New research shows that shared-decision making methods for women with opioid-use disorders (OUD) help them make informed treatment decisions that reflect their preferences and personal values.
Hendreé Jones, PhD, professor of obstetrics and gynecology at the UNC Department of Obstetrics and Gynecology, is co-author of the paper, “Shared Decision-Making Tool for Treatment of Perinatal Opioid Use Disorder,” that was published recently in Psychiatry Online. Jones is also executive director of the UNC Horizons Program, a substance-use disorder treatment program for pregnant and parenting women and their families.
In the development of their study, the team used the IPDAS Instrument (IPDASi), which covers six areas that can guide decision-making — information, probabilities, values, decision guidance, evidence and disclosure. They used this framework to create an aid that would facilitate a conversation to help pregnant women with OUD make informed choices about whether they would choose to continue or taper methadone or buprenorphine during pregnancy. The aid summarizes treatment choices, known impact of the substances on both mother and baby, as well as the benefits and risks of tapering methadone or buprenorphine treatment during their pregnancy. Individual assessments, such as likelihood of relapse with illicit drugs if they decide to taper, as well as their personal feelings and desires about treatment, were designed to help the provider and patient discuss the pros and cons of tapering methadone or buprenorphine together.
According to a survey filled out by participants after the process, 95 percent of the women reported being clear about their choices to either continue or taper buprenorphine or methadone. Participants said the process provided them with sufficient medical information they could understand, as well as risks or benefits, about their treatment choices. A majority of the participants also agreed that their resulting choice reflected their personal values.
Such shared-decision making empowers women with OUD to make informed, evidence-based decisions they can feel more confident about making.
“Having an evidence-based tool to guide conversations to help patients and providers make decisions about treatments that will work best for each pregnant patient is a method that empowers and engages patients in their treatment and holds promise for helping women remain drug-free, deliver safely and have a healthy baby,” says Jones.