Medications for alcohol use disorder:? Unfilled prescriptions and treatment trajectories

Ended Project Grant Awarded Last action

Award ID
R01AA029267
Recipient
Awarding agency
Obligated
$6,491,116

Award facts

Assistance listing
93.273 Alcohol Research Programs
Completion date
Originally
Funding
  • $5,693,698.00 Federal
  • $797,418.00 Non-federal
Place of performance
Massachusetts, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Many individuals with alcohol use disorder (AUD) receive no treatment, including evidence-based pharmacotherapies. Previous research on AUD medication use has primarily relied on claims data, and thus focuses on only a portion of the AUD medication treatment process (i.e., filled prescriptions). Using only claims data, IT is not possible to distinguish the characteristics of individuals who do not receive a prescription from a clinician from those who receive one but do not fill IT. IT is also not possible to understand how medication prescriptions and fills fit into the trajectory of AUD treatment received. To design practice and policy interventions that will improve AUD medication use, clinicians and policy makers need to understand who "falls off" at each point in the treatment process. We propose to use a dataset from a large national insurer with linked claims and electronic health record (EHR) data for the period 2010-2023, as well as interviews of AUD providers, in a mixed methods study. The linked data will allow US to observe written prescriptions for each patient as well as whether or not the prescriptions were filled. The linked data will also allow US to incorporate clinically relevant information available in ehrs but not claims. Using these data, we will: 1) for individuals diagnosed with AUD, identify patient and provider characteristics associated with being prescribed an AUD medication and the time from index AUD encounter to prescription; 2) for individuals diagnosed with AUD who are prescribed an AUD medication, identify patient and prescriber characteristics associated with filling the prescription and with time to prescription fill; and 3) identify trajectories of AUD care that incorporate information on prescriptions written for individuals diagnosed with AUD, and examine the association between different treatment trajectories and indicators of subsequent relapse and injury. The study's mixed methods approach, including semi-structured interviews of providers who treat AUD about the factors that influence their AUD medication prescribing decisions, will allow a more nuanced examination of AUD medication prescribing than quantitative analyses alone allow. The findings will help pinpoint where in the treatment process different types of people fall out of treatment and how different treatment trajectories are associated with relapse and injury, informing future intervention and policy design.

Transactions

Action Federal Non-federal Date
Amendment $0 $0
Amendment $45,422 $0
Amendment $408,797 $0
Amendment $408,797 $0
Amendment $810,009 $0
Amendment $810,009 $0
Amendment $810,009 $0
Amendment $805,819 $0
Amendment $797,418 $0
Original award $797,418 $797,418

Subawards

Subrecipient Amount Awarded
Brandeis University Dominic Hodgkin, PhD (Multiple Principal Investigator) will oversee the project jointly with PI Huskamp. As multiple PI(with Dr. Haiden Huskamp), he will… $112,874
The Rand Corporation Dr. Uscher-Pines will serve as a co-investigator on this project and will lead the qualitative aim. She will be responsible for data collection and analysis for… $90,382
The Johns Hopkins University Hendricks. She will carry out the following tasks: 1. Facilitate the acquisition of the necessary administrative data, including claims, enrollment and… $4,906
Brandeis University Dominic Hodgkin, PhD (Multiple Principal Investigator) will oversee the project jointly with PI Huskamp. As multiple PI(with Dr. Haiden Huskamp), he will… $94,575
The Johns Hopkins University Hendricks. She will carry out the following tasks: 1. Facilitate the acquisition of the necessary administrative data, including claims, enrollment and… $49,053
The Rand Corporation Dr. Uscher-Pines will serve as a co-investigator on this project and will lead the qualitative aim. She will be responsible for data collection and analysis for… $33,818

Quick answers

Who received award R01AA029267?

R01AA029267 was awarded to President And Fellows Of Harvard College by National Institute on Alcohol Abuse and Alcoholism (National Institutes of Health) on July 1, 2021.

How much is award R01AA029267 worth?

$6,491,116 has been obligated on R01AA029267: $5,693,698 in federal funding and $797,418 in non-federal funding.

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