Document Detail


Early adoption of injectable naltrexone for alcohol-use disorders: findings in the private-treatment sector.
MedLine Citation:
PMID:  20409441     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The U.S. substance-abuse treatment system has been slow to adopt medications for the treatment of alcohol-use disorders (AUDs). The objectives of this study are to (a) determine how the inherent characteristics of injectable naltrexone (i.e., relative advantage, complexity, trialability, observability, compatibility) shape organizational-level decisions to adopt the medication and (b) identify key predictors of adoption and barriers that impede adoption.
METHOD: This study uses data from a nationally representative sample of 345 privately funded U.S. substance-abuse treatment programs to examine adoption (current use) of injectable naltrexone.
RESULTS: Sixteen percent of private treatment programs are early adopters of injectable naltrexone. Multivariate logistic regression models reveal that organizational size and percentage of patients paying with private insurance are significant predictors of adoption. The most salient predictor of adoption is innovation compatibility, measured by program use of other AUD pharmacotherapies. Barriers to adoption include cost, lack of access to prescribing physicians, and lack of knowledge about the medication. Injectable naltrexone, however, is addressing the patient compliance barrier, demonstrated by 70% of patients receiving at least 2 months of medication.
CONCLUSIONS: The adoption of AUD pharmacotherapies remains low, with only half of the sampled programs prescribing any AUD pharmacotherapies. Patterns of early adoption of injectable naltrexone are, however, promising. Results highlight innovation compatibility and relative advantage as explanations of organizational decisions to adopt injectable naltrexone. Future research will move beyond issues of adoption and provide a more detailed examination of the implementation process.
Authors:
Amanda J Abraham; Paul M Roman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of studies on alcohol and drugs     Volume:  71     ISSN:  1938-4114     ISO Abbreviation:  J Stud Alcohol Drugs     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2010-07-23     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  101295847     Medline TA:  J Stud Alcohol Drugs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  460-6     Citation Subset:  IM    
Affiliation:
Institute for Behavioral Research, 112 Barrow Hall, University of Georgia, Athens, Georgia 30602-2401, USA. aabraham@uga.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Alcohol Deterrents / administration & dosage,  therapeutic use*
Alcohol-Related Disorders / rehabilitation*
Data Collection
Diffusion of Innovation*
Health Knowledge, Attitudes, Practice
Humans
Injections
Logistic Models
Medication Adherence
Multivariate Analysis
Naltrexone / administration & dosage,  therapeutic use*
Physician's Practice Patterns / statistics & numerical data
Private Sector
Substance Abuse Treatment Centers / statistics & numerical data
United States
Grant Support
ID/Acronym/Agency:
F32AA016872/AA/NIAAA NIH HHS; R01DA14482/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Alcohol Deterrents; 16590-41-3/Naltrexone
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Parental R-rated movie restriction and early-onset alcohol use.
Next Document:  Medical therapy for major depressive disorder in Latinos.