Diffusion, Adoption, and Implementation of Pharmacotherapies in Alcohol Tx

描述（由申请人提供）：尽管最近在酒精依赖治疗药物的开发方面取得了进展，但治疗界在采用和实施这些循证实践方面进展缓慢。拟议的研究通过检查最近FDA批准的三种用于治疗酒精依赖的药物-纳曲酮，阿坎酸和Vivitrol的采用，扩散和实施来解决这种研究与实践的差距。拟议研究的具体目标有三个方面：（1）描述，比较和对比成瘾治疗计划采用，扩散和实施纳洛酮，阿坎酸和Vivitrol的趋势。(2)确定随着时间的推移促进或阻碍这三种药物疗法的传播、采用和实施的关键结构和劳动力特征。(3)指定，测试和比较预测三种药物疗法的采用和实施的多变量模型的“拟合”。拟议研究的数据将取自国家治疗中心研究（NTCS），这是一项对403个私营部门成瘾治疗项目的全国代表性纵向研究。目前和未来的NTCS数据收集为研究人员提供了检查阿坎酸和Vivitrol在日常治疗实践中的“真实的时间”扩散并将总体扩散趋势与1994年获得FDA批准的纳曲酮进行比较的机会。拟议的研究将作出重大贡献，药物滥用卫生服务领域的测试模型的采用和实施的产品，组织和劳动力水平的特点，测试关键的组织和劳动力预测之间的相互作用，并利用多层次和纵向数据分析技术。这项研究的结果将提供有关组织和劳动力特征的重要信息，这些特征塑造了基于研究的医疗技术进入日常实践的运动，并提供了对采用和实施药物治疗的障碍的更好理解。这些信息将与治疗提供者、卫生研究人员和卫生政策制定者有关，因为他们寻求弥合“研究与实践之间的差距”，并改善酗酒者获得优质治疗的机会。

DESCRIPTION (provided by applicant): Despite recent advances in the development of pharmacotherapies for the treatment of alcohol dependence, the treatment community has been slow to adopt and implement these evidence-based practices. The proposed research addresses this research-to-practice gap by examining the adoption, diffusion, and implementation of the three most recent FDA approved pharmacotherapies for the treatment of alcohol dependence-naltrexone, acamprosate, and Vivitrol. The specific aims of the proposed research are threefold: (1) Describe, compare, and contrast trends in the adoption, diffusion and implementation of naltrexone, acamprosate.and Vivitrol by addiction treatment programs. (2) Identify key structural and workforce characteristics that facilitate or impede diffusion, adoption and implementation of these three pharmacotherapies over time. (3) Specify, test, and compare the "fit" of multivariate models predicting the adoption and implementation of the three pharmacotherapies. Data for the proposed research will be taken from the National Treatment Center Study (NTCS), a nationally representative, longitudinal study of 403 privatesector addiction treatment programs. Present and future NTCS data collections provide researchers the opportunity to examine the "real time" diffusion of acamprosate and Vivitrol into everyday treatment practice and to compare overall diffusion trends with naltrexone which received FDA approval in 1994. The proposed research will make significant contributions to the field of substance abuse health services by testing models of adoption and implementation as a product of both organizational and workforce level characteristics, testing for interactions between key organizational and workforce predictors, and utilizing multi-level and longitudinal data analysis techniques. The results of this research will provide important information about the organizational and workforce characteristics that shape the movement of research based medical technologies into everyday practice and provide a greater understanding of the barriers to adoption and implementation of pharmacotherapies. This information will be relevant to treatment providers, health researchers, and health policymakers as they seek to bridge the "research to practice gap" and improve access to quality treatment for persons suffering from alcoholism.