Comparison of Substance Use Screeners in Assessing Prescription Drug Abuse and Other Illicit Drug Use among Pregnant Women

药物使用筛查仪在评估孕妇处方药滥用和其他非法药物使用方面的比较

• 批准号: 9193487
• 负责人: Victoria Hope Coleman-Cowger
• 金额: $ 50.42万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9193487
• 关键词: Admission activity; Adolescent; Adoption; Adult; Advisory Committees; Age; Alcohol or Other Drugs use; Alcohols; American; Amphetamines; Baltimore; Barbiturates; Benzodiazepines; Biochemical; Birth; Birth Order; Birth Weight; Buprenorphine; Centers for Disease Control and Prevention (U.S.); Child; Clinic; Cocaine; Collaborations; Computerized Medical Record; Congresses; Data; Discipline of obstetrics; Drug Exposure; Drug Prescriptions; Drug usage; Ensure; Gestational Age; Goals; Gold; Gynecologist; Hair; Head circumference; Health; Illicit Drugs; Incidence; Lead; Low Birth Weight Infant; Marijuana; Measures; Methadone; Methamphetamine; Minority; Mothers; National Institute of Drug Abuse; Neonatal Abstinence Syndrome; Neurologic; Opiates; Outcome; Oxycodone; Participant; Patients; Perception; Perinatal; Pharmaceutical Preparations; Phencyclidine; Population; Positioning Attribute; Preclinical Drug Evaluation; Pregnancy; Pregnancy Trimesters; Pregnant Women; Prenatal care; Prevalence; Preventive service; Primary Care Physician; Primary Health Care; Propoxyphene; Public Health; Qualitative Methods; Race; Recommendation; Reporting; Research; Research Design; Research Priority; Risk; Role; Schedule; Sensitivity and Specificity; Social Problems; Spontaneous abortion; Subgroup; Surveys; Testing; Third Pregnancy Trimester; Time; Tobacco; Tricyclic Antidepressive Agents; United States; Urine; Visit; Woman; Work; clinical practice; cost; disorder prevention; drug testing; evidence base; high risk; illicit drug use; innovation; insight; instrument; malformation; misuse of prescription only drugs; pregnant; pregnant teen; premature; prescription drug abuse; primary care setting; screening; stillbirth; tool; usability; young adult

Project Summary Over the last 3 decades, use of prescription drugs has increased by more than 60%, and prevalence of prescription drug use among pregnant women is currently estimated around 50%. Children born to women who abuse prescription medications are more likely to be born with neonatal abstinence syndrome, the incidence of which has doubled in the past 5 years. Recent national survey data show that the rate of current illicit drug use is 14.6% among pregnant adolescents, 8.6% among young adults, and 3.2% among adults. The first step in identifying both prescription drug abuse and illicit drug use during pregnancy is screening; however, no specific substance use screener has been recommended for use with pregnant women to identify illicit or prescription drug use. The proposed study will compare and validate three existing substance use screeners - 4 P’s Plus, NIDA Quick Screen/ASSIST, and the Substance Use Risk Profile-Pregnancy scale - among at least 500 pregnant women stratified by trimester of pregnancy presenting to two primary care clinics in Baltimore over 1 year. Specific aims are to: (1) conduct validity analyses to determine sensitivity, specificity, usability, and how each scale compares to the others and to the gold standard of urine and hair drug testing in identifying prescription and illicit drug use; (2) determine the impact of clinic population variables (age, race, trimester of pregnancy) on validity of the three substance use screeners; and (3) assess birth outcomes (birth weight, gestational age, head circumference, and NICU admissions) associated with the most widely used prescription drug and multi-drug exposure. The end goal of the study is to determine which screening tool(s) is most effective in identifying prescription drug abuse and illicit drug use among pregnant women so that evidence- based guidance may be offered to clinicians, utilizing biochemical drug testing as the gold standard to designate use and electronic medical records (EMR) as a supplement to identify prescribed drugs. Aim 3 was added to capture the important and relevant associations between the drug use and birth outcomes.

项目摘要 在过去的三十年中，使用处方药增加了60％以上，并且患病率的流行 目前，孕妇的处方药使用估计约为50％。妇女出生的孩子 滥用处方药更有可能出生于新生儿戒酒综合症，这是事件 在过去的5年中，这增加了一倍。最近的国家调查数据显示，当前非法药物使用率 怀孕青少年的14.6％，年轻人为8.6％，成年人为3.2％。第一步 在怀孕期间确定处方药滥用和非法药物使用是筛查；但是，没有具体的 建议使用筛选器与孕妇一起使用以识别非法或处方 吸毒。拟议的研究将比较并验证三个现有的物质使用筛查器-4 p的Plus， NIDA快速屏幕/辅助以及物质使用风险概况孕量表 - 至少500 孕妇按怀孕的三个月分层，向巴尔的摩的两个初级保健诊所提出1 年。具体目的是：（1）进行有效性分析以确定灵敏度，特异性，可用性以及如何 每个量表都与其他量表以及尿液和头发药物测试的黄金标准进行比较 处方和非法吸毒； （2）确定临床人口变量的影响（年龄，种族，三个月 怀孕）关于三种物质使用筛选器的有效性； （3）评估出生结果（出生体重， 与最广泛的处方相关的胎龄，头圈和NICU入院 药物和多药暴露。该研究的最终目标是确定哪种筛选工具最多 有效地确定孕妇中处方药滥用和非法药物使用，以便证据 - 可以使用生化药物测试作为黄金标准的临床医生提供基于的指导 指定使用和电子病历（EMR）作为识别规定药物的补充。 AIM 3是 添加以捕获药物使用和出生结果之间的重要和相关关联。