Search

Purpose: The purpose was to summarize evidence of long‐term outcomes of children, 2 years and older, exposed to opioids in‐utero. Design: This was a systematic review. Studies were identified by searching the following electronic databases: PubMed, EBSCO HOST/Medline, and Web of Science. Articles were published between 1979 and 2019. Methods: This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta‐Analysis. Two sets of two independent reviewers extracted data and assessed study quality according to National Institutes of Health quality assessment tools. Results: Forty‐three articles met inclusion criteria. Synthesis of articles identified trends toward worse outcomes for children with in‐utero opioid exposure in all areas, most notably related to academic success, behavior, cognition, hospitalizations, and vision. Conclusions: Findings reinforce the necessity of continued research in this area with improved study design. Despite limitations in the current body of evidence, findings from this review are vital knowledge for clinicians, because children exposed to opioids in‐utero are clearly vulnerable to a wide variety of suboptimal health and developmental outcomes. Clinical Relevance: Recognition of all outcomes across childhood associated with in‐utero opioid exposure will inform improved identification and interventions tailored to the most pressing needs of affected children. Despite the need for continued research, there is sufficient evidence to necessitate close, individualized follow‐up throughout childhood. [ABSTRACT FROM AUTHOR]

There are ways to integrate culturally competent services (CCS) and evidence-based practices (EBP) which can improve the experiences of patients and their families and communities when faced with health problems, as well as the effectiveness and positive experiences of practitioners. CCS and EBP evidence should be jointly deployed for helping patients and clinicians. Partnership research models are useful for achieving the integration of CCS and EBP, since they involve close observation of and participation by clinicians and practitioners in the research process, and often use integrated qualitative and quantitative mixed methods. We illustrate this with 3 examples of work that can help integrate CCS and EBP: ongoing collection of information from patients, clinicians and staff, or “evidence farming”; close study and continuous improvement of activities and accommodations; and use of evidence of tacit, implicit cultural scripts and norms, such as being “productive,” as well as explicit scripts. From a research practice point of view, collaborative partnerships will likely produce research with culture and context bracketed in, and will contribute stronger research models, methods, and units of analysis. [ABSTRACT FROM PUBLISHER]