Clinical Trials Network: Pacific Northwest Node

项目总结/摘要 《平价医疗法案》在全国范围内带来了医疗保健提供系统的变化， 《精神健康平等和成瘾平等法》以及华盛顿州的一些地方倡议。作为 这些变化的一部分是物质使用障碍（SUD）治疗正在扩大到专业护理之外， 纳入SUD患病率高的初级保健和急症护理医疗环境。这些 一些倡议使得人们更加关注SUD筛查、短期干预和转诊治疗 （SBIRT）在这些设置中。这些综合性举措是基于合作护理和慢性病 管理方法。未来的研究越来越需要开发和测试有效性 在医疗机构实施的SUD干预措施，并与专业SUD治疗计划相关联。这 这一观点也反映了NIDA国家药物滥用治疗临床试验网络的未来方向 (CTN)因为它将其研究重点扩展到社区专业治疗计划（CTPs）之外。在 为了促进CTN的扩展目标和研究重点，太平洋西北地区（PNW） Node提出以下具体目标：（1）通过以下方式提高PNW Node研究团队的能力： 增加具有实践和研究专长的调查员， 初级保健实践为基础的研究网络和协作护理模式，整合行为健康 和SUD治疗组件纳入初级和急性护理环境，并协调和使用电子 跨多个医疗保健系统的病历系统;（2）扩大范围，人口，多样性， 通过在我们目前的CTP中添加一个 许多大型的全州和区域性的基于实践的初级保健临床和研究网络， 参与综合行为健康协作护理的计划;（3）设计和实施务实， 比较有效性、登记研究和其他类型的创新研究，由SUD双向提供信息 研究人员和临床医生以及初级和急性护理提供者，评估SBIRT， 和药物治疗，以及烟草、酒精、非法药物和 滥用处方阿片类药物;和（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让中心，以及酒精 和药物滥用研究所为医疗保健和SUD提供者提供关于SUD，协作护理 与慢性病管理模式、整合过程、方法之间的有效衔接 初级保健和专科SUD CTP。这种培训也为传播研究提供了机会。

PROJECT SUMMARY/ABSTRACT 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.