Research to practice: adoption of naltrexone in alcoholism treatment
Research to practice: adoption of naltrexone in alcoholism treatment
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DOI：
10.1016/s0740-5472(02)00319-7
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发表时间：
2003-01-01
影响因子：
3.9
通讯作者：
Swift, R
中科院分区：
文献类型：
--
作者：
Thomas, CP;Wallack, SS;Swift, R
纳曲酮是一种处方药，于 1994 年 12 月被批准作为酒精中毒和酒精滥用治疗咨询的辅助药物，是几十年来第一种治疗酒精中毒的新药物。最初的对照试验表明它可以有效预防复发，而后来的试验显示出不同的结果。尽管许多治疗酒精中毒的医生和其他人发现纳曲酮对治疗非常有帮助，但它仍然是一项尚未广泛使用的技术。在这项研究中，我们研究了哪些临床医生在实践中采用纳曲酮的原因是什么，以及哪些临床和非临床因素阻碍了其使用。在我们对酗酒治疗临床医生的邮件调查中，80% 的医生和 45% 的非医生报告至少很少开纳曲酮处方或推荐纳曲酮，但只有 15% 的医生（即使是成瘾专家）经常开纳曲酮处方。采用纳曲酮的最大障碍是资金和对该药物的了解不足，其次是缺乏关于有效性的足够证据。如果临床医生参与积极推广纳曲酮使用的治疗计划，那么他们最有可能采用纳曲酮。我们的结论是，为了使新的药物滥用治疗药物在临床实践中得到广泛采用，有关它的信息必须是财产导向的，临床医生必须相信其有效性，必须有足够的资金，临床医生工作的治疗组织必须促进其使用。 (C) 2003 Elsevier Science Inc. 保留所有紧身衣。
Naltrexone, a prescription medication, was approved in December 1994 as an adjunct to counseling in treatment of alcoholism and alcohol abuse, representing the first new medication for alcoholism in several decades. Initial controlled trials indicated that it is effective in preventing relapse, while later trials show mixed results. Although many physicians and others treating alcoholism have found naltrexone to be very helpful in treatment, it is still a technology that has not been used widely. In this study, we examine which clinicians have adopted naltrexone into practice for what reasons, and what clinical and nonclinical factors acted as barriers to its use. In our mail survey of alcoholism treatment clinicians, 80% of physicians and 45% of nonphysicians report prescribing or recommending naltrexone at least rarely, but only 15% of physicians, even among addiction specialists, prescribe naltrexone often. The strongest barriers to adoption of naltrexone were financing and inadequate knowledge about the medication, followed by lack of sufficient evidence regarding effectiveness. Clinicians were most likely to adopt naltrexone if they were affiliated with treatment programs that actively promoted its use. We conclude that in order for a new substance abuse treatment medication to be widely adopted in clinical practice, information about it must be property directed, clinicians must be convinced of its effectiveness, it must be adequately financed, and the treatment organizations in which clinicians work must promote its use. (C) 2003 Elsevier Science Inc. All tights reserved.