Bringing Alcohol and Other Drug Research to Primary Care

将酒精和其他药物研究引入初级保健

基本信息

批准号：
10380135
负责人：
Alicia Ann Kowalchuk
金额：
$ 65.39万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10380135
关键词：
Academic Detailing Address Adopted Advisory Committees Affect Alcohol consumption Alcohols Area Awareness Behavioral Cessation of life Cities Clinic Clinical Communities Computers Counseling County Education and Outreach Educational Models Educational process of instructing Effectiveness Ensure Family Practice Funding Generations Goals Health Health Professional Hispanic Internal Medicine Intervention Knowledge Leadership Learning Module Literature Measures Methods Modeling Modification Patients Persons Pharmaceutical Preparations Population Preventive Preventive service Primary Care Physician Primary Health Care Professional Practice Professional counselor Psychologist Quality of life Recommendation Research Resources Social Workers Substance Use Disorder Teaching Method Testing Texas Time Training Training Programs Treatment Protocols Underrepresented Minority Work alcohol and other drug alcohol screening and brief intervention base care providers computerized disability education research efficacy evaluation evidence base hands-on learning improved innovation medication-assisted treatment metropolitan opioid therapy opioid use disorder outreach outreach program patient population practice setting prevent process evaluation program dissemination programs screening screening and brief intervention screening, brief intervention, referral, and treatment skills training substance use tool underserved area uptake

项目摘要

Alcohol and other substance use disorders (SUD) such as opioid use disorder (OUD) are serious problems affecting all segments of the US population. The impact of these conditions can be severe, including declines in health and quality of life, disability, and death. Evidence-based tools available to healthcare professionals for addressing these conditions in primary care, including screening and brief interventions (SBI), preventive counseling, and medication-assisted treatments, are underutilized, even as the burden of SUD continues to worsen. Primary care is an essential point of contact for addressing SUD, but significant gaps persist in training programs, implementation and resources. Despite over a decade of nationally funded implementation initiatives, the alcohol SBI/Screening Brief Intervention and Referral to Treatment (aSBI/SBIRT) model has uneven uptake across primary care practices. The aSBI model, for example, has earned a Grade B recommendation by the US Preventive Services Task Force (USPSTF). Yet, while the SBI components of SBIRT have shown efficacy for addressing risky alcohol use in primary care, the RT (referral and treatment) components have not, nor has SBI made a clear impact on other substances beyond alcohol. With a cadre of medications for treating AUD and OUD available for prescription by primary care clinicians, and more recent literature supporting the efficacy of medication therapy (MAT) for OUD uncoupled from counseling therapies, it is time to move past treatment referral in primary care to directly providing MAT for AUD and OUD. This program will use evidence based outreach and educational methods including short courses, asynchronous, computerized, interactive modules, and in-person professional academic detailing to deliver up to date knowledge and skills training to large and diverse groups of primary care professionals in the Greater Houston Metropolitan Area (GHMA) and the Rio Grande Valley (RGV), Texas. It will be the first work of its kind to evaluate the efficacy of academic detailing with specific regard to SUD treatment training and practice uptake, measuring changes in awareness, knowledge, understanding, clinician confidence, and intent to adopt and implement substance use screening and interventions, such as MAT for SUD, into daily practice. Process evaluation of engagement and outreach strategies will guide program modification and expansion. The program will 1. Develop and implement engaging AUD and OUD educational outreach strategies, including academic detailing and innovative, interactive, computer-based asynchronous tools, for 300 practicing primary care providers in the GHMR and the RGV, Texas and 2. Evaluate the extent to which intensive academic detailing improves the effectiveness of a comprehensive, interactive, asynchronous outreach program on awareness, knowledge, understanding, and intent to incorporate AUD/OUD screening and treatment protocols into practice.

酒精和其他物质使用障碍 (SUD)，例如阿片类药物使用障碍 (OUD) 是严重问题影响美国各阶层人口。这些情况的影响可能很严重，包括下降健康和生活质量、残疾和死亡。医疗保健专业人员可用的循证工具解决初级保健中的这些问题，包括筛查和简短干预（SBI）、预防性尽管 SUD 的负担继续加重，但咨询和药物辅助治疗并未得到充分利用恶化。初级保健是解决 SUD 问题的重要联系点，但在这方面仍然存在重大差距培训计划、实施和资源。尽管国家资助实施了十多年倡议中，酒精 SBI/筛查简短干预和转诊治疗 (aSBI/SBIRT) 模式已初级保健实践的接受程度不均匀。例如，aSBI 模型获得了 B 级美国预防服务工作组 (USPSTF) 的推荐。然而，虽然 SBI 组件 SBIRT 已显示出在初级保健、RT（转诊和治疗）中解决危险饮酒问题的功效成分没有，SBI 也没有对酒精以外的其他物质产生明确的影响。拥有一支干部队伍初级保健临床医生可以开处方治疗 AUD 和 OUD 的药物，以及最近的药物支持与咨询疗法无关的 OUD 药物治疗 (MAT) 疗效的文献，是时候从初级保健转诊转为直接为 AUD 和 OUD 提供 MAT 了。该计划将使用基于证据的推广和教育方法，包括短期课程、异步、计算机化、交互式模块和现场专业学术细节来交付迄今为止，为大湾区大量不同的初级保健专业人员提供了知识和技能培训休斯顿都会区 (GHMA) 和德克萨斯州格兰德河谷 (RGV)。这将是其首部作品用于评估学术细节的有效性，具体涉及 SUD 治疗培训和实践吸收，衡量意识、知识、理解、临床医生信心和采用意愿的变化并在日常实践中实施物质使用筛查和干预措施，例如针对 SUD 的 MAT。过程对参与和外展战略的评估将指导方案的修改和扩展。这计划将 1. 制定并实施吸引 AUD 和 OUD 的教育推广战略，包括为 300 名小学实践者提供学术细节和创新、交互式、基于计算机的异步工具德克萨斯州 GHMR 和 RGV 的护理提供者，以及 2. 评估强化学术学习的程度详细说明提高了全面的、交互式的、异步的外展计划的有效性纳入 AUD/OUD 筛查和治疗方案的意识、知识、理解和意图付诸实践。