To Test A Payer/Treatment Agency Intervention to Increase Use of Buprenorphine

测试付款人/治疗机构干预以增加丁丙诺啡的使用

• 批准号: 8186578
• 负责人: Todd David Molfenter
• 金额: $ 62.18万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8186578
• 关键词: Accidents; Address; Adoption; Advanced Development; Agriculture; Analgesics; Attention; Buprenorphine; Cessation of life; Characteristics; Clinic; Collaborations; Contracts; Controlled Study; Counseling; County; Credentialing; Disease; Effectiveness; Engineering; Environment; Evidence based practice; Foundations; Funding; Grant; Health Personnel; Health Sciences; Healthcare; Heroin; Intervention; Joints; Licensure; Link; Literature; Location; Master' s Degree; Modeling; Nurses; Ohio; Opiate Addiction; Opioid; Oregon; Organizational Change; Organizational Policy; Outcome; Overdose; Patients; Pharmaceutical Preparations; Physicians; Play; Policies; Policy Maker; Primary Health Care; Protocols documentation; Provider; Public Health; Randomized; Recovery; Regulation; Reimbursement Mechanisms; Research; Research Personnel; Role; Rosa; Schools; Site; System; Testing; Training; Universities; Wisconsin; Wood material; Work; addiction; arm; base; college; design; evidence base; experience; implementation research; implementation science; improved; innovation; opioid abuse; payment; programs; prospective; substance abuse treatment; tool; treatment center; treatment organization

DESCRIPTION (provided by applicant): A team of researchers from the University of Wisconsin-Madison College of Engineering and Oregon Health & Science University will test whether clinician training and the use of organizational change strategies are sufficient for disseminating an evidence-based practice (EBP), or if changes to both organizational systems and payer policy result in greater EBP use. Demonstrating the role of payment policy as a driver in the adoption of evidence-based practices could provide a contribution to dissemination and implementation science. This study will employ an intervention that was developed through the Robert Wood Johnson Foundation-funded Advancing Recovery (AR) program. In AR, payer/treatment organization partnerships in 12 states collaborated to remove systemic barriers to the adoption of EBPs such as medication-assisted treatment for substance abuse disorders. The resulting "AR Framework" of payer and organizational change strategies will be tested against its ability to increase the use of the addiction medication buprenorphine as compared to organizational change strategies alone. Buprenorphine is an EBP for treating people addicted to heroin or opioid-based pain medications for non-medical use. Buprenorphine has experienced low adoption rates and is not a standard part of addiction treatment. In Ohio, the location of the study, deaths to due to accidental opioid overdoses have increased by 304% over the past decade and surpassed auto accidents as the leading cause of accidental deaths in 2006. Ohio was selected for the study because of the public health significance of opioid abuse and because each county in Ohio acts as a stand-alone payer, offering 48 unique eligible payer environments. This trial will develop a deeper understanding of the role payers and treatment organizations play in implementing and disseminating EBPs and will focus on the public health issue of rising opioid abuse. PUBLIC HEALTH RELEVANCE: This trial will study the impact of Ohio counties (payers) and addiction treatment organizations working in partnership to remove systemic barriers to adoption of the evidence-based practice (EBP) buprenorphine, a medication for opioid dependence. While various implementation strategies have targeted clinicians and/or treatment provider organizations, we believe this to be among the first controlled studies to systematically study the impact payer and provider strategies have on the implementation and dissemination of an EBP.

描述（由申请人提供）：来自威斯康星大学麦迪逊分校工程学院和俄勒冈健康与科学大学的研究人员团队将测试临床医生培训和组织变革策略的使用是否足以传播循证实践（EBP） ），或者组织系统和付款人政策的变化是否导致 EBP 使用量增加。展示支付政策作为采用循证实践的驱动力的作用可以为传播和实施科学做出贡献。这项研究将采用由罗伯特·伍德·约翰逊基金会资助的推进康复 (AR) 计划开发的干预措施。在 AR 领域，12 个州的付款人/治疗组织合作消除了采用 EBP 的系统性障碍，例如药物滥用障碍的药物辅助治疗。由此产生的付款人和组织变革策略的“AR 框架”将根据其与单独的组织变革策略相比增加成瘾药物丁丙诺啡使用的能力进行测试。丁丙诺啡是一种 EBP，用于治疗非医疗用途的海洛因或阿片类止痛药成瘾者。丁丙诺啡的采用率较低，并且不是成瘾治疗的标准组成部分。在研究所在地俄亥俄州，因意外服用阿片类药物过量而导致的死亡人数在过去十年中增加了 304%，并在 2006 年超过车祸成为意外死亡的主要原因。选择俄亥俄州进行这项研究是因为其公共卫生状况阿片类药物滥用的重要性，并且因为俄亥俄州的每个县都是独立的付款人，提供 48 个独特的合格付款人环境。该试验将更深入地了解付款人和治疗组织在实施和传播 EBP 方面所发挥的作用，并将重点关注阿片类药物滥用日益增加的公共卫生问题。 公共卫生相关性：这项试验将研究俄亥俄州各县（付款人）和成瘾治疗组织合作的影响，以消除采用循证实践（EBP）丁丙诺啡（一种治疗阿片类药物依赖的药物）的系统性障碍。虽然各种实施策略都针对临床医生和/或治疗提供者组织，但我们相信这是第一个系统研究支付者和提供者策略对 EBP 实施和传播影响的对照研究之一。