Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs

Schiff, Davida M.; Partridge, Shayla; Gummadi, Nina H.; Gray, Jessica; Stulac, Sara; Costello, Eileen; Wachman, Elisha M.; Jones, Hendrée E.; Greenfield, Shelly F.; Taveras, Elsie M.; Bernstein, Judith

doi:10.1016/j.acap.2021.04.016

Cited by 11 publications

(16 citation statements)

References 29 publications

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“…Qualitative work examining logistical barriers to integrating care has highlighted the importance of interpersonal communication between providers in creating successful care partnerships 33 . Relationship building is a vital strategy to increasing buy-in from nontraditional providers within the integrated care model, which in turn increases patient access to care 34 . In addition, health care discrimination and structural racism, prominent drivers of disparities in health care access and engagement, likely contribute to the low uptake of consultative services and warrant further investigation 35 …”

Section: Discussionmentioning

confidence: 99%

An Integrated Care Model for Pregnant and Postpartum Individuals Receiving Medication for Opioid Use Disorder

et al. 2022

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Objectives: Perinatal opioid use disorder is increasing. Integrated obstetric/addiction care models likely optimize parent-infant dyad outcomes, but the ideal combination of services is unknown. This study (1) describes pregnancy-to-postpartum service utilization by people receiving buprenorphine at an integrated Obstetric/Addiction Clinic and (2) explores the association between service utilization and postpartum buprenorphine continuation. Methods: This retrospective medical record review study uses research registry data from an outpatient Obstetric/Addiction Clinic. All patients are invited to participate in the research registry. For patients who consent, monthly medical record abstractions are conducted beginning with their first clinic visit to collect demographic, obstetric, and substance use disorder treatment variables. Present analyses included patients who delivered an infant between June 2019 and June 2021, started buprenorphine during pregnancy, and were receiving buprenorphine at delivery. Overall service utilization was the number of services (range 0-12) used between 28-weeks gestation and 12-weeks postpartum. Bivariate analyses and multivariable logistic regression assessed associations between service utilization and buprenorphine continuation. Results: Participants (n = 42) were primarily non-Latinx White (67%) with comorbid psychiatric diagnoses (95%). On average, participants used 6 services; prenatal care, mental health care, and postpartum contraception were most utilized. Overall, 69% of participants continued buprenorphine at 6 months postpartum. This did not differ by level of service utilization (bivariate [P = 0.07], multivariable [P = 0.16]). Conclusion: Integrated care with a harm reduction focus supports pregnancy-to-postpartum service utilization and buprenorphine continuation in a patient sample at high risk for medication for opioid use disorder discon-tinuation. Further work is needed to identify evidence-based methods to individualize integrated obstetric/addiction care.

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Section: Discussionmentioning

confidence: 99%

An Integrated Care Model for Pregnant and Postpartum Individuals Receiving Medication for Opioid Use Disorder

et al. 2022

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“…Encouragingly, clinical care has started to integrate care and remove barriers to siloed medical and behavioral health services ( Schiff et al, 2022 ). Prior work has suggested that collaboration and shared decision making between providers in the perinatal period can encourage treatment for both psychiatric conditions and OUD in this critical time period ( Raffi et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Psychiatric comorbidities and their treatment predict buprenorphine continuation among postpartum people with opioid use disorder

Shadowen

Violante

Gataric

et al. 2022

Drug and Alcohol Dependence Reports

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“…Although specific components and staffing models vary, these programs generally provide a combination of medical, behavioral health, and SUD treatment services to the parent, infant, or dyad, including medical care, behavioral health services, substance use treatment, and social supports. [38][39][40][41][42] The physical layout of hospitals may also require redesign to facilitate and support rooming-in, particularly given longer lengths of stay of newborns treated for neonatal opioid withdrawal. Logistics around MOUD provision when the birthing parent is discharged but the newborn remains hospitalized can be complex and warrant thoughtful consideration.…”

Section: Clinical Care Model Innovationmentioning

confidence: 99%

Section: Opportunities For Changementioning

confidence: 99%

Redefining Child Protection

Wakeman¹,

Bryant²,

Harrison³

2022

Obstetrics &Amp; Gynecology

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Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs

Cited by 11 publications

References 29 publications

An Integrated Care Model for Pregnant and Postpartum Individuals Receiving Medication for Opioid Use Disorder

An Integrated Care Model for Pregnant and Postpartum Individuals Receiving Medication for Opioid Use Disorder

Psychiatric comorbidities and their treatment predict buprenorphine continuation among postpartum people with opioid use disorder

Redefining Child Protection

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