Access to Care in Florida for Pregnant Women with Opioid Use Disorder: Lessons from Parents in Recovery

Full Description: Opioid use disorder (OUD) has quadrupled in the United States over the last two decades. While the standard of care for pregnant and non-pregnant women with OUD includes medication-assisted treatment (MAT), there are several barriers to access to MAT, including stigma, insufficient training on clinical care for patients with OUD, exclusion of MAT from medical or psychiatric practices, inadequate coordination of systems of care, and legal, regulatory, and financial barriers. A secret shopper project was implemented in Florida to assess access to treatment for OUD and access to prenatal care for women undergoing MAT/ Feedback was elicited from patients, advocates, and stakeholders to advise on all stages of the project. This analysis focuses on the Parent Advisory Committee, comprised of parenting women in recovery who were recruited from multiple communities, treatment, support groups, and home visiting programs across Florida. Eight parents actively participated in 3-6 of the eight one-hour meetings held via Microsoft Teams, and two also completed individual interviews.

Throughout the project, committee members noted challenges specific to the access and quality care for MAT and to accessing prenatal care from their own experiences and reflections on the past. These include a low number of providers who accept Medicaid, a lack of communication between obstetricians and MAT providers, treatment centers only accepting cash payments, inadequate counseling services, unsafe environments surrounding MAT clinics, and a stigma from healthcare providers and community partners regarding OUD and MAT. Committee members also noted a dire need for an easily accessible, accurate, and comprehensive list of MAT providers and OB providers who care for MAT patients in Florida. Health insurance and care needs to be affordable, with patient advocates to help navigate systems.
To shape the future of MAT treatment for women and pregnant parents, committee members recommend increasing the number of prenatal care providers who accept Medicaid, improving communication between OBs and MAT providers, and increasing peer and family integration into advisory calls, presentations of studies, and educational forums in order to raise awareness and improve access to and quality of care. To reduce stigma, they also recommend education throughout the community and integration of training for providers, receptionists, and other healthcare providers to help reduce judgment and increase empathy, understanding, and information gathering (asking questions in a sensitive way). This study aims to provide the community members and programs, and healthcare providers with a deeper understanding of the challenges and barriers recovering parents face when trying to access MAT, with the goal of providing more appropriate, patient-centered care that is easily accessible.

Abbreviated Description: A secret shopper project was developed to measure and understand the barriers and access to treatment for Opioid Use Disorder (OUD) in Florida, access to prenatal care for parents undergoing Medicated Assisted Treatment (MAT) for OUD, and establish a community advisory group to advise researchers on all stages of the project. This analysis focuses on this Parent Advisory Committee, which shared their experiences and reflections while recommending future directions for MAT treatment for women and pregnant parents. The committee identified several needs, most notably the need for increased awareness among communities and healthcare providers through training and community education initiatives, increased providers accepting Medicaid and improved communication between OBs and MAT providers.

For more information, please contact Saloni Mehra at mehras@usf.edu.