1 / 12

Multidisciplinary Approach to Opiate Use Disorder in Pregnancy: Team Education & Curricular Development

In response to the opioid crisis, a collaborative initiative involving OBGYN providers was undertaken, focusing on educating healthcare professionals on managing Opiate Use Disorder in pregnancy. This project, supported by the NYSHealth foundation, includes training sessions at county hospitals, personalized action plans, and knowledge assessments. The aim is to improve care delivery and reduce the impact of overdose deaths in New York State.

elmahdali
Download Presentation

Multidisciplinary Approach to Opiate Use Disorder in Pregnancy: Team Education & Curricular Development

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A Multidisciplinary Approach to team Education and Curricular Development on Opiate Use Disorder Leah Kaufman, MD SUNY Upstate David Garry, MD SUNY Stonybrook Neil, Seligman, MD Univ of Rochesterarry@stonybrookmedicine.ed Kathleen Dermady, CNM SUNY Upstate Presenting/Contact Author Leah Kaufman, MD FACOG kaufmale@upstate.edu This education has been made possible through funding from the New York State Health Foundation (NYSHealth).

  2. Background and Project Design • Given the Crisis with Opiate Use Disorder, the need for OBGYN providers to treat withdrawal and patients in pregnancy but a paucity of programs for OBGYN providers, an educational plan was formed. • ACOG District II with the NYS Health Foundation convened a summit of Multi Disciplinary care Providers in Syracuse ,NY in 2017. • A white paper and two bundles on management resulted • Team leaders now travel to county hospitals teaching the bundles, leading discussions of local case management and determining action plan steps for those departments 2 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  3. Background cont In 2012, providers wrote 259 million prescriptions for opioids • More than enough for every American adult to have a bottle of pills • 20% of those with a pain-related diagnosis, acute or chronic, receive an opioid prescription • Opioid prescriptions: » Have a place in pain management when used appropriately » Can lead to OUD Source: https://www.cdc.gov/vitalsigns/opioid-prescribing/ https://www.researchgate.net/publication/278354874_Vital_Signs_ Overdoses_of_Prescription_Opioid_Pain_Relievers-United_States_1999- 2008_Reprinted_from_MMWR_vol_60_pg_1487-1492_2011 3 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  4. Where Pain Relievers Were Obtained for Most Recent Nonmedical Use among Past Year Users Aged 12 or Older: 2012-2013 Source: SAMHSA 2013; https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab6-47a 4 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  5. Impact of Overdose Deaths in NYS The drug-related death rate for women is 8.7 per every 100,000 people and 22 per 100,000 people for men. In both, the number of drug deaths have grown considerably – a 48% increase from 2010-2015 for women and an 83% increase for men. Drug Deaths by Sex in New York State 2010-2015 2010 2011 2012 2013 2014 2015 Female 601 701 735 821 826 891 Male 1,159 1,448 1,527 1,662 1,684 2,118 Centers for Disease Control and Prevention, National Center for Health Statistics, “Underlying Cause of Death 1999-2015,” on CDC WONDER Online Database, released December 2016. Data are from the Multiple Cause of Death Data File, 1999-2015, as compiled from data provided by the fifty-seven vital statistics jurisdictions through the Vital Statistics Cooperative Program, http://wonder.cdc.gov/mcd-icd10.html. Source: http://www.rockinst.org/pdf/health_care/2017-04-20-By_numbers_brief_no8.pdf 5 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  6. New York State Opioid-Related Deaths New York State overdose deaths involving any opioid, crude rate per 100,000 population Source: https://www.health.ny.gov/statistics/opioid/ 6 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  7. Design: Hospital Approach • At each of the hospital presentations, representatives from each of the following groups have been present and engaged • Action plans created for the site after bundle presentation, local case presented and reviewed by visiting ACOG team. • Nursing • Social Worker • Women’s Health Care Provider including ob-gyn, midwife, hospitalist, resident, medical and nursing students • Anesthesiologists • Neonatologists • Behavioral Health Specialists • Emergency Department 7 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  8. Results From 5/2018-9/2019, the Bundle was presented on request at 8 hospitals by a task force member. • A pre- and post-presentation test containing 8 items assessing basic knowledge of OUD management and 2 items assessing knowledge about local hospital policies was administered using Mentimeter (Stockholm, Sweden). • Baseline site characteristics were described. • Test performance was assessed pre- and postpresentation • Cases were reviewed and an action plan created after the visit for each of the local hospitals to meet their local needs and ensure the were aware of the educational bundle resources 8 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  9. Results • The bundle was presented at 8 hospitals. • Participant characteristics: • Community-based hospital 6/8 (75%) • Ob/Gyn residency 2/8 (25%) • Annual delivery volume 454 to 8,389 births • >1,000 deliveries/year 5/8 (62.5%) • 101 and 66 respondents answered the pre- and post presentation questions, respectively. • The attrition rate ranged from 0-77%. • The mean correct response rate was 74.9% pre, and 86% post. • Among respondents: • 66.7% to 76.8% were either unsure or stated no specific protocols exist for screening and referral to treatment. • 90.4% were motivated by the presentation to educate themselves about current hospital screening policies. 9 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  10. Conclusions • Opioid Use Disorder is an area requiring a curriculum specific to Women’s Health as our providers will be treating patients acutely and chronically with this disorder • A team approach to education to focus needed areas of education is most efficient • Providers when surveyed retain and are secure in their understanding of clinical information surrounding management of these patients but need institutions and departments to do more to support them in their understanding or process and policies. 10 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II 2018

  11. ACOG District II Opioid Use Disorder in Pregnancy Task Force & Key Partners Leah Kaufman, MD FACOG Co-Chair David Garry, DO, FACOG Co-Chair Cynthia Abraham, MD, FACOG Michelle Bode, MD, MPH Erin Bortel, MSW Sharon Chesna, MPA Michele Calvo, MPH Kathleen Dermady, DNP, LM, CNM, NP Darcy Dreyer Christie Finch Aimee Gomlak, FACHE Dede Hill Julia Hunter, MD, MPH, FASAM Kristen Lawless, MS Marilyn Kacica, MD, MPH Melissa Kubenik, MD, FACOG Nicholas Kulbida, MD, FACOG Helena LaDue, LMSW, CASAC Kristen Lawless, MS Cassie Leonard, MD, FACOG Lauren Miller, MD, MPH Maria Morris-Groves, MSEd Debby O’Brien James Scott, MD, FACOG Neil Seligman, MD, MS, FACOG Kari Siddiqui Maggie Taylor, PhD Darlene Walker, RN, FNP Bridget Walsh Ellie Ward Anar Yukhayev ACOG District II: Iffath Abbasi Hoskins – Chair Christa Christakis, MPP – Executive Director Kelly Gilchrist – Manager, Medical Education  Alliance for Innovation on Maternal Health (AIM)  NYSDOH’s New York State Perinatal Quality Collaborative (NYSPQC)  NYS Office of Alcoholism and Substance Abuse Services (OASAS)  NYSDOH AIDs Institute, Office of Drug User Health  HANYS’ Statewide Opioid Addiction Prevention and Management Collaborative 11 https://www.acog.org/About-ACOG/ACOG-Districts/District-II/Opioid-Use-Disorder-in-Pregnancy ACOG District II, 2019

  12. Contact ACOG District II For questions on this project: Kelly Gilchrist Manager, Medical Education kgilchrist@ny.acog.org Leah Kaufman, MD kaufmale@upstate.edu American College of Obstetricians and Gynecologists (ACOG), District II 100 Great Oaks Boulevard, Suite 109 Albany, NY 12203 (518) 436-3461 www.acogny.org Stay up to date: Like us on Facebook! Follow us! Twitter: @ACOGD2

More Related