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

药物使用筛查仪在评估孕妇处方药滥用和其他非法药物使用方面的比较

• 批准号: 9193487
• 负责人: Victoria Hope Coleman-Cowger
• 金额: $ 50.42万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9193487
• 关键词: Admission activity; Adolescent; Adoption; Adult; Advisory Committees; Age; Alcohol or Other Drugs use; Alcohols; American; Amphetamines; Baltimore; Barbiturates; Benzodiazepines; Biochemical; Birth; Birth Order; Birth Weight; Buprenorphine; Centers for Disease Control and Prevention (U.S.); Child; Clinic; Cocaine; Collaborations; Computerized Medical Record; Congresses; Data; Discipline of obstetrics; Drug Exposure; Drug Prescriptions; Drug usage; Ensure; Gestational Age; Goals; Gold; Gynecologist; Hair; Head circumference; Health; Illicit Drugs; Incidence; Lead; Low Birth Weight Infant; Marijuana; Measures; Methadone; Methamphetamine; Minority; Mothers; National Institute of Drug Abuse; Neonatal Abstinence Syndrome; Neurologic; Opiates; Outcome; Oxycodone; Participant; Patients; Perception; Perinatal; Pharmaceutical Preparations; Phencyclidine; Population; Positioning Attribute; Preclinical Drug Evaluation; Pregnancy; Pregnancy Trimesters; Pregnant Women; Prenatal care; Prevalence; Preventive service; Primary Care Physician; Primary Health Care; Propoxyphene; Public Health; Qualitative Methods; Race; Recommendation; Reporting; Research; Research Design; Research Priority; Risk; Role; Schedule; Sensitivity and Specificity; Social Problems; Spontaneous abortion; Subgroup; Surveys; Testing; Third Pregnancy Trimester; Time; Tobacco; Tricyclic Antidepressive Agents; United States; Urine; Visit; Woman; Work; clinical practice; cost; disorder prevention; drug testing; evidence base; high risk; illicit drug use; innovation; insight; instrument; malformation; misuse of prescription only drugs; pregnant; pregnant teen; premature; prescription drug abuse; primary care setting; screening; stillbirth; tool; usability; young adult

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/ASSIST, and the Substance Use Risk Profile-Pregnancy scale - among at least 500 pregnant women stratified by trimester 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 and hair 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 and multi-drug exposure. 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 so that evidence- based guidance may be offered to clinicians, utilizing biochemical 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 drug use and birth outcomes.

项目概要 过去 3 年来，处方药的使用量增加了 60% 以上，并且 目前估计孕妇使用处方药的比例约为 50%。下列妇女所生的孩子 滥用处方药更有可能出生时患有新生儿戒断综合症， 过去5年翻了一番。最近的全国调查数据显示，目前非法药物使用率 怀孕青少年中这一比例为 14.6%，青壮年中为 8.6%，成人中为 3.2%。第一步 筛查是识别妊娠期间处方药滥用和非法药物使用的过程；但没有具体 建议孕妇使用物质使用筛查仪来识别非法或处方药物 药物使用。拟议的研究将比较和验证三种现有的物质使用筛查仪 - 4 P’s Plus、 NIDA 快速筛查/ASSIST，以及药物使用风险状况-怀孕量表 - 至少 500 项 前往巴尔的摩两家初级保健诊所就诊的孕妇按怀孕三个月分层超过 1 年。具体目标是：（1）进行有效性分析以确定敏感性、特异性、可用性以及如何 每个量表都与其他量表以及尿液和毛发药物检测的黄金标准进行比较，以识别 处方药和非法药物的使用； (2) 确定临床人群变量（年龄、种族、妊娠三个月）的影响 怀孕）关于三种物质使用筛查的有效性； (3) 评估出生结果（出生体重、 胎龄、头围和 NICU 入院）与最广泛使用的处方相关 药物和多种药物暴露。该研究的最终目标是确定哪种筛选工具最有效 有效识别孕妇处方药滥用和非法药物使用情况，以便证据- 可以为临床医生提供基于指导，利用生化药物测试作为黄金标准 指定使用情况和电子病历 (EMR) 作为识别处方药的补充。目标 3 是 添加以捕获药物使用和出生结果之间的重要且相关的关联。