BARRIERS TO RECOVERY AND THE ASSOCIATION BETWEEN SHARED DECISION-MAKING AND RETENTION IN CARE AMONG PERINATAL WOMEN WITH OPIOID USE DISORDER
Author(s)
Ruth Jeminiwa, PhD, Elizabeth Ford, PharmD candidate, Priyanka Sanghavi, PharmD candidate, Michaela Bell, PharmD candidate, Amber King, PharmD;
Thomas Jefferson University, Jefferson College of Pharmacy, Philadelphia, PA, USA
Thomas Jefferson University, Jefferson College of Pharmacy, Philadelphia, PA, USA
OBJECTIVES: There is limited understanding of how patient involvement in treatment decisions or shared decision-making (SDM) influences treatment retention among pregnant, recently miscarried, and postpartum women with opioid use disorder (PMPWOUD). This study aimed to (1) describe the barriers to treatment for PMPWOUD and (2) examine the association between SDM and treatment retention.
METHODS: A cross-sectional survey was administered to PMPWOUD who were currently pregnant, had given birth in the past 12 months, or had miscarried in the past 24 months. Eligible participants were identified through our institution’s electronic health record using ICD-10 codes for opioid-related disorders and pregnancy. Recruitment was conducted electronically via MyChart messages, emails, phone calls, and text messages. The survey captured self-reported duration of treatment retention in the past year (“12 months” vs “11 months or less”) and perceived involvement in treatment decisions or SDM (“very involved” vs “not very involved”). A multiple-response item elicited participants’ biggest challenges to staying in recovery. Descriptive statistics summarized participant characteristics, and chi-square test assessed the association between SDM and retention in care.
RESULTS: Of 198 participants, 48% reported continuous retention in the past year. Mental health issues (66.7%), financial stress (55.9%), and cravings (41.2%) were the most common challenges to staying in recovery, followed by stigma (37.3%), lack of support (33.9%), and childcare responsibilities (23.2%). SDM was significantly associated with treatment retention (χ² = 6.807, p = .009). Among participants reporting high involvement in SDM, 58.4% were continuously engaged in treatment compared to 39% among others. The odds of continuous engagement were 2.2 times higher for those very involved versus others (OR ≈ 2.20).
CONCLUSIONS: These findings highlight barriers to recovery and suggest that high involvement in shared decision-making may improve treatment continuity. Future interventions should prioritize patient involvement in treatment decisions and address identified barriers.
METHODS: A cross-sectional survey was administered to PMPWOUD who were currently pregnant, had given birth in the past 12 months, or had miscarried in the past 24 months. Eligible participants were identified through our institution’s electronic health record using ICD-10 codes for opioid-related disorders and pregnancy. Recruitment was conducted electronically via MyChart messages, emails, phone calls, and text messages. The survey captured self-reported duration of treatment retention in the past year (“12 months” vs “11 months or less”) and perceived involvement in treatment decisions or SDM (“very involved” vs “not very involved”). A multiple-response item elicited participants’ biggest challenges to staying in recovery. Descriptive statistics summarized participant characteristics, and chi-square test assessed the association between SDM and retention in care.
RESULTS: Of 198 participants, 48% reported continuous retention in the past year. Mental health issues (66.7%), financial stress (55.9%), and cravings (41.2%) were the most common challenges to staying in recovery, followed by stigma (37.3%), lack of support (33.9%), and childcare responsibilities (23.2%). SDM was significantly associated with treatment retention (χ² = 6.807, p = .009). Among participants reporting high involvement in SDM, 58.4% were continuously engaged in treatment compared to 39% among others. The odds of continuous engagement were 2.2 times higher for those very involved versus others (OR ≈ 2.20).
CONCLUSIONS: These findings highlight barriers to recovery and suggest that high involvement in shared decision-making may improve treatment continuity. Future interventions should prioritize patient involvement in treatment decisions and address identified barriers.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR7
Topic
Patient-Centered Research
Topic Subcategory
Patient Engagement