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Medication-Assisted Treatment Use Among Pregnant Women With Opioid Use Disorder
- Source :
- Obstet Gynecol
- Publication Year :
- 2019
-
Abstract
- OBJECTIVE: To evaluate temporal trends in medication-assisted treatment utilization among pregnant women with opioid use disorder. METHODS: We conducted a retrospective cohort study using Pennsylvania Medicaid administrative data. Trends in medication-assisted treatment utilization, opioid pharmacotherapy (methadone and buprenorphine) and behavioral health counselling, were calculated using pharmacy records and procedure codes. Cochrane-Armitage tests evaluated linear trends in characteristics of pregnant women using methadone versus buprenorphine. RESULTS: In total, we evaluated 12,587 pregnancies among 10,741 women with opioid use disorder who had a live birth between 2009 and 2015. Across all years, 44.1% of pregnant women received no opioid pharmacotherapy, 27.1% used buprenorphine, and 28.8% methadone. Fewer than half of women had any behavioral health counseling during pregnancy. The adjusted prevalence of methadone use declined from 31.6% (95% CI: 29.3%–33.9%) in 2009 to 25.2% (95% CI: 23.3%–27.1%) in 2015, while the adjusted prevalence of buprenorphine use increased from 15.8% (95% CI: 13.9%–17.8%) to 30.9% (95% CI: 28.8%–33.0%). Greater increases in buprenorphine use were found in geographic regions with large metropolitan centers, such as the Southwest (+24.9%) and the Southeast (+12.0%), compared to largely rural regions, such as the New West (+5.2%). In 2015, the adjusted number of behavioral health counseling visits during pregnancy was 3.4 (95% CI: 2.6–4.1) among women using buprenorphine, 4.0 (95% CI: 3.3–4.7) among women who did not use pharmacotherapy, and 6.4 (95% CI: 4.9–7.9) among women using methadone. CONCLUSIONS: Buprenorphine use among Medicaid-enrolled pregnant women with opioid use disorder increased significantly over time, with a small concurrent decline in methadone use. Behavioral health counseling utilization was low, but highest among women using methadone.
- Subjects :
- Adult
medicine.medical_specialty
Adolescent
Databases, Factual
Article
Cohort Studies
Young Adult
Pharmacotherapy
Pregnancy
medicine
Opiate Substitution Treatment
Humans
Retrospective Studies
business.industry
Medicaid
Obstetrics and Gynecology
Retrospective cohort study
Opioid use disorder
Middle Aged
Pennsylvania
medicine.disease
Opioid-Related Disorders
United States
Buprenorphine
Analgesics, Opioid
Pregnancy Complications
Opioid
Emergency medicine
Female
business
Methadone
medicine.drug
Cohort study
Subjects
Details
- ISSN :
- 1873233X
- Volume :
- 133
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Obstetrics and gynecology
- Accession number :
- edsair.doi.dedup.....d3019a9e65c94fb6dad7b3ae8ce2bd0e