Beacon-OUD: Behavioral Economic Screening Tool of Opioid Use Disorder for Use in Clinical Practice

项目摘要 阿片类药物使用障碍（OUD）是美国过度残疾、发病率和死亡率的主要原因。 states.目前，近1000万美国人滥用阿片类药物，270万美国人患有 OUD。仅在过去一年，美国阿片类药物过量死亡人数就增加了近30%，导致每年 死亡率> 100，000，相当于每5分钟死亡一人。鉴于美国阿片类药物流行的范围， 是一个必要的需要，积极主动，例行，循证OUD筛查个人的处方主要 护理提供者或心理健康临床医生。然而，对阿片类药物滥用的筛查表现不佳，费力， 并且易受需求特征和对患者污名化的关注的影响。打击这些 问题，BEAM Diagnostics，Inc.开发了Beacon-OUD，一种可商业化的OUD数字筛选工具。的 该工具基于癌症病理学的理论行为框架，这是一种广泛采用的行为 成瘾行为的经济学方法Beacon-OUD是：（1）快速，易于交付给患者， 自动化，标准化的评分，以减少时间障碍;（2）可访问，易于理解和自我， 管理;（3）非污名化和评估风险，而不披露敏感信息;（4）面向当前 和未来，而不是过去，OUD行为;和5）可互操作并与患者的医疗记录集成， 提高OUD评估和以患者为中心的护理标准。在这个项目的第一阶段，我们 一项临床研究，验证Beacon-OUD对阿片类药物滥用的稳健预测准确性， 从供应商处获得关于可行性和可接受性的积极报告。第二阶段SBIR的目标是 将Beacon-OUD的开发扩展为完全实现的商业产品，既作为独立工具， 在大型多站点健康护理系统的电子病历（EMR）系统内的集成工具 每年为大约100万名门诊病人提供服务。目标1将优化用户体验和可访问性， Beacon-OUD作为一个产品，生产全面的临床参考资料，并完成了西班牙- 语言翻译Aim 2将Beacon-OUD集成到EPIC中，EPIC是一种广泛使用的电子医疗记录 卫生系统合作伙伴内的系统，以改善阿片类药物的可用性、工作流程能力和记录保存 直接在病人的病历中滥用。此外，目标2将启动教育和实施举措 推广Beacon-OUD在初级保健中的应用最后，BEAM将完成探索性目标，以验证 并扩展Beacon-OUD作为OUD治疗预后的基于测量的护理工具的临床实用性。在 在第二阶段项目结束后，BEAM将把Beacon-OUD作为数字评估推向市场 用于OUD测量，既可作为独立产品，也可作为EMR集成版本。

PROJECT SUMMARY Opioid use disorder (OUD) is a major contributor to excessive disability, morbidity, and mortality in the United States. Currently, almost 10 million Americans misuse opioid substances and 2.7 million Americans suffer from OUD. In the past year alone, U.S. opioid overdose deaths have increased by nearly 30%, resulting in an annual mortality rate of >100,000, akin to a death every 5 minutes. Given the scope of the U.S. opioid epidemic, there is an essential need for proactive, routine, evidence-based OUD screening by an individual’s prescribing primary care provider or mental health clinicians. However, screening for opioid misuse is underperformed, laborious, and is susceptible to demand characteristics and concerns about stigmatizing the patient. To combat these issues, BEAM Diagnostics, Inc. developed Beacon-OUD, a commercializable digital screening tool for OUD. The tool is based on the theoretical behavioral framework of reinforcer pathology, a widely adopted behavioral economic approach to addictive behavior. Beacon-OUD is: (1) quick and easy-to-deliver to patients, with automated, standardized scoring to reduce time barriers; (2) accessible, easy-to-comprehend and self- administer; (3) non-stigmatizing and assesses risk without disclosing sensitive information; (4) oriented to current and future, not past, OUD behavior; and 5) interoperable and integrated with a patient’s medical record to improve the standards for OUD assessment and patient-centered care. In Phase I of this project, we conducted a clinical study, validating Beacon-OUD as demonstrating robust predictive accuracy of opioid misuse and receiving positive reports of feasibility and acceptability from providers. The goal of this Phase II SBIR is to extend Beacon-OUD’s development into a fully realized commercial product, both as a stand-alone tool and as an integrated tool within an electronic medical record (EMR) system at a large multi-site healthcare system serving approximately 1M outpatients per year. Aim 1 will optimize the user-experience and accessibility of Beacon-OUD as a product, produce comprehensive clinical reference materials, and complete a Spanish- language translation. Aim 2 will integrate Beacon-OUD into EPIC, a widely used electronic medical record system within a health system partner to improve usability, workflow capabilities, and record-keeping of opioid misuse directly in a patient’s medical chart. In addition, Aim 2 will launch education and implementation initiatives to promote Beacon-OUD’s use primary care. Finally, BEAM will complete an Exploratory Aim seeking to validate and expand Beacon-OUD’s clinical utility as a measurement-based care tool for OUD treatment prognosis. At the conclusion of this Phase II project, BEAM will have brought Beacon-OUD to market as a digital assessment for OUD measurement, both as a stand-alone product and an EMR-integrated version.