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

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...

Full description

Saved in:

Bibliographic Details
Published in:	PloS one 2022-01, Vol.17 (1), p.e0261751-e0261751
Main Authors:	Forray, Ariadna, Mele, Amanda, Byatt, Nancy, Londono Tobon, Amalia, Gilstad-Hayden, Kathryn, Hunkle, Karen, Hong, Suyeon, Lipkind, Heather, Fiellin, David A, Callaghan, Katherine, Yonkers, Kimberly A
Format:	Article
Language:	eng
Subjects:	Addictions Ambulatory Care Facilities Analgesics, Opioid - metabolism Behavior, Addictive - drug therapy Buprenorphine - therapeutic use Clusters Community health care Community involvement Community participation Drug abuse Education Female Health aspects Health care Health services Humans Medicine Medicine and Health Sciences Mortality Narcotics Neonatal abstinence syndrome Obstetrics Opioid-Related Disorders - drug therapy Opioids Patient Participation Patients People and Places Postpartum Period Pregnancy Pregnant Women Prenatal care Primary care Psychiatry Reproductive health Study Protocol Substance use disorder Videoconferencing Womens health
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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. 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. 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. Clinicaltrials.gov trial registration number: NCT0424039.
ISSN:	1932-6203 1932-6203