This month, the University of Kentucky received $4.9 million to expand its program that helps pregnant women with substance abuse disorders in rural Kentucky.
The three-year-old program, called PATHways, gives specialized care, including therapy and education on how to to lessen neonatal abstinence syndrome when participants' babies are born. It’s been pretty successful. Seventy-seven percent of participating pregnant women test negative for drugs when they go into labor, and for every treatment session women are up to 18 percent more likely to have a negative urine test for drugs at a follow-up appointment.
PATHways Medical Director Agatha Critchfield has long wanted to expand the program to women who live too far from Lexington to be part of the UK program.
“Women in the community are getting substance abuse care to a certain extent, [but] not like what we’re giving at PATHways. They might get their MAT [medication-assisted therapy] at one provider, but they might get their counseling somewhere else,” Critchfield said. “They’re certainly not going to get the sub-specialized prenatal care, like no one’s going to teach them infant massage or NAS [neonatal abstinence syndrome] reduction techniques.”
That’s where the money from the nonprofit Patient-Centered Outcomes Research Institute comes in. An estimated 1,700 women will be part of the trial. And while UK expands PATHways, the university is also trying to figure out which method gets the best results.
One half of the participating pregnant women will get care via telemedicine – connecting with providers via a computer monitor at their local health clinic. The other half will get similar help, but in-person.
At the end of five years, Critchfield and her team will analyze which method had the best outcomes. The goal, eventually, is to keep the program going, in whatever form, even after the trial ends.
The program offers medication-assisted treatment, education for pregnant moms to reduce neonatal abstinence syndrome, peer support and postnatal health care for the moms and their babies. More than 200 women have been treated by the program in Lexington since its start in 2014.
“We’re looking to see how babies do, how moms do, and we’ll pick back up and say, O.K., this PATHways curriculum is better to deliver in the community via telemedicine, or better to deliver by local group nurse-led care," Critchfield said. "And then from there, we’ll continue it in whatever way is better.”
