Western States Node of the National Drug Abuse Treatment Clinical Trials Network

摘要 西部各州节点（WSN）的国家药物滥用治疗临床试验研究议程 网络（CTN）竞争更新测试干预措施，以填补成瘾护理级联，其中 越来越少的吸毒者接受治疗，接受药物治疗，继续接受护理， 并经历持续的恢复。该节点建议继续与 俄勒冈州健康与科学大学（OHSU;托德科瑟伊斯，MPI）和加州大学旧金山弗朗西斯科 (UCSF詹姆斯索伦森，Co-I），并增加了斯坦福大学/帕洛阿尔托弗吉尼亚州（基思汉弗莱斯，MPI）的 协作六个不同的卫生系统参与无线传感器网络：1）OCHIN，2）帕洛阿尔托VA和国家 退伍军人医疗保健管理局，3）OHSU卫生系统，4）斯坦福大学医院和诊所，5） ProtoCall Services，Inc.和6）健康共享和延龄草医疗补助管理的医疗机构。无线传感器网络 测试新的干预措施，扩大阿片类药物使用障碍（MOUD）的药物获得。 无线传感器网络的竞争更新应用程序的首要目标是进行合作研究， CTN填补了成瘾护理级联的空白，从而改善了患有成瘾症的人的生活。 药物使用障碍我们的成瘾护理级联为重点的研究议程，通过对话制定 与不同的调查人员和利益相关者，包括使用毒品的人。两个研究主题 （药物试验和混合实施试验，以缩小成瘾护理级联的差距）提供四个 CTN研究的例子，可以帮助缩小治疗差距。研究主题1（药物试验）， 药物试验1针对的是对目前可用的MOUD不感兴趣的OUD患者， 将他们随机接受长效口服氢吗啡酮与促进转诊美沙酮， 丁丙诺啡，以改善治疗中的参与和保留。药物试验2是一项多中心III期试验 米氮平与安慰剂治疗甲基苯丙胺使用障碍的试验 使用冰毒在研究主题2（混合实施试验）中，两个试验比较了 提高MOUD的参与度和保留率。混合容错性-实施试验1是一个群集- 电话+移动健康行为支持服务的随机试验，以改善对丁丙诺啡的保留， 初级保健.混合型自主性-实施试验2测试远程监护同伴支持干预 与每周同伴监督相比， 治疗我们在这个研究议程中充满了节点的基础设施和脆弱领域的专业知识。 人口、卫生系统、电子健康记录研究、数据科学和临床试验管理。 无线传感器网络提供这些资源的CTN网络使用在未来的CTN协议。最后，WSN继续 将CTN作为培训、传播和研究应用的平台。

Abstract The Western States Node's (WSN) research agenda for the National Drug Abuse Treatment Clinical Trials Network (CTN) competing renewal tests interventions to fill gaps in the Addiction Care Cascade, where progressively fewer people with drug use engage in treatment, receive pharmacotherapy, are retained in care, and experience sustained recovery. The Node proposes to continue the successful partnership between Oregon Health & Science University (OHSU; Todd Korthuis, MPI) and University of California San Francisco (UCSF; James Sorensen, Co-I), and adds Stanford University/Palo Alto VA (Keith Humphreys, MPI) to the collaboration. Six diverse health systems participate in WSN: 1) OCHIN, 2) The Palo Alto VA and national Veterans Healthcare Administration, 3) The OHSU health system, 4) Stanford Hospital and Clinics, 5) ProtoCall Services, Inc., and 6) Health Share and Trillium Medicaid managed care organizations. The WSN tests novel interventions that expand access to medications for opioid use disorder (MOUD). The overarching goal of the WSN's competing renewal application is to conduct collaborative research within the CTN that fills gaps in the Addiction Care Cascade and thereby enhances the lives of people living with drug use disorders. Our Addiction Care Cascade-focused research agenda developed through conversations with diverse investigators and stakeholders including people who use drugs. Two research themes (medication trials and hybrid implementation trials to close gaps in the Addiction Care Cascade) provide four examples of CTN studies that could help close treatment gaps. In Research Theme 1 (medication trials), Medication Trial 1 targets people with OUD who are not interested in currently available MOUD and randomizes them to receive long acting oral hydromorphone versus facilitated referral methadone or buprenorphine to improve engagement and retention in treatment. Medication Trial 2 is a multisite phase 3 trial of mirtazapine versus placebo for people with methamphetamine use disorder to reduce methamphetamine use. In Research Theme 2 (hybrid implementation trials), two trials compare strategies to enhance engagement and retention on MOUD. Hybrid Effectiveness-Implementation Trial 1 is a cluster- randomized trial of telephonic + mHealth behavioral support services to improve retention on buprenorphine in primary care. Hybrid Effectiveness-Implementation Trial 2 tests a telementoring peer support intervention versus weekly peer supervision to improve peer success in engaging and retaining people who use drugs in treatment. We suffuse this research agenda with the Node's infrastructure and expertise in vulnerable populations, health systems, electronic health records research, data science and clinical trials management. WSN offers these resources to the CTN network for use in future CTN protocols. Finally, WSN continues to use the CTN as a platform for training, dissemination, and research applications.