Integrating Addiction Research in Health Systems: The Addiction Research Network

 描述：超过2000万美国成年人和青少年患有物质使用障碍(SODS)和与物质使用(SU)相关的问题。然而，大多数肥皂水患者从未接受过肥皂水治疗。从历史上看，对肥胖症的研究一直集中在一小部分正在寻求或已经从事专门的肥胖症治疗的肥皂症患者身上。拟议的临床试验网络成瘾研究网络(ARN)节点的总体目标将是进行尖端研究，以改善所有在医疗环境中看到的SU/SUD患者的结果。ARN包括全美15个使用HMO研究网络(HMORN‘s)虚拟数据仓库的大型医疗系统，提供地理和种族/民族多样性以及医疗和SU/SUD护理系统的多样性。拟议的ARN节点有三个广泛的议程-1)评估在医疗环境中识别、接触和治疗SU或SUDS患者的有效实践；2)开发和测试有效、实用的方法，作为常规医疗的一部分持续实施这些实践；以及3)开发和传播关于SU和SUDS的创新研究方法。三名PI将领导ARN节点，每一位都具有对我们的研究议程至关重要的专业知识。Weisner博士拥有25年以上在公共和私人医疗机构领导SUD研究的经验，他将作为Kaiser Permanente的高级PI领导ARN。她在Kaiser Permanente与坎贝尔博士合作，坎贝尔博士是研究阿片类药物滥用和以患者为中心的比较有效性研究的专家，布拉德利博士是团体健康公司的高级PI，他在医疗环境中针对未寻求治疗的酒精滥用和肥皂水患者拥有20年的研究经验。ARN将有三个核心：1)行政核心将支持ARN节点的所有方面；2)实施核心将支持以患者为中心的设计，以实用、可持续的方法在常规医疗环境中使用电子健康记录(EHR)实施SUD护理；以及3)分析核心，具有编程、使用电子健康记录数据的生物统计和经济学方面的专业知识，将支持创新方法研究和研究设计。ARN的工作将利用HMORN使用EHR和全国虚拟数据仓库在卫生系统中进行务实的临床试验和比较有效性研究的20年。ARN节点将为基于人群的研究提供坚实的基础--包括务实的随机对照试验、比较有效性研究和实施研究--可以评估长期健康结果。此外，通过我们与15个学习型医疗系统的连接，我们的研究将设计方法来提高现实世界医疗环境中SU和SUD的护理质量。通过这种方式--与其他CTN节点一起--ARN节点将帮助建立下一个成瘾卫生服务研究所需的基础设施。

 DESCRIPTION: Over 20 million US adults and youth suffer from substance use disorders (SUDs) and substance use (SU) related problems. However, most people with SUDs never receive SUD treatment. Historically, research on SUDs has focused on the small minority of patients with SUDs who are seeking, or already engaged in, specialty SUD treatment. The overall goal of the proposed Addictions Research Network (ARN) node of the Clinical Trials Network will be to conduct cutting edge research to improve outcomes in all patients with SU/SUD who are seen in medical settings. The ARN includes 15 large health systems across the US that use the HMO Research Network's (HMORN's) Virtual Data Warehouse, providing geographic and racial/ethnic diversity as well as variation in systems of medical and SU/SUD care. The proposed ARN node has 3 broad agendas-1) to evaluate effective practices for identifying, engaging and treating patients with SU or SUDs in medical settings; 2) to develop and test effective, practical ways to implement these practices in a sustained manner as part of routine medical care; and 3) to develop and disseminate innovative research methods on SU and SUDs. Three PIs will lead the ARN node, each with expertise critical to our research agenda. Dr. Weisner, who has more than 25 years of experience leading SUD research in public and private medical settings, will lead the ARN as Senior PI at Kaiser Permanente. She partners at Kaiser Permanente with Dr. Campbell, an expert in research on opioid misuse and patient-centered and comparative effectiveness research, and Dr. Bradley, Senior PI at Group Health, who has 20 years of research experience targeting non-treatment-seeking patients with alcohol misuse and SUDs in medical settings. The ARN will have 3 Cores: 1) an Administrative Core will support all aspects of the ARN node; 2) an Implementation Core will support patient-centered design of practical, sustainable approaches to implementing SUD care in routine medical settings using electronic health records (EHRs), and; 3) an Analytics Core with expertise in programming, biostatistics using EHR data, and economics, will support innovative methods research and study design. ARN work will leverage the HMORN's 20 years of conducting pragmatic clinical trials and comparative effectiveness research across health systems using EHRs and the nationwide Virtual Data Warehouse. The ARN node will provide a robust foundation for population-based studies-including pragmatic randomized controlled trials, comparative effectiveness studies, and implementation research-that can evaluate long-term health outcomes. Moreover, through our connection to 15 learning healthcare systems, our research will design approaches to improve the quality of care for SU and SUDs in real-world medical settings. In this way-with the other CTN nodes-the ARN node will help build the infrastructure required for the next era of addictions health services research.