UCLA Training Program on Addiction Medicine in Primary Care

描述(由申请者提供)：此申请旨在建立一个加州大学洛杉矶分校初级保健上瘾医学主题的研究培训计划。这一理论基础既反映了该计划的意义，也反映了该领域的最新发展。首先，精神活性物质的使用和滥用是一种“慢性病”，在初级保健患者中非常普遍。初级保健医生经常在“医疗院”的范围内管理慢性病，因此，这是通过初级保健中成瘾问题的医疗管理来减少成瘾对个人、财政和社会影响的一个重要机会。其次，在过去十年中，市场上推出了四种治疗阿片类药物、酒精和尼古丁七种依赖的药物。在描述如何以最佳方式将这些新的和标准的成瘾药物纳入初级保健以改善生活质量和减少患者痛苦的证据方面，存在着很大的差距。该培训计划的目标是为医生和行为实习生提供研究、学术培训和指导专业发展，以过渡到初级保健成瘾药物这一新兴研究领域的独立资助临床研究人员。该应用程序汇集了加州大学洛杉矶分校的14名教师临床研究导师，他们的专业知识涵盖了整个生命周期，包括家庭医学、儿科、普通内科和老年病学。该计划包括一名在初级和专科护理环境中对成瘾药物进行广泛临床研究的项目主任，一名在对代表性不足的人群进行研究方面拥有杰出经验的副主任，以及一个由资深教师导师和一名同行代表组成的执行委员会，该委员会提供指导和监督。描述了提供对受训人员进度和指导质量的持续评估的计划，以及纠正措施以解决进展中的缺陷的程序，如果出现这些缺陷的话。介绍了一项招聘受训人员的积极计划，包括一项招募和留住少数群体调查员的计划。 公共卫生相关性：这项针对医生和博士后学者的培训计划将为下一代医疗保健提供者在发现、护理和治疗有药物滥用问题的患者方面做好准备。在这个国家，药物使用、滥用和依赖的高流行率以及巨大的健康和社会成本证明有必要在初级保健环境中解决药物滥用问题。

DESCRIPTION (provided by applicant): This application seeks to establish a research training program on the topic of addiction medicine in primary care at UCLA. The rationale reflects both the significance of the program and recent developments in the field. First, problem use and abuse of psychoactive substances, which is highly prevalent among primary care patients, is one type of "chronic disease." Primary care physicians frequently manage chronic diseases within the context of the "medical home" and as such, represent an important opportunity to reduce personal, fiscal and social impacts of addiction using medical management of addiction problems in primary care. Secondly, four medications have been brought on market for treating opioid, alcohol and nicotine seven dependence over the past decade. There is a significant gap in the evidence describing how these new and standard addiction medications can be optimally integrated into primary care to improve quality of life and to reduce suffering for those afflicted. The goal of this training program is to provide physician and behavioral trainees with the research, academic training and mentored professional development to transition into independently funded clinical researchers in the emerging area of research on the topic of addiction medicine in primary care. The application brings together 14 faculty clinical research mentors at UCLA whose expertise covers the lifespan and includes family medicine, pediatrics, general internal medicine and geriatrics. The program includes a Program Director who has conducted extensive clinical research on addiction medicine in primary and specialty care settings, an Associate Director with outstanding experience in conducting research on under-represented populations and an Executive Committee that provides guidance and oversight that is comprised of senior faculty mentors and a fellow representative. A plan for providing continual evaluation of trainee progress and mentorship quality is described, complete with procedures for corrective action to address deficiencies in progress, should these arise. An energetic plan for the recruitment of trainees is described, including a plan for recruitment and retention of minority investigators. PUBLIC HEALTH RELEVANCE: This training program for physicians and postdoctoral scholars will prepare the next generation of health care providers in detecting, caring for and treating patients with substance abuse problems. The high prevalence and the significant health and social costs of drug use, abuse and dependence in this country justify the need for substance abuse to be addressed in primary care settings.