Boston University School of Medicine, Department of Obstetrics and Gynecology, 85 East Concord St, 6th Floor, Boston, MA 02118, United States of America; Boston Medical Center, 850 Harrison Ave, Boston, MA 02118, United States of America.
Boston University School of Public Health, Department of Health Law, Policy and Management, 715 Albany St, Talbot Building, Boston, MA 02118, United States of America.
J Subst Abuse Treat. 2021 May;124:108273. doi: 10.1016/j.jsat.2020.108273. Epub 2021 Jan 2.
The COVID-19 pandemic has directly impacted integrated substance use and prenatal care delivery in the United States and has driven a rapid transformation from in-person prenatal care to a hybrid telemedicine care model. Additionally, changes in regulations for take home dosing for methadone treatment for opioid use disorder due to COVID-19 have impacted pregnant and postpartum women. We review the literature on prenatal care models and discuss our experience with integrated substance use and prenatal care delivery during COVID-19 at New England's largest safety net hospital and national leader in substance use care. In our patient-centered medical home for pregnant and postpartum patients with substance use disorder, patients' early responses to these changes have been overwhelmingly positive. Should clinicians continue to use these models, thoughtful planning and further research will be necessary to ensure equitable access to the benefits of telemedicine and take home dosing for all pregnant and postpartum patients with substance use disorder.
新冠疫情直接影响了美国的物质使用和产前护理服务，推动了从面对面的产前护理向远程医疗混合护理模式的快速转变。此外，由于新冠疫情，美沙酮治疗阿片类药物使用障碍的居家用药规定发生了变化，这也影响了孕妇和产后妇女。我们回顾了产前护理模式的文献，并讨论了我们在新英格兰最大的医疗服务网医院和物质使用护理领域的全国领导者在新冠疫情期间开展的物质使用和产前护理服务整合方面的经验。在我们的以患者为中心的物质使用障碍孕妇和产后患者医疗服务中心，患者对这些变化的早期反应非常积极。如果临床医生继续使用这些模式，那么需要进行深思熟虑的规划和进一步的研究，以确保所有物质使用障碍孕妇和产后患者都能公平地获得远程医疗和居家用药的好处。
