Clinical Trials Network: Pacific Northwest Node

 描述：《平价医疗法案》和《精神健康平等与成瘾平等法》在全国范围内以及华盛顿州的一些举措在当地带来了医疗保健提供系统的变化。作为这些变化的一部分，物质使用障碍(SUD)治疗正在扩展到专科护理之外，并纳入到初级保健和急性护理医疗环境中，那里的SUD患病率很高。这些举措使人们更加重视在这些环境中进行SUD筛查、短暂干预和转诊治疗(SBIRT)。这些综合举措以协作护理和慢性病管理方法为基础。越来越需要未来的研究来开发和测试在医疗保健环境中实施并与专门的SUD治疗计划相联系的SUD干预措施的有效性。这一观点也反映了NIDA国家药物滥用治疗临床试验网络(CTN)的未来方向，因为它将其研究重点扩展到基于社区的专业治疗计划(CTP)之外。为了促进社区卫生服务中心扩大的目标和研究重点，太平洋西北地区(PNW)节点提出了以下具体目标：(1)增加PNW节点研究团队的能力，增加在开发和协调基于初级保健实践的研究网络和协作护理模式方面具有实际和研究专长的调查人员，将行为健康和SUD治疗部分整合到初级和急性护理环境中，以及协调和使用跨多个卫生保健系统的电子医疗记录系统；(2)通过在我们目前的CTP中增加一些涉及综合行为健康协作护理的大型全州和地区性初级保健临床和研究网络和计划，扩大与PNW节点相关的研究和临床实践的范围、人群、多样性和重点；(3)设计和开展务实、比较有效的研究、登记和其他类型的创新研究，评估SBIRT、综合行为和药理治疗以及针对烟草、酒精、非法药物和滥用处方阿片类药物的协同护理的组成部分；(4)通过CTN国家传播图书馆、西北和中央落基山脉成瘾技术转移中心，以及酒精和药物滥用研究所内的资源，向保健和急救提供者提供关于SOD、协作护理和慢性病管理模式、整合过程以及初级保健和专业UD CTP之间有效联系的方法的培训。这种培训还为传播研究提供了机会。

 DESCRIPTION: Changes in the healthcare delivery system have been brought about nationally by the Affordable Care Act and the Mental Health Parity and Addiction Equity Act and locally by a number of Washington State initiatives. As part of these changes substance use disorder (SUD) treatment is being expanded beyond specialty care and integrated into primary care and acute care medical settings where SUD prevalence rates are high. These initiatives have led to an increased focus on SUD screening, brief intervention, and referral to treatment (SBIRT) in these settings. These integrative initiatives are based on collaborative care and chronic disease management approaches. There is an increased need for future research to develop and test the effectiveness of SUD interventions implemented in healthcare settings and linked to specialty SUD treatment programs. This viewpoint also reflects the future direction of the NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) as it expands its research focus beyond community-based specialty treatment programs (CTPs). In order to contribute to the CTN's expanded objectives and research priorities, the Pacific Northwest (PNW) Node proposes the following Specific Aims: (1) Increase the capacity of the PNW Node research team by adding investigators with demonstrated practical and research expertise in developing and coordinating primary care practice-based research networks and collaborative care models, integrating behavioral health and SUD treatment components into primary and acute care settings, and harmonizing and using electronic medical record systems across multiple health care systems; (2) Expand the scope, population, diversity, and focus of research and clinical practice settings affiliated with the PNW Node by adding to our current CTPs a number of large state-wide and regional practice-based primary care clinical and research networks and programs involved in integrated behavioral health collaborative care; (3) Design and conduct pragmatic, comparative effectiveness, registry, and other types of innovative studies, informed bidirectionally by SUD researchers and clinicians and primary and acute care providers, that evaluate SBIRT, integrated behavioral and pharmacological treatments, and components of collaborative care for tobacco, alcohol, illicit drugs, and misused prescription opioid medications and (4) Through the CTN National Dissemination Library, the Northwest and the Central Rockies Addiction Technology Transfer Centers, and resources within the Alcohol and Drug Abuse Institute provide training to health care and SUD providers about SUDs, collaborative care and chronic disease management models, the integration process, and methods of effective linkage between primary care and specialty SUD CTPs. Such training also provides opportunities for dissemination research.