Optimizing Pregnancy Treatment Interventions for Moms (OPTI-Mom): A Pilot Study.
Optimizing Pregnancy Treatment Interventions for Moms (OPTI-Mom): A Pilot Study.
复制标题
优化妈妈的怀孕治疗干预措施（Opti-Mom）：一项试点研究。
DOI：
10.1097/adm.0000000000000370
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发表时间：
2018
影响因子：
5.5
通讯作者：
Tarter R
中科院分区：
文献类型：
--
作者：
Cochran GT;Hruschak V;Abdullah W;Krans E;Douaihy AB;Bobby S;Fusco R;Tarter R
近年来，孕妇阿片类药物使用障碍（OUD）的公共卫生负担显著增加。优化母亲妊娠治疗干预研究是一个试点项目，旨在检查患者导航（PN）干预模式的可行性，以减少药物使用，改善心理健康和生活质量，并增加OUD孕妇对治疗服务的参与。一组重复措施试点研究进行治疗寻求孕妇阿片类药物依赖开始丁丙诺啡维持治疗。参与者接受了患者导航（PN）干预，分为分娩前10次和产后4次。参与者完成了基线和产前产后干预部分的评估。使用描述性统计评估人口统计数据，并使用一般估计方程分析来检查卫生和服务参与随时间的变化。共有21名妇女入组并完成了PN干预和随访评估。参与者报告了对非法阿片类药物的戒断（B=0.15, 95% CI= 0.1-0.2）、药物使用（OR=5.25, 95% CI= 2.1-13.0）和抑郁（OR=7.70, 95% CI= 2.4-25.1）的改善。结果还显示，总体健康状况有所改善（B=0.17, p=0.06, 95% CI= 0.0-0.3），药物使用治疗出席率有所增加（B=2.15, p=0.07, 95% CI= - 0.2-4.5）。大多数研究参与者获得了充分或更好的产前护理。这些发现支持PN是一种可行的辅助干预措施，在寻求阿片类药物依赖的孕妇开始丁丙诺啡治疗时，显示出改善健康和服务参与的希望。
The public health burden of opioid use disorder (OUD) among pregnant women has significantly increased in recent years. The Optimizing Pregnancy Treatment Interventions for Moms study was a pilot project that examined the feasibility of a patient navigation (PN) intervention model to reduce substance use and improve mental health, quality of life, and to increase engagement with treatment services among pregnant women with OUD. A one-group repeated measures pilot study was conducted with treatment seeking pregnant women with opioid dependence initiating buprenorphine maintenance treatment. Participants received the patient navigation (PN) intervention delivered as 10 sessions prior to delivery and 4 sessions postpartum. Participants completed assessments at baseline and following the prenatal and postnatal portions of the intervention. Demographics were assessed using descriptive statistics, and general estimating equation analyses were employed to examine changes in health and service engagement across time. A total of 21 women were enrolled and completed the PN intervention and follow up assessments. Participants reported improvements in abstinence from illicit opioids (B=0.15, 95% CI=0.1–0.2), drug use (OR=5.25, 95% CI=2.1–13.0), and depression (OR=7.70, 95% CI=2.4–25.1). Results also showed non-significant trends suggesting enhancements in general health (B=0.17, p=0.06, 95% CI= 0.0–0.3) and increases in substance use treatment attendance (B=2.15, p=0.07, 95% CI= −0.2–4.5). Most study participants achieved adequate or better prenatal care. These findings provide support that PN is a feasible adjunctive intervention that shows promise for health improvements and service engagement among treatment seeking pregnant women with opioid dependence initiating buprenorphine.