D-H Researchers, Providers to Receive $5.3 Million Award to Study Treatment of Opioid Use Disorders in Pregnant Women
A research team led by Sarah Lord, PhD, and Daisy Goodman, DNP, MPH, at Dartmouth’s Geisel School of Medicine, has been approved for a $5.3 million funding award from the Patient-Centered Outcomes Research Institute (PCORI)—to conduct comparative clinical effectiveness research on medication-assisted treatment (MAT) for pregnant women with opioid use disorders (OUD).
The award is one of nine new comparative clinical effectiveness research awards being offered by PCORI (with a total of $74 million in funding) to support research on a range of conditions that impose high burdens on patients, caregivers and the health care system.
Northern New England has among the highest rates of opioid dependence, and opioid-related deaths, in the U.S. with prevalence highest and growing among those between 18 and 35 years of age. In this region, 5-8 percent of newborns have mothers with an opioid use disorder, putting them at much greater risk for poor outcomes such as preterm birth and long-term hospitalization for neonatal withdrawal and other complications.
For pregnant women with opioid use disorder, MAT—which combines maintenance medication with psychosocial services—has been shown to significantly reduce these risks. However, it can be difficult for pregnant women to find MAT providers. This has prompted a growing number of maternity care providers to prescribe MAT in their own practices, while other providers follow the traditional approach of referring patients to specialty MAT programs.
For the five-year project, the team will compare the outcomes of two medication-assisted treatment models of care.
“Our research questions reflect what women affected by opioid use disorder and their care providers indicated as most important to them,” explains Lord, an assistant professor of psychiatry at Geisel and director of the Dissemination and Implementation Core of the Dartmouth Center for Technology and Behavioral Health. “We are interested in whether integrated care models, where women receive maternity care and treatment for OUD together in the same practice, are more effective than models where women receive maternity care from one practice and are referred to OUD treatment at another location. These models have not been directly compared in research studies of maternity care for women with OUD. We’re hoping the results of our study will inform both practice and policy with regard to services for women and their infant children.”