After a 2020 study by Vanderbilt University Medical Center showed that women have difficulty accessing treatment for opioid use disorder (TUU), the researchers analyzed feedback received from study participants to provide more light on barriers to attention, which they included from long retention seasons. to difficult interactions with clinic receptionists during phone calls seeking an appointment.
A “secret shopper” study published in JAMA network open in 2020 they used trained actors trying to treat themselves opioid use disorder in 10 US states. More than 10,000 unique “patients” were randomly assigned to be pregnant or non-pregnant and have private or Medicaid-based insurance to assess differences in access experiences.
The results revealed many challenges when scheduling a first-time appointment to receive medication for the OUD, including finding a provider to take out insurance instead of cash. Access to treatment was even more difficult women who are pregnant and have TUU, with pregnant women 20% less likely to be accepted for treatment than non-pregnant women.
Trained actors provided nearly 18,000 comments describing what happened during calls and pregnant calls, and people with Medicaid documented the most important barriers to getting an appointment. The qualitative study is published in Women’s health problems.
“Even though these people who have trained did not actually have an opioid use disorder and even though they were not desperately trying to get help for themselves and their baby, they still felt stigmatized during those calls,” he say the author, principal, Julia Phillippi. D., CNM, Assistant Professor and Academic Director of the Nursing-Midwifery Program at Vanderbilt University School of Nursing School. “They often felt overwhelmed by the emotion because of how they treated them, both good and bad. That really says something.”
Many people who have called have had less than welcoming and often stigmatizing responses from the person answering the phone. A secret shopper reported that the receptionist said, “People don’t usually show up for appointments because they decide they want to have one last hoorah before they come.”
Callers were often put on hold or transferred repeatedly. One person who called commented, “The waiting time to talk to someone is crazy,” while another said, “I told them I was looking for a treatment for addiction and I was four months pregnant;
Not all interactions were negative. One person who called reported, “I would like to note that everyone I spoke to throughout the call, including the receptionist, was deeply empathetic, knowledgeable, and helpful.”
As the U.S. opioid crisis has grown, women have become increasingly affected. According to the National Center for Health Statistics, between 1999 and 2016 the rate of drug-related deaths among women rose from 3.9 to 13.4 per thousand.
Treatment that involves drugs for opioid use disorder (MOUD) is highly effective in reducing overdose death and improving quality of life. To pregnant woman, MOUD improves pregnancy outcomes, included premature birth.
“We are setting record levels of overdose deaths in the U.S., most likely worsened by the COVID-19 pandemic,” said Stephen Patrick, MD, director of the Child Health Policy Center at Vanderbilt University School of Medicine, professor associate of Pediatrics and Health Policy and neonatologist at the Vanderbilt University Medical Center. “We know that drugs to treat opioid disorder reduce the risk of overdose death for the mother and increase the likelihood that the birth will take place with a higher birth weight. We should facilitate access to treatment and certainly not be more difficult “.
The authors recommend interventions to improve access to UDO care for women of childbearing age, including increasing the number of clinics in the U.S. that provide MOUD regardless of pregnancy status and insurance; more training for people who take calls to the clinic; and addressing the issue at the national level through policy reform.
Julia C. Phillippi et al, Women of Reproductive Age Experience of Accessing Treatment for Opioid Disorder: “We Don’t Do It Here,” Women’s health problems (2021). DOI: 10.1016 / j.whi.2021.03.010
Vanderbilt University Medical Center
Citation: Secret Buyers Study Reveals Barriers to Opioid Treatment for Women (2021, June 3) Retrieved June 3, 2021 at https://medicalxpress.com/news/2021-06-secret -shopper-barriers-opioid-treatment.html
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