Improving Combined Buprenorphine-Behavioral Treatment

改善丁丙诺啡联合行为治疗

• 批准号: 6869738
• 负责人: Warren K Bickel
• 金额: $ 87.26万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-03-10 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6869738
• 关键词: behavior modification; behavioral /social science research tag; buprenorphine; clinical research; clinical trials; combination therapy; community mental health services; computer assisted patient care; counseling; drug abuse chemotherapy; drug abuse therapy; drug addiction; human subject; human therapy evaluation; opiate alkaloid; patient care management; patient oriented research; rural health

DESCRIPTION (provided by applicant): In this competing continuation we propose to continue and expand our prior aims. First, we will continue our study of computerized treatment. In a prior trial, computer-delivered Community Reinforcement Approach (CRA) with contingency management (CM) was as effective as therapist-delivered CRA with CM. The design of that study, however, did not indicate whether the computer-delivered CRA produced increases in therapeutic outcomes over that produced by the CM procedures alone. Thus, we propose to isolate the contribution of the computerized treatment to therapeutic outcomes. Second, we will examine the efficacy of a component of CRA, therapist-delivered facilitation of treatment goals and outreach services (FOS) that cannot be computerized. The efficacy of FOS has not been previously examined. In the process, we will address the infrequently acknowledged problem of rural opioid dependence. The aim of this project is to address this serious public health concern by continuing the first and one of only two outpatient clinics providing pharmacotherapies for opioid dependence in the State of Vermont. Opioid-dependent outpatients will receive buprenorphine maintenance across two clinical trials. In the first, patients will be randomized to one of two treatments: (1) computer-delivered CRA along with CM; or (2) CM alone. In the second, patients will be randomized to one of two treatments: (1) therapist-delivered FOS with computer-delivered CRA and CM; or (2) computer-delivered CRA and CM. CM procedures will target both opioid and cocaine abstinence in both trials. Primary outcome measures will include abstinence, HIV-risk behavior, retention and cost-effectiveness. Overall, this research will contribute new empirical information about the efficacy of two approaches of providing CRA with CM. Such information may result in more cost-effective treatment and facilitate dissemination. Moreover, the computerization of substance-abuse treatment may positively impact the treatment field. Finally, this project will contribute positively to this region's public health by providing a substantial portion of all outpatient pharmacotherapy services for opioid dependence in the State of Vermont.

描述（由申请人提供）： 在这种竞争性的延续中，我们建议继续并扩展我们先前的目标。首先，我们将继续研究计算机化治疗。在先前的试验中，计算机提供的社区强化方法（CRA）与应急管理（CM）是一样有效的治疗师提供的CRA与CM。然而，该研究的设计并未表明计算机提供的CRA是否比单独的CM程序产生的治疗结果增加。因此，我们建议隔离计算机化治疗对治疗结果的贡献。其次，我们将研究CRA的一个组成部分的疗效，治疗师提供的治疗目标和外展服务（FOS），不能被计算机化的促进。FOS的功效以前没有被检查过。 在此过程中，我们将解决农村阿片类药物依赖这一不常被承认的问题。该项目的目的是解决这一严重的公共卫生问题，继续开办佛蒙特州第一家也是仅有的两家为阿片类药物依赖提供药物治疗的门诊诊所之一。 阿片类药物依赖门诊患者将在两项临床试验中接受丁丙诺啡维持治疗。首先，患者将随机接受两种治疗之一：（1）计算机提供的CRA沿着CM;或（2）单独使用CM。在第二组中，患者将随机接受两种治疗之一：（1）治疗师提供的FOS与计算机提供的CRA和CM;或（2）计算机提供的CRA和CM。CM程序将在两项试验中针对阿片类药物和可卡因戒断。主要结果指标将包括禁欲，艾滋病毒风险行为，保留和成本效益。 总体而言，这项研究将有助于新的实证信息的有效性，两种方法提供CRA与CM。这种信息可能会导致更具成本效益的治疗，并促进传播。此外，药物滥用治疗的计算机化可能对治疗领域产生积极影响。最后，该项目将通过在佛蒙特州提供阿片类药物依赖门诊药物治疗服务的很大一部分，为该地区的公共卫生做出积极贡献。