Reproductive-Age Women's Experience of Accessing Treatment for Opioid Use Disorder: “We Don't Do That Here”

Julia C. Phillippi, Rebecca Schulte, Kemberlee Bonnet, David D. Schlundt, William O. Cooper, Peter R. Martin, Katy B. Kozhimannil, Stephen W. Patrick

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: For reproductive-age women, medications for opioid use disorder (OUD) decrease risk of overdose death and improve outcomes but are underutilized. Our objective was to provide a qualitative description of reproductive-age women's experiences of seeking an appointment for medications for OUD. Methods: Trained female callers placed telephone calls to a representative sample of publicly listed opioid treatment clinics and buprenorphine providers in Florida, Kentucky, Massachusetts, Michigan, Missouri, North Carolina, Tennessee, Virginia, Washington, and West Virginia to obtain appointments to receive medication for OUD. Callers were randomly assigned to be pregnant or non-pregnant and have private or Medicaid-based insurance to assess differences in the experiences of access by these characteristics. The callers placed 28,651 uniquely randomized calls, 10,117 to buprenorphine-waivered prescribers and 754 to opioid treatment programs. Open-ended, qualitative data were obtained from the callers about the access experiences and were analyzed using a qualitative, iterative inductive-deductive approach. From all 28,651 total calls, there were 17,970 unique free-text comments to the question “Please give an objective play-by-play of the description of what happened in this conversation.” Findings: Analysis demonstrated a common path to obtaining an appointment. Callers frequently experienced long hold times, multiple transfers, and difficult interactions. Clinic receptionists were often mentioned as facilitating or obstructing access. Pregnant callers and those with Medicaid noted more barriers. Obtaining an appointment was commonly difficult even for these persistent, trained callers. Conclusions: Interventions are needed to improve the experiences of reproductive-age women as they enter care for OUD, especially for pregnant women and those with Medicaid coverage.

Original languageEnglish (US)
Pages (from-to)455-461
Number of pages7
JournalWomen's Health Issues
Volume31
Issue number5
DOIs
StatePublished - Jun 7 2021

Bibliographical note

Funding Information:
Funding/Support: Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R01DA045729 (Patrick). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2021 Jacobs Institute of Women's Health

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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