Dissemination, adoption, and implementation of acamprosate for treating alcohol use disorders.
OBJECTIVE
Acamprosate has been available in the United States for treating alcohol use disorders (AUDs) for nearly a decade, yet few studies have examined its use within AUD treatment organizations. In addition to describing dissemination and adoption of acamprosate, this study provides novel data regarding organizational processes that underlie its implementation within adopting programs.


METHODS
Data were drawn from interviews with leaders of a nationally representative sample of 307 organizations delivering AUD treatment. Quantitative indicators of organizational characteristics, dissemination, adoption, and implementation of acamprosate, as well as qualitative measures of implementation processes, were measured during face-to-face interviews.


RESULTS
Only 18.0% (n = 55) of sampled organizations had adopted acamprosate for treating AUDs, and adoption was positively associated with accreditation, having a physician on staff, receiving information about acamprosate via pharmaceutical representatives, and learning about this medication from other treatment providers. Within adopting programs, an average of 6.0% of AUD patients were currently receiving acamprosate. Numerous implementation challenges were identified, including appropriate patient selection, patient reluctance to be prescribed acamprosate, suboptimal adherence, its costs, and limited counselor training.


CONCLUSIONS
The limited adoption and implementation of acamprosate likely limits the potential public health impact of this adjunct to AUD treatment. Research integrating the perspectives of organizational leaders, medical professionals, and patients is needed to determine whether specific strategies can address the implementation challenges identified in the current study and increase use of acamprosate in specialty AUD treatment settings.
Department of Behavioral Science, University of Kentucky, Lexington, Kentucky.
Hannah K
HK
Knudsen
Owens Institute for Behavioral Research and Department of Sociology, University of Georgia, Athens, Georgia.
Paul M
PM
Roman
D000077443:Acamprosate; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006284:Health Plan Implementation / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D033181:Information Dissemination; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014482:United States Substance Abuse and Mental Health Services Administration / Q000639:trends*
D000427:Alcohol Deterrents; D013654:Taurine; D000077443:Acamprosate