Breaking News
December 19, 2018 - Researchers uncover genes that play a key role in the inactivation of X chromosomes
December 19, 2018 - The case for the federal minister of health to recall them
December 19, 2018 - Regular theatre and cinema visits keeps depression away in seniors finds study
December 19, 2018 - Personalization techniques give a new lease of life to anticancer vaccines
December 19, 2018 - Research opens door to development of drug or vaccine for late-onset Alzheimer’s
December 19, 2018 - Single workout can boost metabolism for days
December 19, 2018 - UI study leads to better understanding of signaling capacity between neurons
December 19, 2018 - Gut microbiome plays role in immune system regulation, study finds
December 19, 2018 - How MAPK translocation leads to drug resistance in melanoma
December 19, 2018 - Increasing prevalence of antibiotic resistance in the U.S. linked with occasional use
December 19, 2018 - Mind-body exercises may improve cognition in older adults
December 19, 2018 - Hepatitis C drug can eliminate chikungunya, yellow fever virus
December 19, 2018 - Separating male and female mice changes the way they smell, shows study
December 19, 2018 - FDA Approves Genentech’s Tecentriq in Combination With Avastin and Chemotherapy for the Initial Treatment of Metastatic Non-Squamous Non-Small Cell Lung Cancer
December 19, 2018 - Mediterranean Diet for Osteoarthritis | About OA
December 19, 2018 - Successful bladder repair using silk fibroid scaffolds
December 19, 2018 - Quidel receives CE mark to use Sofia 2 Lyme+ Fluorescent Immunoassay with Sofia 2 analyzer
December 19, 2018 - Horizon Discovery partners with C4XD to validate novel synthetic lethal oncology targets
December 19, 2018 - Research suggests a promising therapeutic target to treat or prevent metabolic disorders
December 19, 2018 - Split liver transplants could save children on wait list finds study
December 19, 2018 - Michigan-based food manufacturer ordered to discontinue operations after recurrent food safety violations
December 19, 2018 - HPV discovery could lead to new treatments for cervical cancer
December 19, 2018 - Real-time neurofeedback controls Parkinson’s brainwaves
December 19, 2018 - Incorrect prescribing warnings in electronic prescribing systems
December 19, 2018 - New $1.6 million NIH grant supports study on a gene vital to circadian rhythms
December 19, 2018 - Racial Disparities Seen Among Teens Undergoing Flu Vaccination
December 19, 2018 - To resolve inflammation, location matters
December 19, 2018 - Dancing could help older women to perform their daily tasks
December 19, 2018 - Research identifies new therapeutic target for cancer treatment and tissue regeneration
December 19, 2018 - Energy costs, social isolation contribute to health risk of older adults in extreme weather
December 19, 2018 - Potential combination therapy against rare disease of the bone marrow could improve treatment
December 19, 2018 - Researchers aim to improve cognition, reverse weight gain in schizophrenia
December 19, 2018 - UC San Diego Health offers new DRG stimulation device for phantom limb pain
December 19, 2018 - Study examines relationship between growth restriction and risk of childhood mortality
December 19, 2018 - New study provides insights on increased risk of suicide in young patients visiting ED
December 19, 2018 - AHA: Thyroid Problems Linked to Worsening Heart Failure
December 19, 2018 - World-first coeliac disease vaccine enters Phase 2 trials
December 19, 2018 - RNA sequencing offers novel insights into the microbiome
December 19, 2018 - A promising, effective vaccine for common respiratory disease
December 19, 2018 - Protein may slow progression of emphysema, study finds
December 19, 2018 - Studying atrial fibrillation — and exploring new frontiers in precision health
December 19, 2018 - A New Way To Get College Students Through A Psychiatric Crisis — And Back To School
December 19, 2018 - Optum, UnitedHealthcare take action to help people affected by North Carolina winter storms
December 18, 2018 - Weight change in middle-aged, elderly Chinese Singaporeans related to increased risk of death
December 18, 2018 - Immune cells sacrifice themselves to protect us from invading bacteria
December 18, 2018 - Watching brain cells fire, with a twist of gravitational waves
December 18, 2018 - 2018 in Review
December 18, 2018 - Getting the Most Out of the CLARITY Technique
December 18, 2018 - NVF shoes provide a viable option for track and road racing
December 18, 2018 - CRISPR may restore effectiveness of chemotherapies used to treat lung cancer
December 18, 2018 - New app accurately measures and charts progression of skin wounds
December 18, 2018 - Persistent Discrimination ID’d Among Physician Mothers
December 18, 2018 - Cellphone technology developed to detect HIV
December 18, 2018 - A Stanford doctor hits the field with the 49ers — as their airway management physician
December 18, 2018 - The Rise of Anxiety Baking
December 18, 2018 - Just one night of sleep deprivation increases the urge to eat
December 18, 2018 - Study reveals mechanism behind failed remyelination in MS
December 18, 2018 - New genetic testing method increases the precision of biomarker analysis
December 18, 2018 - Simple technique to effectively treat underdiagnosed cause of debilitating chest pain
December 18, 2018 - Barbershop-based medical intervention can successfully lower blood pressure, new data shows
December 18, 2018 - Food labels have caused changes in consumers’ intake and industry’s use of key additives
December 18, 2018 - Sickest children could benefit from split liver transplants
December 18, 2018 - Scientists create patient-specific model to identify most effective treatment for appendix cancer
December 18, 2018 - ‘Little Foot’ endocast reveals a small brain combining ape-like and human-like features
December 18, 2018 - New therapy for childhood blindness shows ‘very promising’ results
December 18, 2018 - Researchers discover promising new compound against Buruli ulcer
December 18, 2018 - Study finds significant use of traditional, complementary and alternative medicines in Sub-Saharan Africa
December 18, 2018 - California Farm Implicated in Outbreak of E. coli Tied to Romaine Lettuce
December 18, 2018 - Mobile health has power to transform HIV/AIDS nursing
December 18, 2018 - Celiac Vaccine in Clinical Trials at Columbia
December 18, 2018 - Research into mental health first aid prompts practical guidance and resources for workplace
December 18, 2018 - Researcher conducts study to investigate peripheral blood markers of Alzheimer’s disease
December 18, 2018 - Researchers identify link between mucus in the small airways and pulmonary fibrosis
December 18, 2018 - EU Commission’s Health Policy Platform to host EKHA program on transplantation
December 18, 2018 - Survivors of childhood Hodgkin lymphoma have high risk of developing solid tumors
December 18, 2018 - Small changes to cafeteria design can get kids to eat healthier, new assessment tool finds
December 18, 2018 - From Machines to Cyclic Compounds
December 18, 2018 - New study reveals best assessment tools to establish delirium severity
December 18, 2018 - Rice University scientists develop synthetic protein switches to control electron flow
December 18, 2018 - Home-based pulmonary function monitoring for teens with Duchenne muscular dystrophy
Effective management of neonatal abstinence syndrome requires coordinated ‘cascade of care’

Effective management of neonatal abstinence syndrome requires coordinated ‘cascade of care’

image_pdfDownload PDFimage_print

Effective management of neonatal abstinence syndrome (NAS) – withdrawal symptoms occurring in infants exposed to opioids in utero – requires a coordinated “cascade of care” from prevention through long-term follow-up, reports a study in Advances in Neonatal Care, official journal of the National Association of Neonatal Nurses. The journal is published in the Lippincott portfolio by Wolters Kluwer.

Based on interviews with frontline providers caring for infants affected by NAS, the researchers identify four essential areas to improve care for this increasingly common complication of opioid use. “Greater resources, coordination, and cross-disciplinary education are urgently needed across the cascade of care to effectively address NAS,” write Jennifer L. Syvertsen, PhD, MPH, of the University of California, Riverside and colleagues at the University of Southern California.

Critical Areas to Improve Care for Infants Exposed to Opioids Neonatal abstinence syndrome (NAS) can result from legally prescribed opioid medications, misuse of prescription opioids, illicit drugs such as heroin, or medication-assisted therapy to treat opioid use disorders, including Suboxone or methadone. Infants exposed to any of these forms of opioids during gestation are at risk of NAS, developing signs and symptoms of opioid withdrawal after birth. Timely and effective care can lower the impact and costs of NAS. However, standardized care and treatment resources are often lacking, both for women and their infants affected by NAS.

The researchers conducted in-depth interviews with 18 central Ohio healthcare providers caring for infants and families affected by NAS. Ohio has among the highest rates of opioid use and NAS in the United States. In 2015, nearly 2,200 infants were hospitalized for NAS, at a cost of over $133 million. “Rather than an acute diagnosis, we propose that NAS is better conceptualized as cascade of care – and there is a need to better coordinate and provide care at each stage of the cascade,” Dr. Syvertsen and coauthors write. Informed by analysis of the provider interviews, the researchers discuss four interrelated components of the cascade of care:

  • Prevention. Care begins with preventing the misuse of opioids and other drugs. Preventive efforts should encompass the “social determinants of health” such as poverty, lack of education, and limited opportunities. “Although there is an urgent need for prevention programming and drug treatment, current resources do not meet the demand,” the researchers write.
  • Prenatal Care and Drug Treatment. The providers stressed the need for supportive care for pregnant women using opioids, rather than punitive approaches. While comprehensive care programs have yielded promising results, NAS can occur even in infants born to mothers receiving recommended medication-assisted treatment for opioid use disorder. “Barriers in communication and a shortage of integrative prenatal programs to address opioid use in pregnancy often leave women confused and frustrated about a subsequent NAS diagnosis at the hospital,” Dr. Syvertsen and colleagues write.
  • Labor and Delivery. Infants must be monitored for signs of NAS, with treatment if needed; providers stressed that consistency in following protocols is critical to reducing infant length of stay in the hospital. Programs to sensitize staff and mitigate stereotyping attitudes toward the mothers of babies with NAS have led to better care. In rural areas, the infant has to be transported to a higher-level newborn intensive care unit, creating barriers to mother-infant bonding.
  • Aftercare. Supportive aftercare includes access to drug treatment and social services, monitoring the child’s development, and providing a healthy home environment for the infant to thrive. The providers cited variations in policies and procedures, noting that available resources are stretched to the limit. While services are available for pregnant women, all too often they “shut down” after delivery.

“Our current focus on the period of pregnancy alone is insufficient to address the complexity of NAS,” Dr. Syvertsen and colleagues write. Their article provides examples of interview quotes illustrating each of the four elements of the cascade of care and important subthemes.

Dr. Syvertsen and coauthors highlight the need for programs and policy at each stage of the cascade, toward the critical goal of stemming the tide of NAS. They conclude: “Unless we make a serious political commitment to create fair drug policy, adapt a more integrative approach to addressing NAS, and adequately support the initiatives that we know can work, NAS incidence will continue to rise and devastate communities.”

Source:

https://wolterskluwer.com/

Tagged with:

About author

Related Articles