Photo Credit: Herjua

The following is a summary of “Pediatric primary care of children with intrauterine opioid exposure: survey of academic teaching practices,” published in the June 2024 issue of Pediatrics by Rohde et al.

Intrauterine opioid exposure (IOE) has surged over the past two decades, resulting in heightened needs for affected children post-birth. No clinical guidelines exist to address the primary care of children with IOE. This study aims to characterize clinician-reported screening and referral practices, identify barriers to effective primary care for these children, and explore clinician- and practice-level characteristics associated with these perceived barriers.

A cross-sectional survey was conducted from April to June 2022, targeting pediatric residents, pediatricians, and advanced practitioners at 28 primary care clinics affiliated with seven pediatric residency programs. The survey assessed screening practices, clinical approaches related to IOE, and perceived barriers to addressing parental opioid use disorder (OUD). Descriptive statistics were employed to analyze survey responses, and a two-stage cluster analysis was used to identify response patterns and the distribution of reported barriers.

Out of 1,004 clinicians invited to participate, 329 (32.8%) responded, with 325 pediatric residents and pediatricians included in the final analysis. While nearly all respondents (99.3%) acknowledged the importance of screening for parental substance use, only 11.6% reported doing so routinely. Approximately half of the respondents routinely refer children with IOE to early intervention services and social work. The most frequently cited barrier to addressing parental OUD was the lack of standard substance use screening protocols. Clinicians who reported fewer barriers to addressing parental OUD were more likely to have access to OUD treatment programs and home visiting programs.

There is significant variability in primary care screenings and referral practices for children with IOE among pediatricians. Enhanced access to parental OUD treatment programs alleviates some of the perceived barriers to addressing parental OUD in pediatric settings. Developing and implementing standardized guidelines for the primary care of children with IOE may improve outcomes and provide more consistent care.

Source: sciencedirect.com/science/article/abs/pii/S1876285924002171