671: Healthcare care providers’ roles and attitudes towards substance use disorder during pregnancy

Abstract

Patients with substance use disorders (SUD) may be stigmatized by healthcare providers, leading to delayed care and worse outcomes. We assessed attitudes toward SUD as a potential barrier to care during and after pregnancy by provider role. The Collaborative Values Inventory from the National Center on Substance Abuse and Child Welfare was distributed to inpatient and outpatient staff at a tertiary care center for women and infants from July-Sept 2018. Self-reported interaction with pregnant, postpartum, or newborn patients was a criterion for participation. The 57-item survey addressed drug testing, parenting, child removal/reunification, treatment/relapse, SUD as a disease, and confidence in the response to SUD. Respondents were classified based on their self-reported role: 1) MD/NP 2) RN 3) PCT/Other [patient care technicians, surgical technicians, ultrasound technicians, respiratory therapists] or 4) Clerical staff. Groups were compared using chi square or analysis of variance (ANOVA) tests as appropriate. Of 942 employees, 237 (25%) responded. Exposure groups differed in terms of age, race, years of experience, and gender. The majority of respondents supported universal drug screening of pregnant women and infants, though MD/NP were less likely to endorse universal screening or to view drug screens as the best indicator of recovery (Fig 1). While >90% reported SUD is a disease, MD/NP were more likely to support pharmacotherapy for SUD during pregnancy and recognize that treatment beyond pharmacotherapy and withdrawal management is needed (Fig 2). Although the majority of respondents recognized SUD as a disease, responses regarding treatment highlight discrepancies in perception of the need for pharmacotherapy and indications for drug testing. Educational efforts should be targeted based on providers’ roles in an aim to improve uniformity around an evidence-based approach to SUD treatment during pregnancy among different provider types.View Large Image Figure ViewerDownload Hi-res image Download (PPT)