Oregon Health and Science University, Department of Public Health and Preventive Medicine, 3181 SW Sam Jackson Park Road, CB 669, Portland, OR 97239, USA.
J Psychoactive Drugs. 2011 Sep;Suppl 7:27-39. doi: 10.1080/02791072.2011.601988.
The demand to connect research findings with clinical practice for patients with substance use disorders has accelerated state and federal efforts focused on implementation of evidence-based practices (EBPs). One unique state driven strategy is Oregon's Evidence-Based Practice mandate, which ties state funds to specific treatment practices. Clinicians play an essential role in implementation of shifts in practice patterns and use of EBPs, but little is understood about how legislative efforts impact clinicians' sentiments and decision-making. This study presents longitudinal data from focus groups and interviews completed during the planning phase (n = 66) and early implementation of the mandate (n = 73) to investigate provider attitudes toward this policy change. Results reflect three emergent themes: (1) concern about retaining individualized treatment and clinical latitude, (2) distrust of government involvement in clinical care, and (3) the need for accountability and credibility for the field. We conclude with recommendations for state agencies considering EBP mandates.
对于物质使用障碍患者而言，将研究发现与临床实践联系起来的需求，加速了各州和联邦政府集中精力实施基于证据的实践（EBP）的步伐。一项独特的州驱动策略是俄勒冈州的基于证据的实践授权，该授权将州资金与特定的治疗实践联系起来。临床医生在实施实践模式转变和使用 EBP 方面发挥着至关重要的作用，但对于立法努力如何影响临床医生的情绪和决策，人们知之甚少。本研究通过在计划阶段（n = 66）和授权的早期实施阶段（n = 73）完成的焦点小组和访谈，提供了纵向数据，以调查提供者对这一政策变化的态度。结果反映了三个新出现的主题：（1）对保留个性化治疗和临床自由度的担忧，（2）对政府参与临床护理的不信任，以及（3）对该领域问责制和可信度的需求。我们对考虑实施 EBP 授权的州机构提出了建议。
