Improving Access to Treatment for Women with Opioid Use Disorder

改善患有阿片类药物使用障碍的女性获得治疗的机会

• 批准号: 10442184
• 负责人: Stephen W Patrick
• 金额: $ 13.76万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10442184
• 关键词: Address; Age; Appointment; Birth Weight; Buprenorphine; Caring; Characteristics; Clinic; Communities; Data; Data Set; Diagnosis; Discipline of obstetrics; Drug usage; Eligibility Determination; Employment; Ensure; Ethnic Origin; Ethnic group; Evidence based treatment; Family Practice; Female of child bearing age; Fetal Development; First Pregnancy Trimester; Funding; Future; Growth; HIV risk; Health; Health Personnel; Health Services Accessibility; Health Services Research; Healthcare; Improve Access; Individual; Infant; Infant Health; Insurance; Insurance Coverage; Location; Maternal Health; Measures; Medicaid; Medicaid eligibility; Medical; Medicine; Methadone; Methods; Mothers; National Institute of Drug Abuse; Neonatal; Opioid Antagonist; Opioid agonist; Outcome; Outpatients; Patient Self-Report; Patients; Pattern; Personal Satisfaction; Pharmaceutical Preparations; Pharmacotherapy; Policies; Pregnancy; Pregnant Women; Privatization; Provider; Race; Randomized; Reporting; Reproducibility; Source; Surveys; Time; Treatment Cost; Uninsured; United States Dept. of Health and Human Services; Visit; Wait Time; Woman; Women Status; addiction; adverse outcome; base; community setting; criminal behavior; drug mechanism; experience; experimental study; flexibility; health care availability; health equity; health inequalities; illicit drug use; improved; in utero; kappa opioid receptors; mu opioid receptors; opioid agonist therapy; opioid exposure; opioid treatment program; opioid use; opioid use disorder; overdose death; overdose risk; pregnant; prescription opioid; prevent; programs; racial and ethnic; relapse risk; reproductive; treatment strategy; waiver

Opioid use, diagnoses of opioid use disorder among pregnant women, and complications from in utero opioid exposure increased dramatically over the past two decades. Despite evidence that medications for opioid use disorder are highly effective for preventing adverse outcomes from opioid use disorder, most patients needing treatment do not receive it with evidence of differential patterns of access for minoritized racial and ethnic groups compared to non-minoritized groups. Disparities in opioid use disorder treatment and medication access may intersect with race and ethnicity and pregnancy status for women seeking treatment for opioid use disorder. Receiving treatment for opioid use disorder during pregnancy is crucial for maternal and infant health and wellbeing; however, issues of equitable treatment access for racial and ethnically minoritized women remains understudied. Extending the ongoing NIDA-funded project (R01DA045729), which conducted a randomized field experiment of pregnant and non-pregnant “secret shoppers” attempting to obtain appointments at opioid treatment programs or with outpatient buprenorphine providers, this health equity supplement seeks to determine if non-white patients identified barriers to obtaining an appointment for opioid use disorder treatment. In addition, we seek to determine if racial concordance was a determining factor in women’s reported experiences based on secret shoppers’ race/ethnicity matching with community setting of clinic locations. Explanations of underlying mechanisms of these barriers will be explored using qualitative data. Leveraging the unique data from the NIDA-funded field experiment, this study will 1) determine if racial concordance between secret shoppers and the communities that surround clinic locations influenced their ability to a) obtain an appointment for treatment, b) wait time for treatment, c) out of pocket costs for treatment, and d) determine if these outcomes varied by pregnancy status and treatment provider type, and 2) explore secret shoppers’ qualitative descriptions of racial discriminatory encounters and experiences when seeking treatment and medication at opioid treatment program, either with opioid treatment programs or outpatient buprenorphine providers, attending to variability based on race/ethnicity and pregnancy status. Data from this study will inform future studies aimed at mitigating health inequities at the confluence of opioid use disorder, pregnancy, and race.

阿片类药物使用，孕妇阿片类药物使用障碍的诊断，以及子宫内阿片类药物的并发症

项目成果

Association between punitive policies and neonatal abstinence syndrome among Medicaid-insured infants in complex policy environments.

• DOI: 10.1111/add.15602
• 发表时间: 2022-01
• 期刊: Addiction (Abingdon, England)
• 作者: Faherty LJ;Heins S;Kranz AM;Patrick SW;Stein BD
• 通讯作者: Stein BD

Neonatal Opioid Withdrawal Syndrome Is Associated With Infant Foster Care Entry At The County Level.

• DOI: 10.1377/hlthaff.2021.00460
• 发表时间: 2021-11
• 期刊: Health affairs (Project Hope)
• 作者: Loch SF;Stein BD;Ghertner R;McNeer E;Dupont WD;Smart R;Patrick SW
• 通讯作者: Patrick SW

Opioid Litigation and Maternal-Child Health-Investing in the Future.

阿片类药物诉讼和未来母婴健康投资。

• DOI: 10.1001/jamapediatrics.2019.5009
• 发表时间: 2020
• 期刊: JAMA pediatrics
• 影响因子: 26.1
• 作者: Patrick,StephenW;Davis,CoreyS;Stein,BradleyD
• 通讯作者: Stein,BradleyD

Improving the Child Welfare System to Respond to the Needs of Substance-Exposed Infants.

• DOI: 10.1542/hpeds.2019-0106
• 发表时间: 2019-08-01
• 期刊: Hospital pediatrics
• 作者: Patrick, Stephen W;Frank, Richard G;Stein, Bradley D
• 通讯作者: Stein, Bradley D

Medications for opioid use disorder among pregnant women referred by criminal justice agencies before and after Medicaid expansion: A retrospective study of admissions to treatment centers in the United States.

医疗补助扩大前后刑事司法机构转介的孕妇阿片类药物使用障碍药物：对美国治疗中心入院情况的回顾性研究。

• DOI: 10.1371/journal.pmed.1003119
• 发表时间: 2020
• 期刊: PLoS medicine
• 影响因子: 15.8
• 作者: Winkelman,TylerNA;Ford,BeckyR;Shlafer,RebeccaJ;McWilliams,Anna;Admon,LindsayK;Patrick,StephenW
• 通讯作者: Patrick,StephenW