Friedmann Peter D, Jiang Lan, Alexander Jeffrey A
Center on Systems, Outcomes & Quality in Chronic Disease & Rehabilitation (SOQCR), Research Service, Providence Veterans Affairs Medical Center and Alpert Medical School of Brown University, Providence, RI, USA.
J Behav Health Serv Res. 2010 Jul;37(3):322-37. doi: 10.1007/s11414-009-9169-z. Epub 2009 Mar 19.
To examine the influence of top managers' characteristics on the adoption of buprenorphine for opioid dependence among U.S. outpatient substance abuse treatment units, this investigation analyzed a cross-sectional national study of 547 such units in the 2004-2005 wave of the Drug Abuse Treatment System Survey. Administrators reported their demographics, training, and treatment orientation, as well as features of the unit and its pattern of use of buprenorphine. Nationally, 15.8% of programs offered any buprenorphine services. Greater adoption of buprenorphine correlated with directors' younger age, longer tenure, male gender, and weaker endorsement of abstinence as the most important treatment goal. Availability of naltrexone and medical services also correlated positively with buprenorphine adoption. The authors conclude that leaders' characteristics are related to the adoption of innovative practices in addiction treatment programs. Future work should examine whether leadership development for community addiction programs might speed up the diffusion of buprenorphine and other innovative, evidence-based practices.
为研究高层管理人员的特征对美国门诊药物滥用治疗机构采用丁丙诺啡治疗阿片类药物依赖的影响，本调查分析了2004 - 2005年药物滥用治疗系统调查中对547个此类机构的全国性横断面研究。管理人员报告了他们的人口统计学信息、培训情况、治疗方向，以及机构的特征及其丁丙诺啡的使用模式。在全国范围内，15.8%的项目提供了任何丁丙诺啡服务。丁丙诺啡的更多采用与主任的年龄较轻、任期较长、男性性别以及对禁欲作为最重要治疗目标的支持较弱相关。纳曲酮和医疗服务的可获得性也与丁丙诺啡的采用呈正相关。作者得出结论，领导者的特征与成瘾治疗项目中创新实践的采用有关。未来的工作应研究社区成瘾项目的领导力发展是否可能加速丁丙诺啡和其他基于证据的创新实践的传播。
