# Health Systems Node of the NIDA Clinical Trials Network

> **NIH NIH UG1** · KAISER FOUNDATION RESEARCH INSTITUTE · 2022 · $1,463,989

## Abstract

PROJECT ABSTRACT
In the ongoing public health crisis of opioid overdoses, the incidence of opioid use disorder (OUD) has
increased and medication-based treatment for OUD remain underutilized. While longer OUD treatment
duration is generally associated with improved patient outcomes, maintaining continuous health insurance
coverage represents a significant challenge to sustaining access to treatment. Patients with OUD may be
vulnerable to experiencing health insurance instability that results in barriers to OUD treatment access. High-
risk care transitions or disruptions to treatment may increase risk of relapse, overdose, and mortality. Despite
the potential for insurance instability to create significant barriers to OUD treatment continuity, current
knowledge regarding its health and mortality impacts is limited due to the challenge of capturing and evaluating
patient outcomes after disenrollment from health systems. To address this knowledge gap, the proposed
Clinical Trials Network (CTN) research concept seeks to examine the association of health insurance instability
and mortality risk among patients receiving buprenorphine treatment for OUD in a multi-site cohort study,
leveraging data from the Prescription Opioid Registry (POR) that include four diverse health systems
participating in the CTN Health Systems Node. The aims of the study are: (1) Ascertain fact and cause of
death from the National Death Index; (2) Examine insurance instability during buprenorphine treatment for
OUD and associated patient and health plan factors; (3) Assess the association of insurance instability and risk
of all-cause, opioid overdose, and other substance-related overdose mortality; and (4) Link data from one
study site to all-payer claims data and criminal justice data to explore events associated with disenrollment
from health plans. The proposed research concept will contribute to understanding the mortality consequences
associated with insurance instability for patients in treatment for OUD. It will also inform strategies in health
systems to ensure continuity of treatment access and to prevent poor outcomes in patients at risk of
experiencing insurance coverage disruptions.

## Key facts

- **NIH application ID:** 10656818
- **Project number:** 3UG1DA040314-08S4
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Katharine Anthony Bradley
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,463,989
- **Award type:** 3
- **Project period:** 2022-09-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10656818

## Citation

> US National Institutes of Health, RePORTER application 10656818, Health Systems Node of the NIDA Clinical Trials Network (3UG1DA040314-08S4). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10656818. Licensed CC0.

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