Project Details
Description
ABSTRACT
My overall goal is to advance the evidence needed to stem the opioid epidemic, and to translate the evidence
into real-world implementation and effective public health policy. The current opioid epidemic in the US was
driven by widespread use of prescription opioids (POs) for chronic pain. In response, guidelines and health
policies increasingly promote use of opioid risk mitigation strategies such as PO tapering (reducing the dose or
discontinuing POs). However, adoption of opioid risk mitigation strategies is outpacing the evidence, for
example, outcomes of PO tapering and optimal strategies for implementing PO tapering in real-world HIV and
primary care settings are unknown. PO tapering can have particularly serious implications for HIV control, if
tapering causes patients to fall out of HIV care or replace POs with illicit or injected opioid use; but the risks
have not been quantified and factors associated with these outcomes have not been described. Given the
overall lack of evidence about PO risk mitigation strategies and their implementation and the urgency of
addressing the epidemic, it is imperative to expand the capacity of clinician-investigators conducting patient-
oriented research on PO use in HIV+ and HIV- individuals. I am a physician who treats chronic pain and opioid
use disorder, an investigator focused on judicious PO prescribing for over a decade, and an educator with a
strong mentoring track record and exceptional institutional resources to support mentees. This K24 mid-career
investigator award will help to expand capacity of clinician investigators in the field by: 1) providing outstanding
mentorship to junior investigators focused on PO use in chronic pain, 2) expanding my research in
implementation science methodologies to optimize translating evidence into practice, and 3) advancing my
development as a leader in translating evidence about PO use into guidelines and health policy. My strong
existing research program focused on PO risk mitigation practices for HIV+ and HIV- patients with chronic
pain, along with exceptional advisors and institutional resources, will provide a platform for mentoring and
expanding my skills. Using my existing study cohorts and new primary data collection including qualitative
interviews and a discrete choice experiment, we propose the following new research aims: 1) to examine the
positive and negative outcomes of PO tapering among HIV+ and HIV- patients with chronic pain, and 2) to
identify patient preferences for different PO tapering strategies among HIV+ and HIV- patients with chronic
pain and high-risk PO use. All proposed research will be conducted with mentees and will provide ample
opportunities for mentee development in diverse research methods, responsible conduct of research, and
preparing manuscripts and grant applications. Findings from the research will inform future interventions and
guidelines for PO tapering. Overall, the proposed plans for mentoring, career development, and research will
expand capacity to address the opioid epidemic.
Status | Finished |
---|---|
Effective start/end date | 3/1/18 → 2/28/24 |
Funding
- National Institute on Drug Abuse: $115,983.00
- National Institute on Drug Abuse: $72,677.00
- National Institute on Drug Abuse: $188,660.00
- National Institute on Drug Abuse: $121,330.00
- National Institute on Drug Abuse: $188,660.00
- National Institute on Drug Abuse: $188,660.00
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