Research Findings Lost in Translation

At the “New Frontier in Addiction Treatment” conference (see Reform May Jolt Field Plagued By Frustration), Harold Perl, Ph.D., discussed the challenge of disseminating not just new substance abuse treatments but other types of new medical treatments into clinical practice.

Perl is senior lead for behavioral research, dissemination, and training at the National Institute on Drug Abuse's Center for the Clinical Trials Network.

“Today, billions of dollars are spent on health research in the United States, but we still know little about how to get the results disseminated, because very little research is conducted on the subject,” he stated. “More specifically, 99 percent of the National Institutes of Health research budget is spent on understanding disease and developing new treatments, but only 1.5 percent is spent on finding ways to effectively use those new treatments.”

“Perhaps we are addicted to discovery and chasing that Nobel Prize without regard to the circumstances,” he continued. “Few investigators focus on implementation science because the time spent on it is not valued. So we should reward those individuals who commit to this type of science.”

“But it's not just implementation science that is needed to get new treatments out into the real world,” he stressed. Human efforts are needed as well.

For example, one audience member said that she had tried to get addiction counselors to adapt a new evidence-based treatment, but had not succeeded because the counselors were so overwhelmed with other concerns, such as a lack of space, too few physicians, and inadequate funding levels. “Maybe you could help them with these concerns and thereby build an alliance with them,” Perl suggested. “And after that, maybe they would be open to adopting the new treatment that you are promoting.”

“It is also important to have a team of individuals in an organization implement a new treatment,” Perl noted. “One individual alone cannot do it. Moreover, it is a long-term process.”

“We also know some of the things that don't work in the dissemination of new treatments,” he pointed out, “for example, simply publishing research results or practice guidelines.”