Facilitating Factors and Barriers to the Use of Medications in Publicly Funded Addiction Treatment Organizations
Facilitating Factors and Barriers to the Use of Medications in Publicly Funded Addiction Treatment Organizations
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DOI：
10.1097/adm.0b013e3181b41a32
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发表时间：
2010-06-01
影响因子：
5.5
通讯作者：
Oser, Carrie B.
中科院分区：
文献类型：
--
作者：
Knudsen, Hannah K.;Roman, Paul M.;Oser, Carrie B.
目的：公共资助的成瘾治疗组织采用药物治疗的速度很慢。很少有研究探讨了与采用不同类型的药物在这一治疗部门的组织因素。本研究确定了组织层面的促进者和障碍，在公共资助的成瘾治疗organizations.Methods的使用药物：面对面的访谈与318名管理员的一个代表性的样本，公共资助的成瘾治疗中心在UnitedStates.Results：只有23.4%的程序报告使用任何的5食品和药物管理局批准的药物治疗成瘾。另有14.3%的项目仅使用批准用于治疗精神疾病的药物。多变量多项逻辑回归结果显示，成瘾药物治疗的几率在政府拥有的项目和有更多医务人员的项目中显着更大。更严重依赖非医疗补助公共资金的项目往往不太可能采用成瘾治疗药物。更多的接触与医药代表正相关的药物administration.Conclusions：目前的公共资金政策和缺乏获得医疗人员的障碍，通过药物由公共资助的成瘾治疗组织。促进采用的努力也可能受益于制药代表更详细的活动。这些研究结果表明，大量的研究投资致力于开发成瘾治疗药物可能有有限的公共卫生影响，因为公共资助的服务提供系统的特点和有限的关注给予这个系统的商业供应商的药物。
Objectives: Publicly funded addiction treatment organizations have been slow to adopt pharmacotherapies. Few studies have examined the organizational factors associated with adoption of different types of medication in this treatment sector. This study identifies the organization-level facilitators and barriers to the use of medications in publicly funded addiction treatment organizations.Methods: Face-to-face interviews with 318 administrators of a representative sample of publicly funded addiction treatment centers in the United States.Results: Only 23.4% of programs reported using any of the 5 Food and Drug Administration-approved pharmacotherapies for treating addiction. An additional 14.3% of programs only used medications approved for the treatment of psychiatric disorders. Multivariate multinomial logistic regression results revealed that the odds of adoption of addiction pharmacotherapies were significantly greater in government-owned programs and in programs with more medical personnel. Programs that relied more heavily on non-Medicaid public funding tended to be less likely to adopt addiction treatment medications. Greater contact with pharmaceutical representatives was positively associated with medication adoption.Conclusions: Current public funding policies and lack of access to medical personnel are barriers to the adoption of medications by publicly funded addiction treatment organizations. Efforts to promote adoption may also benefit from greater detailing activities by pharmaceutical representatives. These findings suggest that the large research investment devoted to developing addiction treatment medications may have limited public health impact because of the characteristics of the publicly funded service delivery system and the limited attention given to this system by commercial purveyors of medications.