Presentation Title

Retrospective Chart Review of Patients in Medication-Assisted Therapy in Their First Year Postpartum to Assess Retention

Abstract

Hailey V. Cray, University of Vermont Honors College

Honors College Thesis: Retrospective Chart Review of Patients in Medication-Assisted Therapy in Their First Year Postpartum to Assess Retention

Advisor: Marjorie C. Meyer, MD: Larner College of Medicine Associate Professor of Maternal and Fetal Medicine

Abstract

Background:

Opioid use disorders (OUD) have long been a public health concern, and in Vermont, they profoundly affect pregnant and postpartum women. Vermont offers women with OUD medication-assisted treatment (MAT) to help curb illicit use, cravings, and withdrawal alongside providing comprehensive prenatal care. However, little is known about how these women navigate the transition between prenatal and postpartum MAT prescribing, a particularly challenging period in their lives. Retention in MAT has long been associated with better outcomes, but retention duration and the factors contributing to retention in these MAT programs after delivery are unknown.

Study Aims:

This study aims to identify the factors helping or inhibiting MAT continuation following pregnancy and seeks to pinpoint areas where the transition between prenatal and postpartum MAT can be improved.

Methods:

A retrospective chart review of selected patients with an opioid use disorder who were treated with MAT during pregnancy at UVMMC from 2017 to 2018 with a plan to transition to their primary care provider following delivery was conducted. IRB approval was not required as this was considered quality improvement work. Data reviewed included assessments taken at MAT initiation both at UVMMC and future providers, pregnancy outcomes and relapses, their MAT transition after delivery, the outcome and barriers of the transition, and their retention and duration of treatment in MAT after delivery.

Results:

Results are currently in-progress, but will include a table of demographics, obstetrical information, relapses, and substance abuse history, a table of retention information, and a table summarizing MAT assessments. Graphs will include a chart of the proportion of women retained, tapered, or lost to follow-up, a chart of common barriers to treatment, and charts illustrating custody status, contraception use, and psychiatric co-morbidities of this population.

Conclusion:

It is our hope that the results from this study will provide information on the lives of the patients being served and identify unmet needs in the current MAT system in Vermont. This will help improve retention rates in Vermont Hub and Spoke treatment programs for this vulnerable population.

Primary Faculty Mentor Name

Marjorie Meyer

Status

Undergraduate

Student College

College of Arts and Sciences

Program/Major

Biology

Primary Research Category

Health Sciences

Second College (optional)

Honors College

Secondary Research Category

Vermont Studies

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Retrospective Chart Review of Patients in Medication-Assisted Therapy in Their First Year Postpartum to Assess Retention

Hailey V. Cray, University of Vermont Honors College

Honors College Thesis: Retrospective Chart Review of Patients in Medication-Assisted Therapy in Their First Year Postpartum to Assess Retention

Advisor: Marjorie C. Meyer, MD: Larner College of Medicine Associate Professor of Maternal and Fetal Medicine

Abstract

Background:

Opioid use disorders (OUD) have long been a public health concern, and in Vermont, they profoundly affect pregnant and postpartum women. Vermont offers women with OUD medication-assisted treatment (MAT) to help curb illicit use, cravings, and withdrawal alongside providing comprehensive prenatal care. However, little is known about how these women navigate the transition between prenatal and postpartum MAT prescribing, a particularly challenging period in their lives. Retention in MAT has long been associated with better outcomes, but retention duration and the factors contributing to retention in these MAT programs after delivery are unknown.

Study Aims:

This study aims to identify the factors helping or inhibiting MAT continuation following pregnancy and seeks to pinpoint areas where the transition between prenatal and postpartum MAT can be improved.

Methods:

A retrospective chart review of selected patients with an opioid use disorder who were treated with MAT during pregnancy at UVMMC from 2017 to 2018 with a plan to transition to their primary care provider following delivery was conducted. IRB approval was not required as this was considered quality improvement work. Data reviewed included assessments taken at MAT initiation both at UVMMC and future providers, pregnancy outcomes and relapses, their MAT transition after delivery, the outcome and barriers of the transition, and their retention and duration of treatment in MAT after delivery.

Results:

Results are currently in-progress, but will include a table of demographics, obstetrical information, relapses, and substance abuse history, a table of retention information, and a table summarizing MAT assessments. Graphs will include a chart of the proportion of women retained, tapered, or lost to follow-up, a chart of common barriers to treatment, and charts illustrating custody status, contraception use, and psychiatric co-morbidities of this population.

Conclusion:

It is our hope that the results from this study will provide information on the lives of the patients being served and identify unmet needs in the current MAT system in Vermont. This will help improve retention rates in Vermont Hub and Spoke treatment programs for this vulnerable population.