During pregnancy, pain relief is commonly administered, but there is a considerable risk of the highly addictive medicines becoming a problem of their own. Statistics suggest that less than 20% of pregnant women with opioid use disorder get treatment in the United States, with this lack of treatment linked to a range of poor outcomes for mother and child, including poor fetal growth, birth defects and preterm births.
New research from the Medical University of South Carolina explores how telehealth can be an effective way for doctors to reach women who might ordinarily suffer from poor coverage. The research saw around 100 women from four obestetricians’ offices examined to see if consultations via telehealth did as well as face-to-face consultations for opioid use disorder treatment.
The experiment saw all of the women see the doctor for the first appointment, which is mandated by law, but the study suggests that consultations conducted virtually had no real difference in the outcome of either mother or child. It’s a finding that the researchers believe has important implications for the delivery of care and the availability of coverage.
“Integrated, collaborative care, where obstetricians and psychiatrists can work together, is the ideal model for treatment of pregnant women with opioid use disorder. It’s been really hard to create that model from a financial standpoint and because there aren’t a lot of people with expertise in this area,” the researchers say. “Being able to take the people who specialize in this area and maximize their reach to obstetric practices by telemedicine is just a really great way to get women lifesaving treatment for this chronic disease and reduce maternal opioid overdose deaths.”
A need to improve
Of course, not all obstetricians provide consultations virtually, but the paper highlights how it’s an increasingly available option. Indeed, the university itself is driving the change via its Center for Telehealth, which is one of only two Telehealth Centers of Excellence in the United States.
Treatment for opioid use disorder is typically done via a combination of medication and counseling. Drugs such as buprenorphine are used to reduce the craving, with the counseling then used to explore the circumstances that led to the addiction, and how behaviors can be changed. It’s a process that often needs to continue after the baby is born.
“A lot of women will start treatment in pregnancy and do really well. But then in the postpartum period, they are often without insurance and can’t afford to continue their treatment and relapse,” the researchers say. “Drug overdose is one of the leading causes of maternal mortality in the postpartum period.”
Telehealth isn’t a silver bullet on its own, but it could help to improve coverage, and as the research shows that outcomes are identical to in-person care, it’s an option that warrants exploring.
