The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70860

Mary Anne Armstrong, MA¹, Veronica M. Gonzales, BS¹, Leslie Lieberman, MSW², Bruce F. Folck¹, and Gabriel J. Escobar, MD¹. (1) Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, (510) 891-3501, Maryanne.Armstrong@kp.org, (2) Patient Care Services, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612

The purpose of this study was to evaluate Early Start (ES), an obstetric clinic-based perinatal substance abuse treatment program in a Managed Care Organization, in terms of substance use post treatment. From a cohort of 6,774 women who delivered babies 07/01/95-06/30/98 and completed substance use screening questionnaires, we identified 3 groups of women: (1) screened, assessed and treated by ES (SAT, N=139), (2) screened and assessed with no follow-up treatment (SA, N=131), and (3) positive urine toxicology screens but no ES intervention (S, N=111). Medical record review obtained provider notations of alcohol and drug use during the year before and the year after pregnancy. Our hypotheses were that, compared to the women in the other 2 groups, during the post-pregnancy year, the women in the SAT group would decrease their substance use and be asked about their substance use more. We found that there were no substance abuse notations in the majority of charts (68%) and that the notations included quantity and frequency only 3% of the time. For each of the 11 substances, there were no statistical differences among the 3 groups on the % without notations post-pregnancy. For example, 60% of the SAT group, 68% of the SA group and 66% of the S group had no alcohol notations (p-value=0.42). These results suggest that providers are not routinely asking women identified as substance users during pregnancy about substance use in the year after delivery. Alternative methods of obtaining this critical information, such as interviews, should be attempted.

Learning Objectives:

• At the conclusion of the session, the participant will have learned about the evaluation of a perinatal substance abuse treatment program in terms of post-partum substance use and will recognize the value of asking about and documenting substance use at clinic visits.

Keywords: Substance Abuse Treatment, Maternal Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.