Document text
Principal Investigator: Susan L Calcaterra
Organization: UNIVERSITY OF COLORADO DENVER
Fiscal Year: 2024
Award: $189,043
Funding agency: National Institute on Drug Abuse
PROJECT ABSTRACT With the career goal of becoming an independent health services researcher, Dr.
Susan Calcaterra describes a mentored research project and a rigorous career development plan which will
prepare her to become a leader in the integration of opioid use disorder (OUD) treatment in the hospital setting
with linkage to OUD care post discharge. Nearly 200 people died every day from an overdose in 2017 in the
United States (US). In 2012, there were 527,000 hospitalizations due to opioid use which cost more than $15
billion in medical care. For patients with OUD, there are proven benefits to initiating buprenorphine in the
hospital with treatment referrals and prescribing naloxone at discharge. Unfortunately, OUDs are often not
addressed in the hospital resulting in a missed opportunity to provide patients evidence-based treatment.
There are 50,000 hospital-based physicians (hospitalists) caring for hospitalized patients in the US. This vast
workforce offers a potential solution to initiate buprenorphine in the hospital, provide naloxone at discharge,
and ensure patients are referred to ongoing OUD treatment. There is a critical need to determine why
buprenorphine and naloxone are not routinely prescribed to hospitalized patients with OUD and to sustainably
integrate evidence-based OUD treatment in the hospital using the existing workforce. Without this knowledge,
many hospitalized patients will fail to receive lifesaving medication. The proposed research centers on the
hypothesis that hospitalist’s knowledge and beliefs impact OUD treatment and the hospital’s current structures
and processes do not support OUD treatment. Study Aims include: 1) a qualitative investigation into key
barriers to the integration of evidence-based OUD care into hospital practice in three academic hospitals with
hospitalists, psychiatrists, pharmacists, social workers and nurses; 2) the development of a multicomponent
intervention that adapts evidence-based OUD treatment to the hospital setting by addressing reported barriers
in Aim 1 and by systematically meeting the needs of hospitalists, nurses, pharmacists and social workers
within their workflow; and 3) pilot test a multicomponent intervention to improve OUD treatment in one hospital
over 12 months. Use the RE-AIM framework to measure changes in buprenorphine and naloxone prescribing
(Reach) and changes in the number of providers licensed to prescribe buprenorphine (Adoption) pre/post
intervention implementation. Interview hospital providers to identify ongoing Implementation barriers and to
learn about adaptations made to the intervention to improve its efficiency and ease of use. To accomplish
these aims, Dr. Calcaterra will pursue training in 1) qualitative research methods to inform the intervention
development, 2) intervention development to modify healthcare provider behaviors, and 3) dissemination and
implementation science for future intervention dissemination. Upon completion of these activities, along with
intensive mentorship, Dr. Calcaterra will be positioned to conduct a larger comparative effectiveness trial to
further implement, test and refine the intervention’s fidelity (future R01).
Terms: <Address><Adoption><Belief><Bunavail><Buprenorphine><Caring><Communities><Consult><Country><County><Data><Development><Development Plans><Disease Management><Disorder Management><Drugs><Effectiveness><Electronic Health Record><Ensure><Evidence based practice><Evidence based treatment><Focus Groups><Future><Goals><Health Care Providers><Health Personnel><Health Services><Healthcare Providers><Healthcare worker><Hospital Admission><Hospitalists><Hospitalization><Hospitals><Improve Access><Incentives><Inpatients><Intervention><Intervention Strategies><Interview><Investigation><Investigators><Knowledge><Leadership><Learning><Licensing><Life><Link><Literature><Measures><Medical><Medication><Mentors><Mentorship><Methods><Modeling><NIDA><Naloxone><Narcan><Narcanti><National Institute of Drug Abuse><National Institute on Drug Abuse><Nurses><Overdose><Overdose reversal><Patient Care><Patient Care Delivery><Patients><Persons><Pharmaceutical Preparations><Pharmacies><Pharmacists><Pharmacy facility><Physicians><Position><Positioning Attribute><Privatization><Process><Protocol><Protocols documentation><Provider><Psychiatrist><Publications><Qualitative Research><R-Series Research Projects><R01 Mechanism><R01 Program><RE-AIM><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Recovery><Reporting><Research><Research Grants><Research Methodology><Research Methods><Research Personnel><Research Project Grants><Research Projects><Researchers><Scientific Publication><Screening procedure><Services><Social Workers><Specialist><Specialty><State Hospitals><Structure><Suboxone><Survey Instrument><Surveys><Testing><Training><United States><Universities><Zubsolv><addiction><addiction treatment referral><addictive disorder><barriers to implementation><buprenorphine + naloxone><buprenorphine and naloxone><buprenorphine with naloxone><buprenorphine-naloxone><buprenorphine/naloxone><care for patients><care of patients><career><career development><caring for patients><clinician behavior><comparative effectiveness trial><consults><cost><develop therapy><developmental><dissemination science><distribute naloxone><drug/agent><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><evidence base><experience><health care personnel><health care worker><health provider><health workforce><healthcare personnel><high risk><implementation barriers><implementation challenges><implementation intervention><implementation science><improved><innovate><innovation><innovative><intervention development><intervention refinement><interventional strategy><medical personnel><medical specialties><medication for opioid use disorder><meeting><meetings><multi-component intervention><multi-faceted intervention><multi-modal intervention><multicomponent intervention><multifaceted intervention><multimodal intervention><naloxone availability><naloxone dispensary><naloxone dispensation><naloxone dispensing><naloxone distribution><naloxone provision><new approaches><novel approaches><novel strategies><novel strategy><nurse><opiate consumption><opiate crisis><opiate drug use><opiate intake><opiate use><opiate use disorder><opioid consumption><opioid crisis><opioid drug use><opioid epidemic><opioid intake><opioid use><opioid use disorder><physician behavior><pilot test><post intervention><provide naloxone><provider behavior><reach, efficacy, adoption, implementation, and maintenance><referred for addiction care><referred to addiction treatment><research and methods><reverse overdose><safety net><screening tools><skill acquisition><skill development><skills><substance use><substance using><therapy development><treatment development><treatment provider><waiver>