PARCKA Pilot Grant Award Program

The goal of the PARCKA Pilot Grant Award Program is to enable faculty and trainees to obtain information, data, and results that can help them to prepare for major research grant submissions to the National Institutes of Health, Veterans Affairs, and other agencies or to initiate new directions in addiction-related clinical care, education, or advocacy activities.

The PARCKA Pilot Grant Award Program is intended to assist junior faculty or trainees or more senior faculty or trainees who are exploring new addiction-related topics in anticipation for larger grant awards.

2023-2024 AWARDEE

MARCELA SMID, MD, MS, MA

University of Utah’s opioid-sparing protocol for post-cesarean pain management for dyads affected by opioid and other substance use disorder: maternal, post-cesarean pain-related and infant outcomes

Principal Investigators: Marcela Smid, MD, MA, MS (right)
Co-Investigators: Torri Metz, MD, MS, Theresa Kurtz, MD and Elizabeth Charron, PhD
Duration: July 1, 2023 - June 30, 2024

Poor post-cesarean pain management is associated with adverse perinatal outcomes and few evidence-based practices exist to guide interventions particularly for individuals with opioid use disorder. Many institutions have developed their own pain management strategies for this population. The University of Utah is part of the Buprenorphine for Opioid Use Disorder and Cesarean Outcomes (BRONCO) Consortium, a five-institution collaborative. The BRONCO Consortium aims to compare pain management strategies across these five institutions to inform a larger trial to determine optimal pain management strategy for pregnant individuals with OUD delivering via cesarean. We have completed data abstraction for those 108 individuals with OUD who received the University of Utah’s opioid-sparing protocol, which was implemented in 2018. This project aims to further compare post-cesarean pain score and opioid usage during delivery hospitalization among three groups of individuals who delivered at the University of Utah via cesarean (2014-2022): 1) individuals with OUD/SUD who received the opioid sparing protocol (2018-2022) 2) individuals with OUD/SUD who did not receive the opioid-sparing protocol (2014-2022) and 3) matched control individuals without OUD/SUD (2014-2022). The results of this study will help to inform the planned R01 submission on pain management strategies for postcesarean pain management for individuals with OUD.

2024-2025 AWARDEE

LAURA STOLEBARGER, BSN, RN

Expanding a Collaborative Care Model for Patients with Methamphetamine Use Disorder and Associated Cardiopulmonary Conditions

Principal Investigators: Laura Stolebarger, BSN, RN (right)
Co-Investigators: Michael Incze, MD, MSEd; Katharine Clapham, MD; and Jennalyn Mayeux, APRN
Duration: July 1, 2024 - June 30, 2025

Methamphetamine use disorder (MUD) has been increasingly recognized as a major public health concern, especially in the western US. Methamphetamine use is associated with increased risk of death, as well as the development of severe acute and chronic cardiopulmonary sequelae. While national estimates currently suggest that 4-5% of people with pulmonary arterial hypertension (PAH) have a methamphetamine-associated etiology (meth-PAH), registry data at the University of Utah, where patients with PAH are routinely screened for methamphetamine use, identified a meth-PAH prevalence of 24%. Currently, there are no FDA-approved pharmacologic treatments for MUD, but behavioral treatments such as contingency management have been shown to be effective. Integrating contingency management and expert addiction care into cardiology specialty clinics has demonstrated promise in expanding access to MUD treatment. In July of 2023, we started a collaborative care pilot between a primary care-based substance use disorder treatment clinic and pulmonary hypertension program where we provide contingency management, peer support services, and full spectrum primary care coordinated with specialty care for meth-PAH. Our pilot program enrolled 6 patients (in addition to 4 more patients with MUD and no known cardiopulmonary disease), with early signals of benefit including improved MUD and cardiopulmonary outcomes. We seek to expand this work to increase enrollment among patients with meth-PAH as well as patients with methamphetamine-associated heart failure. We plan to eventually develop and test our intervention through a multi-site randomized clinical trial of a collaborative care intervention for patients with methamphetamine-associated cardiopulmonary conditions.