In the Literature

July 13, 2022

In the Literature...

Advanced Practice Provider-Led Medication for Opioid Use Disorder Programs for Pregnant and Parenting Women - This article describes 2 innovative models of advanced practice provider-led medication for opioid use disorder treatment programs offering comprehensive, interprofessional care for pregnant patients and provides implications for broader adaptation of practice. Increasing the number of midwives and nurse practitioners waivered to prescribe buprenorphine and able to connect pregnant patients with opioid use disorder to appropriate community-based resources, treatment, and self-help programs could address alarming substance use trends including overdose deaths and other sequelae associated with the opioid epidemic.

Expanding Opioid Use Disorder Treatment in Priority Areas: The Role of Certified Nurse-Midwives - Perinatal opioid use disorder (OUD) is associated with maternal and neonatal morbidity, and treatment has been definitively shown to improve outcomes for both. As of 2018, certified nurse-midwives (CNMs) can prescribe buprenorphine for the treatment of OUD by obtaining a Drug Addiction Treatment Act waiver. Using the software GeoDa, authors identified priority counties in the United States and the number of waivered and nonwaivered CNMs in these areas. Counties were designated as priority if they had drug-poisoning mortality rates in the top 20th percentile of all US counties and no health care providers waivered to treat OUD or had a waivered health care provider per population rate in the bottom 20th percentile. Analysis identified 141 priority counties in 23 states concentrated in rural areas throughout the Appalachian region of the United States. Tennessee had the most priority counties of any state. As of 2020, only 26 CNMs in the United States were waivered to prescribe buprenorphine, none of whom practiced in priority counties. Of the CNMs practicing in priority counties and without waivers, 59% (39 of 66) practiced in states where CNMs have independent practice authority. CNMs are uniquely positioned to treat perinatal OUD given their scope of practice as primary and reproductive health care providers, especially in rural, underserved areas. To increase the number of midwives prescribing buprenorphine and expand treatment access, researchers, educators, practice leaders, and policy makers must address barriers to and experiences of treating OUD.

Call Proposals - PQCNC 2024

It's time for PQCNC to consider initiatives for launch in January of 2024.

What areas of perinatal care need attention and offer the greatest opportunities for improvement? In thinking about this consider large scale impact, the potential to pull together all newborn providers, or all maternal providers, or maternal and newborn providers in a project which allows partnership with patients and families as we seek to make North Carolina the best place to give birth and be born.

Consider the continuum of perinatal care. We are currently working in maternity clinics in clOUDi 2.0 and while it is a work in progress, we seek to continue evolving this pre and postnatal presence.

This is not a request for a white paper or detailed discussion of what your project might look like. We simply ask for a paragraph or two that addresses the key intervention opportunity and the impact it will have.

We will present these initiative proposals later in the year at our Annual Meeting on September 29th in Raleigh.

Submit your proposal

Registration is now open for the PQCNC Annual Meeting on September 29th at the McKimmon Center in Raleigh NC.

Come listen to speakers of general interest, proposals for new initiatives and then vote for what you think PQCNC should work on in 2024

Contact me!

Keith M Cochran

qiadvisor@pqcnc.org

984-974-7871

'Unoffice' hours - click here to schedule a Zoom meeting