Adoption of Buprenorphine in an HMO Setting

在 HMO 环境中采用丁丙诺啡

• 批准号: 6866860
• 负责人: DENNIS MCCARTY
• 金额: $ 56.27万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-15 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6866860
• 关键词: behavioral /social science research tag; buprenorphine; clinical research; drug abuse chemotherapy; health care personnel performance; health care service evaluation; health care service utilization; health services research tag; human subject; interview; longitudinal human study; managed care; patient /disease registry; patient care personnel relations; patient care planning; patient oriented research

DESCRIPTION (provided by applicant): The Food and Drug Administration approved buprenorphine for the treatment of opioid dependence and qualified physicians may treat opioid dependence in their practices. Reports suggest, however, that adoption of the medication has been slow. Studies of the use of buprenorphine in practice settings may help identify barriers to more widespread utilization. This study examines the use of buprenorphine within two large group health plans (Kaiser Permanente Northwest and Northern California). Data on services provided to members with diagnoses of opioid dependence will be extracted from administrative data systems for the period before (2000 - 2002) and after (2003 - 2008) FDA approval of buprenorphine. Utilization patterns are assessed and costs are estimated. Patient and practitioner interviews complement the quantitative analyses, add detail on trends, and suggest influences on the use of buprenorphine as a detoxification and maintenance medication. The investigation has three specific aims: Aim 1: Describe health care and addiction medicine services provided to members with a diagnosis of opioid dependence in two health plans (e.g., use of primary care, hospitalization, emergency care and addiction medicine including buprenorphine, clonidine, methadone, and counseling services). Aim 2: Examine the health plan and patient costs associated with services provided to patients with diagnoses of opioid dependence and assess the impact of buprenorphine on those costs (estimate annual costs, compare patients with and without buprenorphine, and assess patient costs). Aim 3: Identify factors that facilitate and inhibit the adoption and use of buprenorphine through interviews with 530 patients and 96 practitioners and administrators.

描述（由申请人提供）： 食品药品监督管理局批准丁丙诺啡治疗阿片类药物依赖性和合格的医生，可以治疗阿片类药物的依赖性。然而，报告表明，采用药物很慢。在实践环境中使用丁丙诺啡的研究可能有助于确定更广泛利用的障碍。这项研究检查了在两个大型卫生计划（Kaiser Permanente Northwest和North California）中使用丁丙诺啡的。在（2000-2002）和之后（2003-2008）FDA批准丁丙诺啡之前，将从管理数据系统中提取提供给成员提供的服务的服务数据。评估利用模式并估算成本。患者和从业者访谈补充了定量分析，增加了趋势的详细信息，并提出了对使用丁丙诺啡作为排毒和维持药物的影响。调查具有三个具体目标： 目标1：描述为成员提供的医疗保健和成瘾医学服务，并在两项健康计划中诊断为阿片类药物依赖性（例如，使用初级保健，住院，急诊和成瘾医学，包括丁丙诺啡，可乐定，美沙酮和咨询服务）。 AIM 2：检查与为患者提供的服务诊断为阿片类药物依赖的服务相关的健康计划和患者成本，并评估丁丙诺啡对这些费用的影响（估计年费用，比较有或没有丁丙诺啡的患者，并评估患者费用）。 目标3：通过对530名患者以及96名从业人员和管理人员的访谈，确定促进和抑制丁丙诺啡采用和使用的因素。