TY - JOUR
KW - Ambulatory Care Facilities
KW - Analgesics, Opioid/metabolism
KW - Behavior, Addictive/drug therapy
KW - Buprenorphine/therapeutic use
KW - Female
KW - Humans
KW - Opioid-Related Disorders/drug therapy
KW - Patient Participation
KW - Postpartum Period
KW - Pregnancy
KW - pregnant women
AU - A. Forray
AU - A. Mele
AU - N. Byatt
AU - Londono Tobon
AU - K. Gilstad-Hayden
AU - K. Hunkle
AU - S. Hong
AU - H. Lipkind
AU - D. A. Fiellin
AU - K. Callaghan
AU - K. A. Yonkers
A1 - 
AB - INTRODUCTION: The prevalence of opioid use disorder (OUD) in pregnancy increased nearly five-fold over the past decade. Despite this, obstetric providers are less likely to treat pregnant women with medication for OUD than non-obstetric providers (75% vs 91%). A major reason is many obstetricians feel unprepared to prescribe medication for opioid use disorder (MOUD). Education and support may increase prescribing and overall comfort in delivering care for pregnant women with OUD, but optimal models of education and support are yet to be determined. METHODS AND ANALYSIS: We describe the rationale and conduct of a matched-pair cluster randomized clinical trial to compare the effectiveness of two models of support for reproductive health clinicians to provide care for pregnant and postpartum women with OUD. The primary outcomes of this trial are patient treatment engagement and retention in OUD treatment. This study compares two support models: 1) a collaborative care approach, based upon the Massachusetts Office-Based-Opioid Treatment Model, that provides practice-level training and support to providers and patients through the use of care managers, versus 2) a telesupport approach based on the Project Extension for Community Healthcare Outcomes, a remote education model that provides mentorship, guided practice, and participation in a learning community, via video conferencing. DISCUSSION: This clustered randomized clinical trial aims to test the effectiveness of two approaches to support practitioners who care for pregnant women with an OUD. The results of this trial will help determine the best model to improve the capacity of obstetrical providers to deliver treatment for OUD in prenatal clinics. TRIAL REGISTRATION: Clinicaltrials.gov trial registration number: NCT0424039.
AD - Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Psychiatry, University of Massachusetts School of Medicine, Worcester, Massachusetts, United States of America.; Department of Ob/Gyn, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.; Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.; Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, United States of America.; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.; Yale School of Public Health, New Haven, Connecticut, United States of America.; Department of Ob/Gyn, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.; Department of Psychiatry, University of Massachusetts School of Medicine, Worcester, Massachusetts, United States of America.
BT - PloS one
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 1
DO - 10.1371/journal.pone.0261751
IS - 1
JF - PloS one
LA - eng
M1 - Journal Article
N2 - INTRODUCTION: The prevalence of opioid use disorder (OUD) in pregnancy increased nearly five-fold over the past decade. Despite this, obstetric providers are less likely to treat pregnant women with medication for OUD than non-obstetric providers (75% vs 91%). A major reason is many obstetricians feel unprepared to prescribe medication for opioid use disorder (MOUD). Education and support may increase prescribing and overall comfort in delivering care for pregnant women with OUD, but optimal models of education and support are yet to be determined. METHODS AND ANALYSIS: We describe the rationale and conduct of a matched-pair cluster randomized clinical trial to compare the effectiveness of two models of support for reproductive health clinicians to provide care for pregnant and postpartum women with OUD. The primary outcomes of this trial are patient treatment engagement and retention in OUD treatment. This study compares two support models: 1) a collaborative care approach, based upon the Massachusetts Office-Based-Opioid Treatment Model, that provides practice-level training and support to providers and patients through the use of care managers, versus 2) a telesupport approach based on the Project Extension for Community Healthcare Outcomes, a remote education model that provides mentorship, guided practice, and participation in a learning community, via video conferencing. DISCUSSION: This clustered randomized clinical trial aims to test the effectiveness of two approaches to support practitioners who care for pregnant women with an OUD. The results of this trial will help determine the best model to improve the capacity of obstetrical providers to deliver treatment for OUD in prenatal clinics. TRIAL REGISTRATION: Clinicaltrials.gov trial registration number: NCT0424039.
PY - 2022
SN - 1932-6203; 1932-6203
T1 - Support Models for Addiction Related Treatment (SMART) for pregnant women: Study protocol of a cluster randomized trial of two treatment models for opioid use disorder in prenatal clinics
T2 - PloS one
TI - Support Models for Addiction Related Treatment (SMART) for pregnant women: Study protocol of a cluster randomized trial of two treatment models for opioid use disorder in prenatal clinics
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 35025898
U3 - 10.1371/journal.pone.0261751
VL - 17
VO - 1932-6203; 1932-6203
Y1 - 2022
Y2 - Jan 13
ER -