Multidisciplinary Prenatal Care of the Patient with Opioid Use Disorder: A One Stop Shop
ACOG ePoster. Peneva R. Apr 27, 2018; 211592; 21R
Ralitza Peneva
Ralitza Peneva
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Abstract
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Introduction: Opioid use has increased dramatically over the past two decades and affects pregnant women across racial, ethnic, and socioeconomic groups. Rates of neonatal drug withdrawal have increased in accordance. Pregnancy provides a unique opportunity to identify and treat opioid use disorders to optimize maternal and fetal health. Most studies focus on targeting this chronic issue with pharmacotherapy, but few have examined the benefits of streamlining care for prenatal patients. We propose combining the evidence-based practice of “SBIRT” (Screening, Brief Intervention, Referral to Treatment) and treatment itself into a multidisciplinary clinical experience.

Methods: This is a descriptive study of a collaboration between the Louisiana State University Departments of Obstetrics and Gynecology and Psychiatry in New Orleans, LA. Prenatal patients with opioid use disorders are referred to addiction psychiatry clinic . Prenatal care is given within the same clinic space to allow for collaboration between services. Inpatient pregnant patients undergoing opioid initiation or treatment are also referred to this specialized clinic upon discharge from the hospital.

Results: Since initiating this joint effort in July 2014, the perinatal psychiatry clinic has had approximately 2.5 scheduled patient encounters per week. A review of delivered patients over the past 5 years shows 3-5 patients/month with opioid use disorders. Of our pregnant patients, this constitutes about 3% of the delivery population.

Conclusion/Implications: This collaboration has improved access to care for pregnant patients with opioid use disorders. Future work includes looking at patient compliance with visits and neonatal outcomes. Multidisciplinary care for this patient population is essential to optimize maternal and fetal outcomes.

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