Shared Decision-Making Tool for Treatment of Perinatal Opioid Use Disorder

Objective:

This study examined the proportion of pregnant women with opioid use disorder (OUD) who made a decision to continue or taper pharmacotherapy for the treatment of OUD after using a shared decision-making aid and determined whether the aid reflected the principles of the International Patient Decision Aid Standards (IPDAS).

Methods:

A shared decision-making aid was developed with the IPDAS instrument to assist pregnant women with OUD receiving care at an outpatient obstetrics clinic in their decision to continue or taper pharmacotherapy for the treatment of OUD. After using the aid, the women (N=22) completed an anonymous survey about the extent to which the aid adhered to IPDAS principles.

Results:

Eighty-two percent (22 of 27) of eligible participants agreed to take part in the study. After the shared decision-making process, 95% (21 of 22) reported choosing to either continue (64%, 14 of 22) or taper (36%, 8 of 22) pharmacotherapy for the treatment of OUD. Participants agreed that they were provided with sufficient information (96%, 21 of 22), outcome probabilities (91%, 20 of 22), and decisional guidance (86%–95% [19 and 21 of 22, respectively]) to make an informed decision. Further, women reported that their choice reflected their values and preferences (77%–91% [17 and 20 of 22, respectively]).

Conclusions:

This shared decision aid provides a tool for providers to use with pregnant women with OUD to ensure that patients make informed treatment decisions that reflect their individual preferences and values.