Comparison of Substance Use Screeners in Assessing Prescription Drug Abuse and Other Illicit Drug Use among Pregnant Women

项目摘要 在过去的30年里，处方药的使用增加了60%以上， 目前估计，孕妇使用处方药的比例约为50%。妇女所生的孩子 滥用处方药更有可能出生时患有新生儿禁欲综合征， 在过去的5年里翻了一番。最近的全国调查数据显示，目前非法药物使用率 在怀孕的青少年中为14.6%，在年轻人中为8.6%，在成年人中为3.2%。的第一步 在怀孕期间同时识别处方药滥用和非法药物使用是一种筛查；然而，没有具体的 已建议孕妇使用物质使用筛查器来识别非法或处方 吸毒。这项拟议的研究将比较和验证现有的三种物质使用筛查方法-4P‘s Plus， NIDA快速筛查，以及至少500名孕妇的物质使用风险概况-妊娠量表- 怀孕三个月的妇女在巴尔的摩的两个初级保健诊所就诊超过一年。 具体目标是：(1)进行有效性分析，以确定敏感度、特异度、可用性以及如何 在识别处方和非法药物方面，比例尺与其他标准和尿液药物检测的黄金标准相比较 药物使用；(2)确定临床人口变量(年龄、种族、怀孕三个月)对有效性的影响 三种物质的使用筛查；以及(3)评估出生结局(出生体重、胎龄、头部 周长和NICU入院人数)与最广泛使用的处方药有关。的最终目标 这项研究旨在确定哪种筛查工具(S)在识别处方药滥用和 在孕妇中非法使用药物，利用尿液药物测试作为黄金标准来指定使用和 电子病历(EMR)作为识别处方药的补充。AIM 3被添加到捕获 最广泛使用的处方药与分娩结局之间的重要和相关关联。

Project Summary Over the last 3 decades, use of prescription drugs has increased by more than 60%, and prevalence of prescription drug use among pregnant women is currently estimated around 50%. Children born to women who abuse prescription medications are more likely to be born with neonatal abstinence syndrome, the incidence of which has doubled in the past 5 years. Recent national survey data show that the rate of current illicit drug use is 14.6% among pregnant adolescents, 8.6% among young adults, and 3.2% among adults. The first step in identifying both prescription drug abuse and illicit drug use during pregnancy is screening; however, no specific substance use screener has been recommended for use with pregnant women to identify illicit or prescription drug use. The proposed study will compare and validate three existing substance use screeners - 4 P's Plus, NIDA Quick Screen, and the Substance Use Risk Profile-Pregnancy scale - among at least 500 pregnant women in all three trimesters of pregnancy presenting to two primary care clinics in Baltimore over 1 year. Specific aims are to: (1) conduct validity analyses to determine sensitivity, specificity, usability, and how each scale compares to the others and to the gold standard of urine drug testing in identifying prescription and illicit drug use; (2) determine the impact of clinic population variables (age, race, trimester of pregnancy) on validity of the three substance use screeners; and (3) assess birth outcomes (birth weight, gestational age, head circumference, and NICU admissions) associated with the most widely used prescription drug. The end goal of the study is to determine which screening tool(s) is most effective in identifying prescription drug abuse and illicit drug use among pregnant women, utilizing urine drug testing as the gold standard to designate use and electronic medical records (EMR) as a supplement to identify prescribed drugs. Aim 3 was added to capture the important and relevant associations between the most widely used prescription drug and birth outcomes.