MUSC Study Shows Telehealth Can Help Treat Pregnant Women With OUD

A telehealth platform offering substance abuse treatment to pregnant women is just as effective as in-person care, according to a recent study.

In a study published in JAMA Psychiatry, researchers at the Medical University of South Carolina (MUSC), one of two federal Telehealth Centers of Excellence, reported “no statistically different differences” in retention rates or clinical outcomes between the connected health platform and traditional care at an clinic or doctor’s office.

The difference, those researchers said, is in access to those services. And at a time when the number of pregnant women dealing with opioid use disorder (OUD) has more than quadrupled and the number of infants born with neonatal abstinence syndrome (NAS) has more than quintupled over the past two decades, care providers need to make those services easier to reach.

“Although integrated obstetric and addiction care is associated with improvements in maternal and newborn health, it can be difficult to achieve, particularly in rural areas, and nationally there remains a dearth of treatment programs for pregnant women with substance use disorders,” the study, led by Constance Guille, MD, MSCR, of MUSC’s psychiatry and behavioral sciences department.

Guille and her colleagues said pharmacotherapy is part of the treatment protocol, yet few women receive that treatment, often because they can’t afford it or can’t find a care provider in their area.

“Telemedicine is a tool to expand the reach of addiction specialists and integrate addiction treatment into obstetric care,” they wrote. “However, legislation originally intended to prevent the prescribing of controlled substances via the internet has hindered progress in the use of telemedicine for the treatment of OUD nationally due to an in-person visit requirement.”

With legislation pending that would enable providers to prescribe controlled substances more easily through a telemedicine platform, and with several health systems testing programs that integrate telehealth with substance abuse treatment for mothers-to-be, Guille and her colleagues launched the study to determine whether such a platform would be effective.

They recruited almost 100 patients at MUSC’s Women’s Reproductive Behavioral Health Program and split them into two groups, offering one group telehealth care and the other traditional care. At the end of the study, they found pretty much the same levels of retention in both groups, both during pregnancy and six to eight weeks after giving birth.

In addition, no “significant differences” were found in the number of infants both with NAS in both groups, the number of days those infants spent in the hospital after birth, or in the percentage of women recording positive urine drug screen results.

“Our findings suggest that telemedicine may be one potential solution to integrating addiction treatment into obstetric care, which is especially important for women living in rural area,” Guille and her colleagues wrote.

“Beyond providing increased access to treatment for OUD, our study suggests that telemedicine can be used to create an integrated model of care,” they added. “Integrated care that includes obstetric and addiction clinicians who communicate and coordinate a woman’s care in (one) location have demonstrated an increase in treatment retention, improved maternal and newborn outcomes, and cost-effectiveness.”

Guille and her colleagues said integrated care programs also see higher retention rates than non-integrated care pathways, which in turn translates to a reduction in substance abuse (including tobacco), an increase in employment, better income, reduced chances of criminal behavior, reduced incidences of depression and more positive parenting attitudes. In addition, the babies are born healthier.

“Our study suggests that telemedicine can be used to create integrated prenatal and addiction care that has the potential to improve maternal and newborn health,” they concluded.