My long-term goal is to become an independent investigator with a focus on studying and implementing innovative approaches for safer, better coordinated, and more patient-centered care for individuals with IBD. The objectives of this proposal are to develop and implement a human-centered Chronic Opioid Use Assessment and Screening Tool (COAST) to assist AYA with IBD and their clinicians to monitor and assess risk for progression to chronic opioid use. Application of human-centered design will assure the active engagement of patients, caregivers, and clinicians, and will facilitate development of a feasible, effective, and sustainable tool that makes it easier for these stakeholders to systematically and longitudinally monitor risk for progression to chronic opioid use. With strong health services and outcomes research doctoral training and prior research on opioid use in IBD care, I am well-equipped, with the support of an experienced and multi-disciplinary mentorship team, to successfully carry out this project. Specific aims are to: Aim 1: Leverage robust clinical data about AYA with IBD from the Northwestern Medicine (NM) Enterprise Data Warehouse (EDW) and conduct a modified Delphi panel with IBD-focused clinicians to delineate low, medium, and high risk categories for progression to chronic opioid use; In Year 1 of this award, using clinical informatics principles, we will use five years of EMR-extracted data and predictive risk modeling to elucidate which combination of factors are associated with low, medium, or high risk for progression to chronic use. To identify risk factors not captured by the EMR that can influence progression to chronic use, we will conduct a modified Delphi panel with IBD-focused clinicians at three Chicago hospitals. H1: Severity of IBD, older age, mental health comorbidities, history of surgery, and prior opioid medication exposure will be associated with the high risk category. Aim 2: Develop the COAST intervention using human-centered design; and In Year 2, we will leverage Northwestern’s Digestive Health Center and the Segal Design Institute to collaboratively brainstorm, prototype, and iteratively refine the intervention, applying human-centered design principles. With input from patients, caregivers, and clinicians, the tool will specifically account for the complex interplay of healthcare needs of IBD patient and clinicians. Ultimately, the COAST will continuously gather patient data and iteratively determine whether a patient is at low, medium, or high risk for progression to chronic opioid use at a given time. H2: Human-centered design will lead to a feasible intervention that meets the needs of patients and clinicians and will be readily adopted.
|Effective start/end date
|1/1/22 → 12/31/24
- Crohn's and Colitis Foundation of America (Award Number #882519)
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