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The Clinical Challenges and Costs of Caring for Infants with Neonatal Opioid Withdrawal Syndrome (NOWS) in the Post-Nursery Period

护理产后新生儿阿片类药物戒断综合征 (NOWS) 婴儿的临床挑战和费用

基本信息

批准号：
10664610
负责人：
Julie Rozelle Gaither
金额：
$ 16.77万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10664610
关键词：
Accidental Injury Address Adolescent Adult Affect Area Attention Autonomic nervous system Award Birth Caring Central Nervous System Child Child Abuse Clinical Community Healthcare Development Diagnosis Disease Eating Epidemiologist Evidence based intervention Family Female of child bearing age Goals Health Care Costs Health Personnel Healthcare Helping to End Addiction Long-term Home Home visitation Hospital Costs Hospitalization Hospitals Infant Infant Care Injury Intervention Interview Knowledge Length of Stay Life Maternal complication Medical Mentorship Mission Modeling Monitor Mothers National Institute of Child Health and Human Development Neonatal Abstinence Syndrome Newborn Infant Opioid Overdose Parents Pediatric Hospitals Pediatric Nursing Personal Satisfaction Postpartum Period Protocols documentation Qualitative Research Recovery Research Research Methodology Resources Risk Safety Site Sleep Social Workers Stress Structure Substance Use Disorder Time Training United States National Institutes of Health Work active method care costs career career development clinical care cost cost effective design economic evaluation evidence base experience gastrointestinal health data high risk high risk infant hospital readmission illicit opioid implementation science improved outcome infancy infant outcome intersectionality large datasets maltreatment maternal opioid use maternal stress medical schools neglect opioid epidemic opioid use disorder postnatal prescription opioid prevent relapse risk secondary analysis skills substance use

项目摘要

PROJECT SUMMARY The increased use of both prescription and illicit opioids among women of child-bearing age over the past two decades has resulted in a five-fold increase in neonatal opioid withdrawal syndrome (NOWS). The requisite monitoring and management of infants with NOWS prolong postnatal hospitalization, resulting nationally in hospital costs that currently exceed $560 million annually. Multiple approaches have been investigated to reduce the substantial care and cost burden of treating infants with NOWS postnatally, including through dyadic approaches such as the Eat, Sleep, Console protocol. Far less attention has been paid to understanding the clinical needs and subsequent trajectory of care for infants with NOWS during the remainder of their infancy— including their risk of hospital readmission and the associated costs. A clearer understanding of these issues is integral to developing protocols to assist mothers with opioid use disorder (OUD) in caring for their infants during a time when the health care needs of both the mother and the child are great. Mothers with OUD are at high risk of relapse and of overdose during the first postpartum year. In turn, the risk of abuse or neglect is highest for all children in the first year of life. Thus, the objective of this career development proposal is to understand the challenges of caring for infants with NOWS in the year following discharge from the birth hospitalization. The first study aims to quantify the risks and costs of hospital readmissions during the first year of life for infants with NOWS. The second study will focus on the challenges of keeping infants with NOWS healthy and safe in the year following discharge from the birth hospitalization, a vulnerable time for both mother and child. Long-term, my goal is to use these findings to inform the development of an evidence-based model of care within the home-visiting framework that addresses the unique needs of families affected by NOWS following discharge from the birth hospitalization. In applying for this award, I am seeking to develop the skills I need to successfully transition into the field of NOWS research. As an epidemiologist with a background in pediatric nursing, I have spent the past 12 years investigating the impact of the opioid crisis on adults (and to a lesser extent, children and adolescents) through secondary analyses of large datasets. I need further training related to 1) the clinical care of infants with NOWS and skillfully working with mothers with OUD, 2) economic evaluations, 3) qualitative research methods, and 4) implementation science. I have assembled a mentorship team led by experts in parental substance use and child abuse that addresses each area of training and leverages the resources available at Yale. The training and research outlined in this proposal promise to have a high impact on my career, as they will provide me with the skills and knowledge that I need to meet my long- term career goal of developing expertise in designing substance use interventions that are evidence-based, cost- effective, and informed by the lived experience of families.

项目总结