| A longitudinal examination of alcohol pharmacotherapy adoption in substance use disorder treatment programs: patterns of sustainability and discontinuation. | |
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MedLine Citation:
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PMID: 21683049 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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ABSTRACT. Objective: The objectives of this study were to (a) identify the patterns of disulfiram (Antabuse) and tablet naltrexone (Revia) adoption over a 48-month period in a nationally representative sample of privately funded programs that deliver substance use disorder treatment; (b) examine predictors of sustainability, later adoption, discontinuation, and nonadoption of disulfiram and tablet naltrexone; and (c) measure reasons for medication discontinuation. Method: Two waves of data were collected via face-to-face structured interviews with 223 program administrators. Results: These data demonstrated that adoption of medications for alcohol use disorders (AUDs) was a dynamic process. Although nonadoption was the most common pattern, approximately 20% of programs sustained use of the AUD medications and 30% experienced organizational change in adoption over the study period. Bivariate multinomial logistic regression models revealed that organizational characteristics were associated with sustainability including location in a hospital setting, program size, accreditation, revenues from private insurance, referrals from the criminal justice system, number of medical staff, and use of selective serotonin reuptake inhibitors at baseline. Two patterns of discontinuation were found: Programs either discontinued use of all substance use disorder medications or replaced disulfiram/tablet naltrexone with a newer AUD medication. Conclusions: These findings suggest that adoption of AUD medications may be positively affected by pressure from accreditation bodies, partnering with primary care physicians, medication-specific training for medical staff, greater availability of resources to cover the costs associated with prescribing AUD medications, and amending criminal justice contracts to include support for AUD medication use. (J. Stud. Alcohol Drugs, 72, 669-677, 2011). |
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Authors:
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Amanda J Abraham; Hannah K Knudsen; Paul M Roman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of studies on alcohol and drugs Volume: 72 ISSN: 1938-4114 ISO Abbreviation: J Stud Alcohol Drugs Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101295847 Medline TA: J Stud Alcohol Drugs Country: United States |
Other Details:
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Languages: eng Pagination: 669-77 Citation Subset: IM |
Affiliation:
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Institute for Behavioral Research, 112 Barrow Hall, University of Georgia, Athens, Georgia 30602-2401. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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