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International Journal of Clinical Pharmacy

, Volume 40, Issue 1, pp 20–25 | Cite as

Pharmacists’ and prescribers’ neonatal abstinence syndrome (NAS) prevention behaviors: a preliminary analysis

  • Nicholas E. HagemeierEmail author
  • Ivy A. Click
  • Heather Flippin
  • Holly Gilliam
  • Alexandra Ross
  • Jeri Ann Basden
  • Ronald CaricoJr.
Short Research Report

Abstract

Background Maternal opioid use and neonatal abstinence syndrome (NAS) incidence have increased markedly in the US in recent years. Objectives (1) To assess prescribers’ and community pharmacists’ guideline-based NAS prevention behaviors; (2) to describe providers’ perceptions of contraceptive appropriateness in female patients of childbearing age. Method Cross-sectional study of 100 randomly selected primary care physicians, 100 prescribers authorized to engage in in-office treatment of opioid use disorders with buprenorphine, 100 pain management clinic directors, and 100 community pharmacists in Tennessee (N = 400 providers total) to evaluate self-reported engagement in 15 NAS prevention behaviors and perceived appropriateness of 8 contraceptive methods in opioid using women of childbearing age. Results An overall response rate of 17.5% was obtained. Pain clinic directors reported the most engagement in NAS prevention, engaging 80% or more of female patients of childbearing age prescribed an opioid in 11 prevention behaviors, followed by buprenorphine prescribers (8 behaviors), primary care physicians (5 behaviors), and community pharmacists (2 behaviors). Pain clinic directors, primary care physicians, and community pharmacists perceived oral contraceptive pills and patches to be as appropriate as long-acting, reversible forms of contraception (e.g., implants, injectable depots, intrauterine devices). Conclusion Provider engagement in behaviors that could prevent NAS is variable. Interventions should be implemented that equip providers to engage patients in conversations about long-acting, reversible contraception.

Keywords

Neonatal abstinence syndrome Pharmacist Prescriber Prevention United States 

Notes

Acknowledgements

The authors express gratitude to the health care providers who participated in the study.

Funding

This project was funded by the Tennessee Department of Health Grant #34347-46814 (Hagemeier & Click, Co-PIs).

Conflicts of interest

The authors declare no conflicts of interest or financial interests specific to the content of this manuscript.

Supplementary material

11096_2017_573_MOESM1_ESM.pdf (304 kb)
Supplementary material 1 (PDF 304 kb)
11096_2017_573_MOESM2_ESM.pdf (304 kb)
Supplementary material 2 (PDF 303 kb)

References

  1. 1.
    Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. Morb Mortal Wkly Rep. 2016;65(50–51):1445–52.  https://doi.org/10.15585/mmwr.mm655051e1.CrossRefGoogle Scholar
  2. 2.
    Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000–2009. JAMA. 2012;307(18):1934–40.  https://doi.org/10.1001/jama.2012.3951.CrossRefPubMedGoogle Scholar
  3. 3.
    Maeda A, Bateman BT, Clancy CR, Creanga AA, Leffert LR. Opioid abuse and dependence during pregnancy: temporal trends and obstetrical outcomes. Anesthesiology. 2014;121(6):1158–65.  https://doi.org/10.1097/aln.0000000000000472.CrossRefPubMedGoogle Scholar
  4. 4.
    Villapiano NL, Winkelman TN, Kozhimannil KB, Davis MM, Patrick SW. Rural and Urban Differences in Neonatal Abstinence Syndrome and Maternal Opioid Use, 2004 to 2013. JAMA Pediatr. 2004;.  https://doi.org/10.1001/jamapediatrics.2016.3750.Google Scholar
  5. 5.
    Heil SH, Jones HE, Arria A, Kaltenbach K, Coyle M, Fischer G, et al. Unintended pregnancy in opioid-abusing women. J Subst Abuse Treat. 2011;40(2):199–202.  https://doi.org/10.1016/j.jsat.2010.08.011.CrossRefPubMedGoogle Scholar
  6. 6.
    Terplan M, Hand DJ, Hutchinson M, Salisbury-Afshar E, Heil SH. Contraceptive use and method choice among women with opioid and other substance use disorders: a systematic review. Prev Med. 2015;80:23–31.  https://doi.org/10.1016/j.ypmed.2015.04.008.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Tennessee Division of Health Care Finance and Administration. Neonatal abstinence syndrome among TennCare enrollees—2013 data. Accessed 14 Jan 2016.Google Scholar
  8. 8.
    Jones J, Mosher W, Daniels K. Current contraceptive use in the United States, 2006-2010, and changes in patterns of use since 1995. Nat Health Stat Rep. 2012;60:1–25.Google Scholar
  9. 9.
    Sweeney LA, Molloy GJ, Byrne M, Murphy AW, Morgan K, Hughes CM, et al. A qualitative study of prescription contraception use: the perspectives of users, general practitioners and pharmacists. PLoS ONE. 2015;10(12):e0144074.  https://doi.org/10.1371/journal.pone.0144074.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Tennessee Department of Health. Tennessee Chronic Pain Guidelines: Clinical Practice Guidelines for Outpatient Management of Chronic Non-Malignant Pain. Nashville, TN; 2014. September 24, 2014.Google Scholar
  11. 11.
    Dillman DA, Smyth JD, Christian LM. Internet, phone, mail, and mixed-mode surveys; the tailored design method. Hoboken: Wiley; 2014.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Pharmacy PracticeETSU Gatton College of PharmacyJohnson CityUSA
  2. 2.Department of Family MedicineETSU Quillen College of MedicineJohnson CityUSA
  3. 3.Rite-Aid PharmacyFancy GapUSA
  4. 4.Center for Health Equity Research and PromotionPittsburghUSA

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