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Implementation of a Neonatal Abstinence Syndrome Weaning Protocol: A Multicenter Cohort Study
- Source :
- Pediatrics
- Publication Year :
- 2015
-
Abstract
- OBJECTIVES: To evaluate the generalizability of stringent protocol-driven weaning in improving total duration of opioid treatment and length of inpatient hospital stay after treatment of neonatal abstinence syndrome (NAS). METHODS: We conducted a retrospective cohort analysis of 981 infants who completed pharmacologic treatment of NAS with methadone or morphine from January 2012 through August 2014. Before July 2013, 3 of 6 neonatology provider groups (representing Ohio’s 6 children’s hospitals) directed NAS nursery care by using group-specific treatment protocols containing explicit weaning guidelines. In July 2013, a standardized weaning protocol was adopted by all 6 groups. Statistical analysis was performed to identify effects of adoption of the multicenter weaning protocol on total duration of opioid treatment and length of hospital stay at the protocol-adopting sites and at the sites with preexisting protocol-driven weaning. RESULTS: After adoption of the multicenter protocol, infants treated by the 3 groups previously without stringent weaning guidelines experienced shorter duration of opioid treatment (23.0 vs 34.0 days, P < .001) and length of inpatient hospital stay (23.7 vs 31.6 days, P < .001). Protocol-adopting sites also experienced a lower rate of adjunctive drug therapy (5% vs 21%, P = .004). Outcomes were sustained by the 3 groups who initially had specific weaning guidelines after multicenter adoption (duration of treatment = 17.0 days and length of hospital stay = 23.3 days). CONCLUSIONS: Adoption of a stringent weaning protocol resulted in improved NAS outcomes, demonstrating generalizability of the protocol-driven weaning approach. Opportunity remains for additional protocol refinement.
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
MEDLINE
Article
Cohort Studies
Clinical Protocols
medicine
Weaning
Humans
Generalizability theory
Neonatology
Retrospective Studies
Morphine
business.industry
Infant, Newborn
Retrospective cohort study
Length of Stay
Opioid-Related Disorders
Analgesics, Opioid
Opioid
Pediatrics, Perinatology and Child Health
Female
business
Neonatal Abstinence Syndrome
Methadone
Cohort study
medicine.drug
Subjects
Details
- ISSN :
- 10984275
- Volume :
- 136
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....6704a416fb9abe0b465b86da868871ef