The National Drug Abuse Treatment Clinical Trials Network

 描述：这是新英格兰联盟节点(NECN)的竞争性续签申请，由耶鲁大学的凯瑟琳·卡罗尔博士和哈佛大学的罗杰·韦斯医学博士领导。NECN在临床试验网络(CTN)中有着出色的生产力记录，领导着4项非常成功的试验，高水平的研究参与，出色的招募 和保留，以及在本供资期间根据CTN试验数据进行同行评议的出版物。NECN调查人员首先撰写了所有3本被引用最多的CTN出版物和所有4本每年被引用最多的CTN出版物。NECN的首要目标是为物质使用障碍开发有效和可持续的干预措施，可在多种医疗环境中提供，解决物质使用的所有多样性。实现 这一目标将包括：1)在单一地点疗效试验的基础上进行多地点疗效试验，对有希望的干预措施进行研究；2)改进干预措施，迄今取得有希望但不大的结果；3)为没有明确确定的护理标准或在早期研究中结果不太理想的流行问题开发创新方法(例如，对初级保健中的药物使用进行筛查和简短干预)。为了实现这些目标，NECN增加了1)覆盖数百万人的地方、地区和国家医院和初级保健网络，以及2)来自7所新英格兰大学的研究人员，他们在成瘾药物和创新技术方面进行了开创性的工作(Fiellin博士、Higgins博士、Marsch博士、O‘Connor博士、Saitz博士、Samet博士)。NECN的研究议程表明，它有能力开发和实施新的方法，以改善药物使用者的治疗，无论他们在哪里联系医疗保健系统。拟议的研究建立在NECN调查人员以前工作的基础上，其中包括：1.初级保健中危险药物使用的筛查和短暂干预(SBI)与重复BIS与基于计算机的认知行为疗法(Saitz，Carroll)；2.产科实践中对怀孕吸烟者的经济激励(Higgins)；3.在急诊科启动丁丙诺啡与阿片依赖患者的易化转诊(Fiellin，D‘OnoFrio)；以及4.使用同行导航器来提高住院期间开始服用丁丙诺啡的阿片依赖患者的治疗保留率(Liebschutz，Stein)。

 DESCRIPTION: This is a competing renewal application for the New England Consortium Node (NECN), led by Kathleen Carroll, Ph.D., of Yale and Roger Weiss, M.D., of Harvard. The NECN has a track record of outstanding productivity in the Clinical Trials Network (CTN), with leadership of 4 highly successful trials, high levels of study participation, excellent recruitment and retention, and 64 peer-reviewed publications from CTN trial data during the current funding period. NECN investigators have first-authored all 3 of the most highly-cited CTN publications and all 4 CTN publications cited most often per year. The overarching goal of the NECN is to develop effective and sustainable interventions for substance use disorders that can be delivered in multiple healthcare settings, addressing substance use in all its diversity. Achieving this goal will entail 1) building on single-site efficacy trials to conduct multi-site effectivenes studies of promising interventions; 2) improving interventions with promising but modest results to date; and 3) developing innovative approaches for prevalent problems with no clearly established standard of care, or with suboptimal results in early studies (e.g., screening and brief intervention for drug use in primary care). To address these goals, the NECN has added 1) local, regional, and national hospital-based and primary care networks that cover millions of individuals, and 2) investigators from 7 New England universities who have conducted seminal work in addiction medicine and innovative technology (Drs. Fiellin, Higgins, Marsch, O'Connor, Saitz, Samet). The NECN research agenda demonstrates its capacity to develop and implement novel approaches to improve treatment for substance users wherever they contact the healthcare system. Proposed studies build on the previous work of NECN investigators and include, among others: 1. Screening and brief intervention (SBI) vs. repeated BIs vs. computer-based cognitive-behavioral therapy for risky drug use in primary care (Saitz, Carroll); 2. Financial incentives for pregnant smokers in obstetrical practice (Higgins); 3. Buprenorphine initiation in the emergency department vs. facilitated referral for opioid dependent patients (Fiellin, D'Onofrio); and 4. Use of peer navigators to enhance treatment retention among opioid dependent patients started on buprenorphine during hospitalization (Liebschutz, Stein).