MEDICATION/PSYCHOTHERAPY TAILORED TO PATIENT RESOURCES

描述：此应用程序是对RFA的响应 酒精中毒的行为/药物治疗。虽然新药 被引入以减少酗酒者的酒精摄入量，但几乎没有 知道这些药物实际上是如何改变酒精摄取模式的 和生活质量，什么样的患者概况可以从这些方面获得最大好处 药物治疗和哪些心理疗法将最终优化治疗 结果。这项提议的具体目的是执行议定书 在RFA中描述，以检查1)的主要影响 药物-心理治疗组合对患者预后的影响 假设患者结局为中等程度的变量。在建议的 随机临床试验，两种治疗方法不同的心理疗法 强度和范围、广谱治疗(BST)和激励 强化治疗将与四种用药条件相结合； 纳曲酮(NTX)、氨基己酸酯(ACA)、NTX ACA和安慰剂。病人是 治疗6个月，并对治疗反应进行追踪 额外的一年。测量的主要结果领域是1)禁欲和 G和2)心理社会功能。这份提案还包括两个 旨在解决与执行有关的关键问题的试点研究 建议的RFA协议。飞行员一号将从大到小开发一种仪器 现有的数据集用于衡量患者的心理社会资源。飞行员2是一名 NTX联合ACA与安慰剂的随机6个月治疗试验 酗酒者也接受英国退伍军人服务税。总体而言，我们预计最好的 一揽子治疗方案将针对 患者的心理社会需求，同时解决生物方面的 通过有效的药物管理实现酒精依赖。 为了满足主要的研究要求，拟议的试点 调查涉及三个目标：评估联合行动的影响 阿卡米松和纳曲酮给药，中试测试和精制 BST，以及开发一种强大而节俭的患者衡量标准 心理社会资源。

DESCRIPTION: This application is a response to the RFA, 'Combined Behavioral/Pharmacologic Treatment of Alcoholism. Although new medications are being introduced to decrease alcohol intake in alcoholics, little is known about how these medications actually change patterns of alcohol intake and quality of life, what patient profile can best benefit from these medications and what psychotherapies will ultimately optimize treatment outcome. The specific aim of this proposal is to implement the protocol described in the RFA to examine 1) the main effects of medication-psychotherapy combinations on patient outcomes and 2) the variables hypothesized to moderate patient outcome. In the proposed randomized clinical trial, two psychotherapies differing in treatment intensity and scope, Broad Spectrum therapy (BST) and Motivational Enhancement therapy will be combined with four medication conditions; Naltrexone (NTX), Acamprosate (ACA), NTX+ACA, and Placebo. Patients are treated for six months and response to treatment is followed for an additional one year. Primary outcome domains measured are 1) abstinence and g and 2) psychosocial functioning. Also included in this proposal are two pilot studies designed to address key questions regarding the implementation of the proposed RFA protocol. Pilot 1 will develop an instrument from large existing data sets to measure patient psychosocial resources. Pilot 2 is a randomized six month treatment trial of NTX plus ACA vs. placebo in alcoholics also receiving BST. Overall, we anticipate that the optimum treatment package will be one that targets the most significant of a patients psychosocial needs while addressing the biological aspects of alcohol dependence via effective medication management. In order to address the main study requirements, the proposed pilot investigation addresses three aims: assessing the effects of combined acamprosate and naltrexone administration, pilot testing and refinement of BST, and development of a robust yet parsimonious measure of patient psychosocial resources.