Titus-Glover Doris, Shaya Fadia T, Welsh Christopher, Qato Danya M, Shah Savyasachi, Gresssler Laura E, Vivrette Rebecca
Department of Pharmaceutical Health Services Research (PHSR), School of Pharmacy, University of Maryland, Baltimore, USA.
Present address: School of Nursing, University of Maryland, Baltimore, Universities at Shady Grove, 9640 Gudelsky Drive, Rockville, MD, 20850, USA.
BMC Health Serv Res. 2021 Mar 10;21(1):215. doi: 10.1186/s12913-021-06182-0.
Medications for opioid use disorder (MOUD) are recommended with adjuvant behavioral therapies, counseling, and other services for comprehensive treatment of maternal opioid use disorder. Inadequate access to treatment, lack of prescribing providers and complex delivery models are among known barriers to care. Multi-disciplinary provider input can be leveraged to comprehend factors that facilitate or inhibit treatment. The objective of this study is to explore provider perceptions of MOUD and factors critical to comprehensive treatment delivery to improve the care of pregnant women with opioid use disorder.
A qualitative research approach was used to gather data from individual provider and group semi-structured interviews. Providers (n = 12) responded to questions in several domains related to perceptions of MOUD, treatment delivery, access to resources, and challenges/barriers. Data were collected, transcribed, coded (by consensus) and emerging themes were analyzed using grounded theory methodology.
Emerging themes revealed persistent gaps in treatment and challenges in provider, health systems and patient factors. Providers perceived MOUD to be a "lifeline" to women.
Inconsistencies in treatment provision, access and uptake can be improved by leveraging provider perceptions, direct experiences and recommendations for an integrated team-based, patient-centered approach to guide the care of pregnant women with opioid use disorder.
阿片类物质使用障碍药物（MOUD）与辅助行为疗法、咨询及其他服务一同被推荐用于全面治疗孕产妇阿片类物质使用障碍。治疗途径不足、开处方的医疗服务提供者缺乏以及复杂的服务提供模式是已知的医疗障碍。多学科医疗服务提供者的意见可用于理解促进或阻碍治疗的因素。本研究的目的是探讨医疗服务提供者对MOUD的看法以及全面治疗服务中至关重要的因素，以改善对患有阿片类物质使用障碍的孕妇的护理。
采用定性研究方法，通过个体医疗服务提供者访谈和小组半结构化访谈收集数据。医疗服务提供者（n = 12）回答了与对MOUD的看法、治疗服务提供、资源获取以及挑战/障碍等几个领域相关的问题。收集数据、转录、编码（通过共识），并使用扎根理论方法分析新出现的主题。
新出现的主题揭示了治疗方面持续存在的差距以及医疗服务提供者、卫生系统和患者因素方面的挑战。医疗服务提供者认为MOUD是女性的“生命线”。
通过利用医疗服务提供者的看法、直接经验和建议，采用基于团队的、以患者为中心的综合方法来指导对患有阿片类物质使用障碍的孕妇的护理，可以改善治疗提供、获取和接受方面的不一致情况。
