Reproductive Health Knowledge, Attitudes, and Behaviors Among Women Enrolled in Medication-Assisted Treatment for Opioid Use Disorder

Meschke, Laurie L.; McNeely, Clea; Brown, Kathleen; Prather, J Mark

doi:10.1089/jwh.2017.6564

Cited by 18 publications

(43 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because a number of health characteristics have been found to be associated with unintended pregnancy, we examined whether participants had experienced any form of intimate partner violence (IPV) in the past six months, problem alcohol use in the past month (as indicated by an AUDIT‐C score of 3 or above, based on the frequency, timing and amount of drinking) and clinically relevant symptoms of depression or anxiety in the past week (from the Brief Symptom Inventory, as indicated by a score of 2 or above on the depression or anxiety subscale) . In addition, we assessed participants' level of stress using the Perceived Stress Scale and emotional social support using the Multidimensional Scale of Perceived Social Support (continuous scores were generated for each).…”

Section: Methodsmentioning

confidence: 99%

Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women

Ralph¹,

Foster²,

Rocca³

2020

Perspect Sexual Reproductive

View full text Add to dashboard Cite

CONTEXT Measurement of pregnancy intentions typically relies on retrospective reporting, an approach that may misrepresent the extent of unintended pregnancy. However, the degree of possible misreporting is unclear, as little research has compared prospective and retrospective reports of intention for the same pregnancies. METHODS Longitudinal data collected between 2010 and 2015 on 174 pregnancies were used to analyze the magnitude and direction of changes in intendedness (intended, ambivalent or unintended) between prospective and retrospective measurements of intendedness using versions of the London Measure of Unplanned Pregnancy (LMUP). Changes were assessed both continuously and categorically. Differences in the degree of change—by pregnancy outcome and participant characteristics—were examined using mixed‐effects linear and logistic regression models. RESULTS Over two and one‐half years of follow‐up, 143 participants reported 174 pregnancies. Approximately half showed changes in intention between the prospective and retrospective assessments, with 38% of participants reporting increased intendedness and 10% decreased intendedness. Reported intendedness increased more among those who gave birth (mean change in continuous LMUP score, 2.2) than among those who obtained an abortion (0.7), as well as among individuals with a college degree (4.1) than among those with a high school diploma (1.2). Participants who reported recent depression or anxiety symptoms showed more stable intentions (0.02) than those who did not (2.1). CONCLUSIONS Retrospective measurement of pregnancy intentions may underestimate the frequency of unintended pregnancy, with such underestimation being greater among certain subgroups. Estimates based on retrospective reports thus may produce inaccurate impressions of intentionality. Further efforts to refine the measurement of pregnancy preferences are needed.

show abstract

Section: Methodsmentioning

confidence: 99%

Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women

Ralph¹,

Foster²,

Rocca³

2020

Perspect Sexual Reproductive

View full text Add to dashboard Cite

show abstract

“…Since the completion of this 2015 systematic review, there have been additional studies that indicate external condoms are still the most commonly used contraceptive by women with opioid use disorder. 5,7,8…”

Section: Contraceptive Behaviorsmentioning

confidence: 99%

“…Patient Beliefs and Knowledge Although most women with opioid use disorder have an awareness of and appreciation for contraceptive use, great variability in contraceptive knowledge may contribute to disparate levels of contraception initiation. 8 One study gauging reproductive health knowledge and attitudes of 283 women with opioid use disorder found that over 70% agreed or strongly agreed that it was important to avoid getting pregnant. Furthermore, women endorsed a high level of consideration for the increased perinatal risk posed by opioid use.…”

Section: Factors Affecting Contraceptive Accessmentioning

confidence: 99%

“…Maternal opioid use disorder increased > 4-fold from 1999 to 2014 and is associated with poor maternal and fetal outcomes. 1,2 Women with opioid use disorder are at 2 to 3 times greater risk for unintended pregnancy than the general population, [3][4][5] with current estimates indicating the unintended pregnancy rate in women with opioid use disorder is over 75% [5][6][7][8][9] (Table 1). Maternal substance use disorder, which includes drug or alcohol use, is associated with an increased risk for pregnancy-related morbidity 10 and neonatal abstinence syndrome (NAS), a condition that occurs when an infant experiences physical withdrawal symptoms due to exposure to maternal medication or drug use, most commonly opioids, before birth.…”

mentioning

confidence: 99%

“…However, it is important to acknowledge that not all pregnancies among women with opioid use disorder are unintended, and all women desiring pregnancy deserve access to patient-centered care. Most women realize that opioid use may negatively impact a pregnancy 8,17 ; however, health care providers need to be familiar with factors that affect contraceptive access in women with opioid use disorder to provide comprehensive, patient-centered care.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Factors Affecting Contraception Access and Use in Patients With Opioid Use Disorder

Stone

Griffin

Fusco

et al. 2020

The Journal of Clinical Pharma

View full text Add to dashboard Cite

Maternal opioid use disorder increased > 4‐fold from 1999 to 2014 and is associated with poor maternal and fetal outcomes. Women with opioid use disorder are at 2 to 3 times greater risk for unintended pregnancy than the general population and may face additional barriers to accessing and effectively using contraception compared to women without opioid use disorder, particularly highly effective long‐acting reversible contraception. Additionally, women with opioid use disorder tend to use less effective forms of contraception such as condoms alone. Barriers to contraceptive access include patient misconceptions or knowledge gaps regarding reproductive health and family planning, cost, intimate partner violence, fear of criminalization, difficulty accessing care, comorbid health conditions, and health care provider misconceptions or practice limitations. Strategies that may assist women with opioid use disorder in achieving their family planning goals include colocation of family planning services within opioid treatment facilities, optimization of patient care services to minimize the need for costly and/or time consuming follow‐up, increasing provider education and awareness of best practices in family planning and opioid use disorder treatment, and providing patient‐centered family planning education and counseling. Additional research is needed to identify and develop strategies that empower women who use opioids to effectively access and use their preferred contraceptive method.

show abstract

Efficacy and Cost-Benefit of Onsite Contraceptive Services With and Without Incentives Among Women With Opioid Use Disorder at High Risk for Unintended Pregnancy

et al. 2021

View full text Add to dashboard Cite

IMPORTANCERates of in utero opioid exposure continue to increase in the US. Nearly all of these pregnancies are unintended but there has been little intervention research addressing this growing and costly public health problem.OBJECTIVE To test the efficacy and cost-benefit of onsite contraceptive services with and without incentives to increase prescription contraceptive use among women with opioid use disorder (OUD) at high risk for unintended pregnancy compared with usual care. DESIGN, SETTING, AND PARTICIPANTSA randomized clinical trial of 138 women ages 20 to 44 years receiving medication for OUD who were at high risk for an unintended pregnancy at trial enrollment between May 2015 and September 2018. The final assessment was completed in September 2019. Data were analyzed from October 2019 to March 2021. Participants received contraceptive services at a clinic colocated with an opioid treatment program.INTERVENTIONS Participants were randomly assigned to receive 1 of 3 conditions: (1) usual care (ie, information about contraceptive methods and community health care facilities) (n = 48); (2) onsite contraceptive services adapted from the World Health Organization including 6 months of follow-up visits to assess method satisfaction (n = 48); or (3) those same onsite contraceptive services plus financial incentives for attending follow-up visits (n = 42).MAIN OUTCOMES AND MEASURES Verified prescription contraceptive use at 6 months with a cost-benefit analysis conducted from a societal perspective. RESULTSIn this randomized clinical trial of 138 women (median age, 31 years [range, 20-44 years]), graded increases in verified prescription contraceptive use were seen in participants assigned to usual care (10.4%; 95% CI, 3.5%-22.7%) vs contraceptive services (29.2%; 95% CI, 17.0%-44.1%) vs contraceptive services plus incentives (54.8%; 95% CI, 38.7%-70.2%) at the 6-month end-of-treatment assessment (P < .001 for all comparisons). Those effects were sustained at the 12-month final assessment (usual care: 6.

show abstract

Reproductive Health Knowledge, Attitudes, and Behaviors Among Women Enrolled in Medication-Assisted Treatment for Opioid Use Disorder

Abstract: Strategies to ensure all women enrolled in MAT for OUD have knowledge of effective contraception and affordable, quality contraception care that is responsive to their complicated and oftentimes traumatic histories are necessary to enhance the women's reproductive health.

Cited by 18 publications

References 36 publications

Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women

Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women

Factors Affecting Contraception Access and Use in Patients With Opioid Use Disorder

Efficacy and Cost-Benefit of Onsite Contraceptive Services With and Without Incentives Among Women With Opioid Use Disorder at High Risk for Unintended Pregnancy

Contact Info

Product

Resources

About