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Inpatient Buprenorphine Initiation for Pregnant Patients.

Amy Lee1, Katherine Stokes, Daisy Goodman

  • 1Dartmouth Health, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.

Obstetrics and Gynecology
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This project created a toolkit to educate clinicians on buprenorphine initiation for pregnant patients with opioid use disorder (OUD). Disseminating this program improves access to essential medications for opioid use disorder (MOUD) and empowers providers.

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Area of Science:

  • Obstetrics and Gynecology
  • Addiction Medicine
  • Pharmacology

Background:

  • Opioid use disorder (OUD) in pregnancy is a growing concern, contributing to increased maternal mortality.
  • Medications for opioid use disorder (MOUD) are recommended but often underutilized due to provider knowledge gaps.
  • Existing clinical practices lack standardized protocols for initiating buprenorphine in pregnant individuals.

Purpose of the Study:

  • To develop and disseminate a comprehensive toolkit for initiating buprenorphine in pregnant patients with OUD.
  • To standardize buprenorphine initiation protocols within the Epic electronic health record (EHR).
  • To enhance healthcare professional and nursing education regarding MOUD in pregnancy.

Main Methods:

  • Creation of educational materials, including PowerPoint presentations on buprenorphine pharmacology and supportive care.
  • Development of a templated Mutual Care Agreement for patient-provider collaboration.
  • Implementation of a standardized Epic EHR order set for buprenorphine micro-dosing initiation.

Main Results:

  • The toolkit provides adaptable resources for institutions to implement inpatient buprenorphine initiation.
  • Educational modules address knowledge gaps concerning MOUD in pregnancy.
  • The EHR order set facilitates consistent dosing, supportive medication management, and comprehensive care planning.

Conclusions:

  • Dissemination of this program is expected to improve pregnant patients' access to MOUD.
  • Empowering clinicians with standardized tools and education enhances care for pregnant individuals with OUD.
  • This initiative addresses critical barriers to effective MOUD treatment in obstetric settings.