Lessons Learned From the Implementation of an Integrated Prenatal Opioid Use Disorder Program

Abstract

ObjectiveTo evaluate key lessons learned from efforts at increasing engagement in integrated prenatal and opioid use disorder services. DesignAn interdisciplinary team consisting of a board-certified obstetrician and registered nurse led the implementation of this multipronged approach driven by several plan–do–study–act cycles to develop an integrated prenatal and opioid use disorder program. Setting/Local ProblemAn urban community health center in Chicago, Illinois, where mental health issues, including substance use, are the leading cause of death for pregnant people. ParticipantsConnections were made with local harm reduction agencies, substance use treatment facilities, and community outreach programs to develop partnerships with organizations providing existing addiction and maternal–child services in the community. Intervention/MeasuresPartnership building was achieved through organization needs assessments, dissemination of information about integrated services, and sustained communication. Referral workflow guides and patient education cards were created and distributed to community partners. Incoming referrals were tracked at the clinic site. Use of the referral materials was evaluated via online surveys distributed to community partners. ResultsIn the 18 weeks of enhanced integration, three patients engaged in services and were initiated on medication for opioid use disorder, two of whom had been referred from agencies targeted in the outreach efforts. Surveys showed that community partners believe the referral guides were easy to use and that the harm reduction information on the patient cards was useful. ConclusionAn urban community health center was equipped to provide comprehensive, integrated services to pregnant people with opioid use disorder, but barriers such as community unawareness and stigma impeded engagement. Sustained collaboration with community partners serving pregnant people with opioid use disorder supports program development and linkage to care. Integrated prenatal and opioid use disorder care is feasible, is destigmatizing in nature, and can lead to improved maternal and fetal outcomes.