Doris Titus-Glover1,2, Fadia T Shaya3, Christopher Welsh4, Danya M Qato3, Savyasachi Shah3, Laura E Gresssler3, Rebecca Vivrette4. 1. Department of Pharmaceutical Health Services Research (PHSR), School of Pharmacy, University of Maryland, Baltimore, USA. dtitus-glover@umaryland.edu. 2. Present address: School of Nursing, University of Maryland, Baltimore, Universities at Shady Grove, 9640 Gudelsky Drive, Rockville, MD, 20850, USA. dtitus-glover@umaryland.edu. 3. Department of Pharmaceutical Health Services Research (PHSR), School of Pharmacy, University of Maryland, Baltimore, USA. 4. Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, USA.
Abstract
BACKGROUND: Medications for opioid use disorder (MOUD) are recommended with adjuvant behavioral therapies, counseling, and other services for comprehensive treatment of maternal opioid use disorder. Inadequate access to treatment, lack of prescribing providers and complex delivery models are among known barriers to care. Multi-disciplinary provider input can be leveraged to comprehend factors that facilitate or inhibit treatment. The objective of this study is to explore provider perceptions of MOUD and factors critical to comprehensive treatment delivery to improve the care of pregnant women with opioid use disorder. METHODS: A qualitative research approach was used to gather data from individual provider and group semi-structured interviews. Providers (n = 12) responded to questions in several domains related to perceptions of MOUD, treatment delivery, access to resources, and challenges/barriers. Data were collected, transcribed, coded (by consensus) and emerging themes were analyzed using grounded theory methodology. RESULTS: Emerging themes revealed persistent gaps in treatment and challenges in provider, health systems and patient factors. Providers perceived MOUD to be a "lifeline" to women. CONCLUSIONS: Inconsistencies in treatment provision, access and uptake can be improved by leveraging provider perceptions, direct experiences and recommendations for an integrated team-based, patient-centered approach to guide the care of pregnant women with opioid use disorder.
BACKGROUND: Medications for opioid use disorder (MOUD) are recommended with adjuvant behavioral therapies, counseling, and other services for comprehensive treatment of maternal opioid use disorder. Inadequate access to treatment, lack of prescribing providers and complex delivery models are among known barriers to care. Multi-disciplinary provider input can be leveraged to comprehend factors that facilitate or inhibit treatment. The objective of this study is to explore provider perceptions of MOUD and factors critical to comprehensive treatment delivery to improve the care of pregnant women with opioid use disorder. METHODS: A qualitative research approach was used to gather data from individual provider and group semi-structured interviews. Providers (n = 12) responded to questions in several domains related to perceptions of MOUD, treatment delivery, access to resources, and challenges/barriers. Data were collected, transcribed, coded (by consensus) and emerging themes were analyzed using grounded theory methodology. RESULTS: Emerging themes revealed persistent gaps in treatment and challenges in provider, health systems and patient factors. Providers perceived MOUD to be a "lifeline" to women. CONCLUSIONS: Inconsistencies in treatment provision, access and uptake can be improved by leveraging provider perceptions, direct experiences and recommendations for an integrated team-based, patient-centered approach to guide the care of pregnant women with opioid use disorder.
Entities:
Keywords:
Medications for opioid use disorder, medication-assisted treatment; Opioid use disorder; Pregnancy and healthcare provider; Pregnant women; Qualitative pilot study
Authors: Sarah C Haight; Jean Y Ko; Van T Tong; Michele K Bohm; William M Callaghan Journal: MMWR Morb Mortal Wkly Rep Date: 2018-08-10 Impact factor: 17.586