Treatment of Pregnant Women With OUD

Support Models for Addiction Related Treatment (SMART) Trial of Opioid Use Disorder OUD) in Pregnant Women

The investigators are testing two models of support for pregnant women with an opioid use disorder (OUD)

The investigators are proposing a cluster randomized clinical trial to compare the effectiveness of two models of support for reproductive health clinicians to provide care for pregnant and postpartum women with an OUD: 1) a collaborative care (CC) approach based upon the Massachusetts Office-Based-Opioid Treatment (OBOT) Model that would provide onsite training, and support to providers and participants through the use of care managers (CMs) vs 2) a telesupport approach modeled on the Project Extension for Community Healthcare Outcomes (ECHO), a remote education model that provides mentorship and guided practice and participation in a learning community, via video conferencing.

Inclusion Criteria:

• Provision of signed and dated informed consent form
• Females age 18 or older
• Documented pregnancy in the medical record at less than 34 weeks gestation
• Delivery date no later than July 1, 2024
• Willingness to adhere to the study schedule
• Confirmed opioid use disorder by the DSM-5 Opioid Use Disorder questionnaire
• Ability to communicate in English
• No current plan to move out of the obstetrical provider treatment area within the study timeframe of approximately 44 weeks

Exclusion Criteria:

• Experiencing cognitive or emotional impairment that precludes the participant from providing informed consent
• Current hospitalization, incarceration, or institutionalization (if women present for care after institutionalization, participation is possible
• Current court case pending that would make incarceration likely during the study treatment period (approximately 44 weeks)