Effect of Residency Training in Treating Maternal Opioid Use Disorder [ID: 1376984

Abstract

INTRODUCTION: Buprenorphine treatment for opioid use disorder (OUD) remains substantially underutilized, reflecting a systemic deficit in medical education. Our study assesses the effect of residency training in a prenatal OUD-specific clinic (CARE) on postgraduate ob-gyn physician attitudes, self-perceived competence, and treatment of maternal OUD. METHODS: 2013–2022 graduates from a single obstetrics and gynecology residency program were invited to participate in an online anonymous survey, which collected information on demographics, attitudes, self-perceived competency, and current practice. Answers from participants who graduated before the establishment of CARE in 2018 were compared to those who trained after the establishment of CARE using Fisher's exact, χ2, and Student t tests. A value of P<.05 was considered statistically significant. RESULTS: 55/86 (64%) physicians completed the survey. Compared to graduates without CARE experience (N=30), those with residency experience in CARE (N=25) were significantly more likely to be actively prescribing buprenorphine (24% versus 3%, P=.02) or planning to obtain an X-waiver (24% versus 3%, P=.03). The majority with CARE experience reported feeling comfortable prescribing buprenorphine during pregnancy (92.0% versus 13.3%, P<.001), confident to treat maternal OUD (84% versus 26.7%, P<.001), and able to manage buprenorphine treatment during pregnancy (88% versus 30%, P<.001). Those with experience in CARE reported that residency provided sufficient training to manage maternal OUD without additional X-waiver training (84% versus 10%, P<.001). Institutional review board approval was obtained. CONCLUSION: Prenatal OUD-specific clinics are known to be associated with improved patient outcomes, and may also significantly expand the ability of ob-gyn residents to treat maternal OUD after graduation.