Literature Collection

Opioid use during pregnancy poses serious risks for the mother and the unborn child. Opioid-use disorder may be managed with medication-assisted treatment (MAT) in an outpatient setting, but few MAT practices specifically address the challenges faced by pregnant women. This article describes a medical office-based educational support group for women in MAT for opioid-use disorder who were pregnant and/or parenting young children. Focus groups were conducted to elicit patient feedback. Women indicated that they found the educational support groups beneficial and offered suggestions. In-office educational support groups for pregnant women in treatment for opioid-use disorder are feasible and well received.

OBJECTIVE: Recent federal investments have accelerated a nationwide transformation of the behavioral health crisis care (BHCC) system, raising pertinent questions about quality and effectiveness. In response to calls to collect more data and define outcomes for assessing BHCC, this study sought to identify patient-centered outcomes (PCOs) from the perspectives of individuals with lived experience of a behavioral disorder and individuals who have delivered BHCC services. METHODS: Via a multiphased recruitment approach, qualitative interviews were conducted with 120 stakeholders: peers with lived experience (N=21), direct-service providers (N=47), program directors and managers (N=44), and executive leaders (N=8). All interview transcripts were analyzed by using an open coding approach to generate emerging themes that captured measurable components of BHCC and outcomes of interest meaningful to stakeholders. RESULTS: A PCO framework for evaluating BHCC was developed by mapping emerging themes to a conceptual framework adapted from Donabedian's structure-process-outcome model. Forty-five themes were identified and grouped under five domains: system structure, system implementation, system use, social outcomes, and health outcomes. CONCLUSIONS: Although further efforts are needed to engage patients and providers in the process of developing specific measures, this framework provides a starting point for PCO research on BHCC.