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Leveraging large-scale administrative claims data to evaluate prescription opioid use, risks, and outcomes in older adults living with HIV

Award Number: K01DA053157
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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PROJECT SUMMARY The purpose of this Mentored Research Scientist Development Award (K01) is to provide support for me to become an independent investigator with a multidisciplinary research program in HIV at the intersection of prescription drug use, comorbidities, and aging. In this project, I propose to leverage existing administrative claims data from Medicare beneficiaries ≥65 years of age from 2007-2018 to determine how high-risk prescription opioid use, e.g. high dose use (≥120 mg/day) or prolonged use (≥90 days), affects health outcomes and health care utilization in older people living with HIV (PLWH). Building on my strong foundation in HIV epidemiology and HIV comorbidities across the lifespan, the training from this K01 will allow me to (1) obtain proficiency in the analysis of large-scale, longitudinal administrative claims data; (2) attain content expertise in prescription drug utilization research and pharmacoepidemiology; and (3) develop expertise in the application of machine learning methods. My career development plan includes specific coursework, seminars, conferences, directed readings, and tailored mentoring from a multidisciplinary team comprised of experts in administrative claims data, substance use epidemiology, pharmacoepidemiology, and machine learning methods. Rutgers University provides an exceptional environment for completion of this training, with research support and infrastructure for analyzing large, multiyear datasets (including Medicare claims) and conducting high-impact HIV research. The proposed research is significant given that a substantial gap exists in understanding how prescription opioid use affects a growing population of aging PLWH who commonly report chronic pain, and have multiple comorbidities, increasing polypharmacy, and increased risk for untoward drug-drug interactions. This research is critical to target appropriate prevention and treatment programs to optimize health outcomes for this population. To fill this gap, specific aims are to: (1) Assess the associations between HIV infection and a) adverse health outcomes (e.g. falls/fractures, dementia, mortality) and b) health care utilization (e.g. emergency department use, inpatient hospitalizations, and outpatient visits) among older adults, and estimate the interaction between HIV infection and high-risk prescription opioid use on adverse outcomes and utilization; (2) Among older PLWH, estimate drug-drug interactions between high-risk prescription opioid use and specific antiretroviral drug classes or sedatives (e.g. benzodiazepines) on risk of adverse health outcomes and health care utilization; and (3) Examine the feasibility of applying existing machine learning approaches to predict adverse health outcomes and high health care utilization among older PLWH based on patient profiles and opioid prescription patterns in a large administrative claims database. Findings from this project will generate valuable new information and tools to support clinical decisions and more precisely target prevention and treatment interventions to improve health for older PLWH who are prescribed opioids, and directly inform an R01 application to study drug-drug and drug- disease interactions between widely used prescription drugs and common comorbidities among older PLWH.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $196,106 )
2024	2024	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Drug Use and Addiction Research Programs	002	5	5/24/2024	NON-COMPETING CONTINUATION	$196,106
2024	2023	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Drug Use and Addiction Research Programs	001	4	5/22/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$26,376
2024	2022	RUTGERS, THE STATE UNIVERSITY	679 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	2	5/22/2024	NON-COMPETING CONTINUATION	-$26,376
														Subtotal = $196,106

Issue Date FY: 2023 ( Subtotal = $249,421 )
2023	2023	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Use and Addiction Research Programs	002	3	9/25/2023	NON-COMPETING CONTINUATION	-$196,106
2023	2023	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Drug Use and Addiction Research Programs	004	4	9/25/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$249,421
2023	2023	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Use and Addiction Research Programs	001	3	5/1/2023	SUPPLEMENT FOR EXPANSION	$53,315
2023	2023	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Use and Addiction Research Programs	003	3	9/25/2023	SUPPLEMENT FOR EXPANSION	-$53,315
2023	2023	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	3	4/28/2023	NON-COMPETING CONTINUATION	$196,106
														Subtotal = $249,421

Issue Date FY: 2022 ( Subtotal = $195,626 )
2022	2022	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Use and Addiction Research Programs	000	2	4/13/2022	NON-COMPETING CONTINUATION	$195,626
														Subtotal = $195,626

Issue Date FY: 2021 ( Subtotal = $195,626 )
2021	2021	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Drug Abuse and Addiction Research Programs	000	1	5/17/2021	NEW	$195,626
														Subtotal = $195,626

Grand Total All Awards = $836,779

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Leveraging large-scale administrative claims data to evaluate prescription opioid use, risks, and outcomes in older adults living with HIV

Award Number: K01DA053157

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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