基于证据的实践在酒精和物质使用障碍中的实施：系统评价方案。
Implementation of evidence-based practice for alcohol and substance use disorders: protocol for systematic review.
机构信息
Faculty of Medicine and Health, Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.
The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
出版信息
Syst Rev. 2020 Feb 7;9(1):25. doi: 10.1186/s13643-020-1285-0.
BACKGROUND
Whilst effective treatments exist for substance use and alcohol use disorders, they are not commonly practised. Studies have shown that only a small percentage of services provide evidence-based treatments such as addiction medications or psychosocial therapies. Although there is a growing body of literature on evidence-based treatment, no synthesis of research on the implementation of evidence-based addiction treatment exists. This proposed systematic review will synthesise and evaluate the effectiveness of implementation programmes in the treatment of patients with drug and alcohol problems using the Consolidated Framework for Implementation Research (CFIR) framework.
METHODS
We will search (from inception onwards) PubMed/MEDLINE, Cochrane Library, PsycINFO, Web of Science and CINAHL. Eligible studies will be clinical trials (e.g. randomised controlled trials, non-randomised controlled trials) and observational studies (e.g. before-and-after studies, interrupted time series) evaluating strategies used to implement evidence-based psychosocial treatments for alcohol and substance use disorders. The primary outcomes will be related to the implementation, service system, or clinical practice (e.g. acceptability, implementation costs, feasibility). Two researchers will independently screen all citations, full-text articles and abstract data. Risk of bias of individual studies will be appraised using appropriate tools. A narrative synthesis will be provided.
DISCUSSION
This project aims to provide evidence to help guide the design of translational research programmes to improve implementation of evidence-based care in drug and alcohol settings. Findings from the study will specify effective strategies for domains of influence including (1) intervention characteristics (e.g. evidence strength and quality, adaptability), (2) outer setting (e.g. patient needs and resources, external policies and incentives), (3) inner setting (e.g. implementation climate, readiness for implementation), (4) individuals involved (e.g. self-efficacy, knowledge and beliefs about the intervention) and (5) the implementation process (e.g. engaging members of the organisation, executing the innovation). Identified gaps in knowledge will guide further study.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42019123812.
背景
虽然有有效的治疗方法可用于治疗物质使用和酒精使用障碍，但这些方法并不常见。研究表明，只有一小部分服务机构提供基于证据的治疗方法，如成瘾药物或心理社会疗法。尽管有越来越多的关于基于证据的治疗方法的文献，但没有关于实施基于证据的成瘾治疗的研究的综合。本拟议的系统评价将使用实施研究综合框架（CFIR）框架，综合和评估治疗药物和酒精问题患者的基于证据的成瘾治疗实施计划的有效性。
方法
我们将从最初开始搜索 PubMed/MEDLINE、Cochrane 图书馆、PsycINFO、Web of Science 和 CINAHL。合格的研究将是评估用于实施酒精和物质使用障碍的基于证据的心理社会治疗的策略的临床试验（例如随机对照试验、非随机对照试验）和观察性研究（例如前后研究、间断时间序列）。主要结果将与实施、服务系统或临床实践相关（例如可接受性、实施成本、可行性）。两名研究人员将独立筛选所有引用、全文文章和摘要数据。将使用适当的工具评估个体研究的偏倚风险。将提供叙述性综合。
讨论
本项目旨在提供证据，以帮助指导设计转化研究计划，以改善药物和酒精环境中基于证据的护理的实施。研究结果将指定有效策略的影响领域，包括（1）干预特征（例如证据强度和质量、适应性），（2）外部环境（例如患者需求和资源、外部政策和激励措施），（3）内部环境（例如实施氛围、实施准备情况），（4）参与的个人（例如自我效能、对干预的知识和信念）和（5）实施过程（例如使组织成员参与、执行创新）。确定知识差距将指导进一步的研究。
系统评价注册
PROSPERO CRD42019123812。
Zotero 插件