具体目标：(1)描述 急性医疗服务利用率高、医疗费用高、多发性慢性病的患病率和危险因素 (2)检查工作人员和患者的态度、接受度、 (3)将老年护理模式纳入阿片类药物治疗方案的可行性和障碍； 为老年疾病和慢性病开发和试点循证老年护理模式 老年人的管理与OUD。这将制定未来的研究议程，广泛整合 以循证为基础的老年慢性病评估与管理模式 物质使用治疗计划。

Project Summary/Abstract: Dr. Benjamin Han's long-term goal is to become a leader in aging and addiction research with expertise on developing chronic care delivery models coordinated within substance use treatment for older adults. This career award will support Dr. Han towards this goal by providing additional training and completing the proposed mentored research to continue his career development into an independent clinician investigator. The proposed research addresses a critical knowledge gap in the setting of an epidemic of older adults with substance use disorders: the current healthcare patterns, burden of chronic disease, and attitudes and barriers towards chronic disease management of older adults with opioid use disorders (OUD). Although it is recognized that older adults with OUD are often medically and socially complex, very little is known regarding the specific health status and needs of this vulnerable population. Dr. Han's proposed career development plan will allow him to address this knowledge gap by working with a team of mentors as well as with the County of San Diego’s Behavioral Health Services who will collaborate on the following training goals: (1) to achieve expertise in advanced quantitative methods and the use of large administrative datasets for addiction health services research; (2) to develop skills in qualitative research theory and practice; and (3) attain proficiency and experience in the development of a care intervention, and the associated skills in assessing feasibility, sustainability, program evaluation, and implementation research. Dr. Han will attain these training goals with guidance from his mentorship team complemented by formal coursework and seminars, and by conducting a research agenda that uses a mixed methods approach with the following specific aims: (1) describe the prevalence and risk factors for high utilization of acute healthcare, high medical costs, multiple chronic conditions, and mortality among older adults with OUD; (2) examine staff and patient attitudes, acceptance, feasibility, and barriers regarding the integration of geriatric models of care into opioid treatment programs; (3) develop and pilot an evidence-based geriatric care model for geriatric conditions and chronic disease management for older adults with OUD. This will set a future research agenda for widely integrating an evidence-based model of geriatric-based chronic disease assessment and management into existing substance use treatment programs.