Center for Behavioral Health Services and Implementation Research, Division of Public Mental Health and Population Sciences, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
Center for Behavioral Health Services and Implementation Research, Division of Public Mental Health and Population Sciences, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA; Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Drug Alcohol Depend. 2021 Aug 1;225:108767. doi: 10.1016/j.drugalcdep.2021.108767. Epub 2021 May 21.
The biomedical research enterprise invests greatly in discovery-oriented science, but significantly less in how to implement the most effective of these innovations. The return on investment in public health benefit is therefore low. In the context of substance-related overdose epidemics, presently with opioids and/or stimulants, the gap in proven treatments and routine access is amplified. Implementation research is designed to deepen understanding of how best to scale-up proven treatments. This study assessed how implementation research has been deployed in the National Institute on Drug Abuse (NIDA) efforts to address the opioid and stimulant epidemics.
Adapting a procedure developed to categorize HIV-focused research, a four-stage systematic mapping review of NIDA-funded R01, R34, R61, and U studies pertaining to opioids and/or stimulants funded between 2015 and 2019 was performed. Abstracts were retrieved using NIH Research Portfolio Online Reporting Tools. Key study characteristics were abstracted and coded by two independent reviewers.
An initial search across NIH institutes yielded 5963 relevant records. Of these, 666 (11.2 %) were NIDA funded. One-hundred-and-thirty-four (20.1 %) of the 666 studies were opioid and/or stimulant treatment related. Of these, 28 (4.2 %) were categorized as Implementation Preparation (IP), and 16 (2.4 %) were categorized as Implementation Research (IR). Over the five-year period, there was a gradual increase in both IP and IR studies.
Implementation research is a small but slowly growing component of the federal portfolio to address substance-related public health issues. To more effectively respond to contemporary overdose epidemics, implementation research must take on an even more significant role.
生物医学研究企业在以发现为导向的科学方面投入巨大，但在如何实施这些创新方面的投入却明显较少。因此，公共卫生投资的回报很低。在与物质相关的药物过量流行的背景下，目前涉及阿片类药物和/或兴奋剂，已证实的治疗方法和常规途径之间的差距被放大了。实施研究旨在深入了解如何最好地扩大已证实的治疗方法。本研究评估了实施研究在国家药物滥用研究所（NIDA）应对阿片类药物和兴奋剂流行的努力中是如何部署的。
采用一种针对艾滋病毒研究进行分类的程序，对 NIDA 资助的 R01、R34、R61 和 U 研究进行了为期四个阶段的系统映射审查，这些研究涉及 2015 年至 2019 年期间资助的阿片类药物和/或兴奋剂。使用 NIH 研究组合在线报告工具检索摘要。两名独立审查员摘录并编码了关键研究特征。
在 NIH 各机构的初步搜索中，共获得了 5963 条相关记录。其中，有 666 项（11.2%）是 NIDA 资助的。在 666 项研究中，有 134 项（20.1%）与阿片类药物和/或兴奋剂治疗有关。其中，有 28 项（4.2%）被归类为实施准备（IP），有 16 项（2.4%）被归类为实施研究（IR）。在五年期间，IP 和 IR 研究都在逐渐增加。
实施研究是联邦投资组合中解决与物质有关的公共卫生问题的一个小但增长缓慢的组成部分。为了更有效地应对当代药物过量流行，实施研究必须发挥更重要的作用。
