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首页> 外文期刊>Journal of substance abuse treatment >Barriers to and facilitators of pharmacotherapy for alcohol use disorder in VA residential treatment programs
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Barriers to and facilitators of pharmacotherapy for alcohol use disorder in VA residential treatment programs

机译：VA居民治疗方案中酒精使用障碍药物治疗的障碍和促进者

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Abstract Among US military veterans, alcohol use disorder (AUD) is prevalent and in severe cases patients need intensive AUD treatment beyond outpatient care. The Department of Veterans Affairs (VA) delivers intensive, highly structured addiction and psychosocial treatment through residential programs. Despite the evidence supporting pharmacotherapy among the effective treatments for AUD, receipt of these medications (e.g., naltrexone, acamprosate) among patients in residential treatment programs varies widely. In order to better understand this variation, the current study examined barriers and facilitators to use of pharmacotherapy for AUD among patients in VA residential treatment programs. Semi-structured qualitative interviews with residential program management and staff were conducted and the Consolidated Framework for Implementation Research was used to guide coding and analysis of interview transcripts. Barriers to use of pharmacotherapy for AUD included cultural norms or philosophy against prescribing, lack of access to willing prescribers, lack of interest from leadership, and perceived lack of patient interest or need. Facilitators included cultural norms of openness or active promotion of pharmacotherapy; education for patients, program staff and prescribers; having prescribers on staff, and care coordination within residential treatment and with other clinic settings in and outside VA. Developing and testing improvement strategies to increase care coordination and consistent support from leadership may also yield increases in the use of pharmacotherapy for AUD among residential patients. Highlights ? Assessed drivers of alcohol use disorder pharmacotherapy in residential treatment. ? Education for providers and patients on addiction treatment were facilitators. ? Care coordination and leadership support also facilitated treatment use.
机译：摘要在美国军事退伍军人中，酒精使用障碍（AUD）是普遍的，并且在严重的情况下，患者需要超越门诊护理的密集副宿性。退伍军人事务部（VA）通过住宿计划提供密集，高度结构的成瘾和心理社会治疗。尽管有证据表明药物治疗的有效治疗，但在住宅治疗方案中的患者中收到这些药物（例如，NALTrexone，Acamprosate）差异很大。为了更好地了解这种变化，目前的研究将障碍和促进者审查使用药物治疗在VA住宅治疗方案中的患者中的患者。对住宅计划管理和工作人员进行半结构性的定性访谈，并综合实施研究框架用于指导对面试成绩单的编码和分析。使用药物治疗的障碍包括澳元的文化规范或防止处方的哲学，缺乏对愿意的公务员缺乏兴趣，以及缺乏患者的兴趣或需求。促进者包括药物治疗的开放性或积极促进的文化规范;患者教育，计划人员和处方;在员工上进行规定，并在住宅治疗中提供协调，并在VA外和外部诊所设置。制定和测试改善战略以提高护理协调和始终如一的领导地位的支持也可能会增加使用药物治疗患者的药物治疗。强调 ？评估饮酒障碍药物治疗的司机治疗。还对成瘾治疗的提供者和患者的教育是促进者。还护理协调和领导支持还促进了治疗用途。

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