Clinician perspectives on the postpartum pain experience and attitudes about pain management

临床医生对产后疼痛经历的看法以及对疼痛管理的态度

基本信息

批准号：
10643626
负责人：
Nevert Badreldin
金额：
$ 16万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-20 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10643626
关键词：
Address Adoption Age Area Attitude Belief Birth Clinical Consolidated Framework for Implementation Research Data Development Discipline of obstetrics Emergency Situation Ethnic Origin Evaluation Focus Groups Foundations Frequencies Frustration Funding Goals Gynecology Healthcare Hospitalization Hospitals Individual Inpatients Intervention Interview Investigation Judgment Life Low income Midwife Minority Minority Groups Minority Women National Institute of Child Health and Human Development Not Hispanic or Latino Nurses Opioid Outcome Outpatients Pain Pain management Patients Physicians Policies Population Postpartum Period Private Practice Professional Organizations Provider Race Reporting Research Research Infrastructure Strategic Planning System United States United States National Institutes of Health Universities Variant Woman Work aged care outcomes disparity reduction experience future implementation health care disparity high risk implementation science improved motherhood obstetric care opioid epidemic opioid exposure opioid misuse opioid overuse opioid use postpartum care postpartum health preference prescription opioid prospective provider factors randomized trial reproductive treatment disparity

项目摘要

PROJECT SUMMARY Opioid misuse has been declared a national emergency in the United States. More than half of hospitalized patients receive an opioid during their hospitalization. As birth is the most common reason for hospitalization, reproductive-aged individuals are particularly vulnerable to opioid exposure and are an important population for addressing the opioid epidemic. Indeed, our data have demonstrated the high frequency of postpartum inpatient and outpatient opioid use, the wide variation in postpartum pain management, the lack of alignment of opioid prescribing with patient reports of pain, and the contributions of obstetric clinicians to opioid prescribing. The opioid epidemic has a differential impact by race/ethnicity; individuals of minority race/ethnicity are less likely to receive an opioid for pain management than non-Hispanic White individuals. Notably, our data show that, despite reporting higher levels of pain postpartum, minority race/ethnicity birthing individuals receive less opioid treatment as inpatients and are less frequently prescribed an opioid upon hospital discharge. A complete understanding and, ultimately improvement, of these experiences and reduction in disparities requires a deeper delve into influences which guide clinicians in their management of postpartum pain. This proposal aims to fill an unmet need for a systematic, in-depth, and unbiased evaluation of obstetric clinicians’ experience of postpartum pain management. We propose a prospective qualitative study of obstetric clinicians, examining factors which influence their approach to postpartum pain management, biases which may contribute to disparities, and their perspectives and preferences of interventions to reduce opioids and improve pain control. We will conduct in-depth focus groups of up to 50 obstetric clinicians, including physicians, advanced practitioners, and nurses. Aim 1 will evaluate beliefs and factors which influence clinicians’ management of postpartum pain, including potential clinician-level biases which may contribute to disparities. Using the Consolidated Framework for Implementation Science, Aim 2 will evaluate clinicians’ perspectives and preferences of interventions to reducing postpartum opioid prescribing and improving pain control, in order to optimize the implementation of future interventions. Optimizing postpartum health, reducing opioid overuse, and reducing disparities in care and outcomes are critical goals of major professional societies and the NICHD 2020 strategic plan. In combination with patient-focused research on postpartum pain management (3R01HD098178-02S1), this work aims to create an essential foundation from which to develop and implement effective and equitable interventions to optimize postpartum opioid prescribing and pain management.

项目摘要阿片类药物滥用已被宣布为美国的一半以上。患者在住院期间接受阿片类药物。生殖时代的个体特别容易受到阿片类药物的扩张和重要人群的影响解决阿片类药物的流行状况。和门诊阿片类药物的使用，产后疼痛管理的广泛变化，阿片类药物的比对不足与患者有关疼痛的报告以及产科临床医生对阿片类药物处方药的贡献。阿片类药物流行对种族/种族的影响很大；为了接受阿片类药物的疼痛管理，比非西班牙裔白人著名。尽管报告产后疼痛程度较高，但少数族裔种族/种族分娩者会接受阿片类药物治疗作为住院医师，并且在出院时不常见阿片类药物理解和最终的改进，对差异的经验和修改需要更深入探究影响临床医生对产后疼痛进行管理的影响。该建议旨在满足系统的深入需求临床医生的产后疼痛管理经验。产科临床医生，检查影响其方法tostpartum疼痛管理的因素，偏见这可能有助于差异，以及它们的观点和干预措施减少阿片类药物的偏好并改善疼痛控制医师，高级从业者和护士1将评估影响的信念和因素临床医生对产后疼痛的管理，包括可能促成的潜在临床医生级偏见。差异。干预措施的观点和偏好，以减少产后阿片类药物预先预设和改进疼痛控制，以优化未来干预的实施。优化产后健康，减少阿片类药物过度使用以及减少护理和结果的差异是至关重要的主要专业社会的目标和NICHD 2020战略计划。对产后疼痛管理的研究（3R01HD098178-02S1），这项工作旨在创建必需品从中开发和不合适的干预措施以优化产后的基础阿片类药物处方和疼痛管理。