Characteristics and outcomes of medication-assisted treatment care models for pregnant women with opioid use disorder: A scoping review.

Abstract

Background: Pregnant women and their unborn children are often overlooked in the opioid crisis, despite increased rates of both maternal complications and neonatal opioid withdrawal syndrome. Although medications for opioid use disorder (MOUD) are considered the gold standard for pregnant women, many either do not have access to or are not offered MOUD as an option.

Objectives: To describe the characteristics of MOUD care models and assess the effectiveness of MOUD Care Models on initiation, adherence, and engagement in treatment for pregnant women with OUD.

Data sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol directed the process of this scoping review. A search for English, peer-reviewed, quantitative studies, published between 2012 and 2023 was conducted in eight scholarly databases. The Joanna Briggs Critical Appraisal tools were used to assess study quality.

Conclusions: The integrated care models included medication management, psychotherapy support, behavioral health care, and medical care management, with added focus on prenatal and postpartum care. Synthesis revealed that treatment engagement, medication adherence, breastfeeding rates, and postdelivery MOUD referrals were higher in integrated care models compared with nonintegrated care models. Pregnant women with OUD in integrated care models have better outcomes compared with those in nonintegrated care models.

Implications for practice: Improvements in care models are necessary to tackle provider shortages, stigma, and financial, geographic, and technological barriers. Addressing these issues will enhance nurse practitioners' ability to provide comprehensive and accessible care to this vulnerable population.