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Contraceptive Utilization and Downstream Feto-Maternal Outcomes for Women with Substance Use Disorders: A Dissertation

eScholarship@UMMS - Wed, 08/17/2016 - 8:27am

Background: One in ten people in the U.S. are affected by a substance use disorder (SUD), roughly one third of whom are women. Rates of unintended pregnancy are higher in this population than in the general public. Little is understood about how women with SUD use prescription contraception and think about pregnancy.

Methods: By analyzing Medicaid claims data and conducting qualitative interviews with women with SUD, this doctoral thesis seeks to: 1) compare any use of and consistent, continued coverage by prescription contraceptives between women with and without SUD; 2) determine the extent to which SUD is associated with pregnancy, abortion, and adverse feto-maternal outcomes in women who use prescription contraception; and 3) explore facilitators of and barriers to contraceptive utilization by women with SUD, using qualitative interviews.

Results: Compared to women without SUD, women with SUD are less likely to use any prescription contraceptive, particularly long-acting reversible methods. Among women who do use long-acting methods, SUD is associated with less continued, consistent coverage by a prescription contraceptive. Among women who use contraception, SUD is also associated with increased odds of abortion. When interviewed, women with SUD report fatalistic attitudes towards pregnancy planning, and have difficulty conceptualizing how susceptibility to pregnancy may change over time. Women with SUD also report that pregnancy has substantial impact on their drug treatment prospects.

Conclusions: This study is the first to examine contraceptive utilization by women with SUD who are enrolled in Medicaid or state-subsidized insurance. Our study may help to inform clinical practice and policy development to improve the reproductive health and wellbeing of women with SUD.

Chemists to get their own preprint server

news@nature - Wed, 08/17/2016 - 4:21am

World’s largest scientific society plans to introduce ChemRxiv for a traditionally reluctant discipline.

Nature News doi: 10.1038/nature.2016.20409

Near-blind shark is world’s longest-lived vertebrate

news@nature - Wed, 08/17/2016 - 4:21am

Greenland shark found to be at least 272 years old.

Nature News doi: 10.1038/nature.2016.20406

Nobel laureate’s death highlights struggles at Egyptian science hub

news@nature - Wed, 08/17/2016 - 4:21am

Cash-strapped Zewail City of Science and Technology is the legacy of Arab chemist Ahmed Zewail.

Nature 536 260 doi: 10.1038/nature.2016.20408

The week in science: 5–11 August 2016

news@nature - Wed, 08/17/2016 - 2:21am

Iranian nuclear scientist executed; Turkey suspends research-agency staff; and private company granted permission to go to the Moon.

Nature 536 130 doi: 10.1038/536130a

FDA Advisors: Over-the-Counter Tests for STIs Offer Benefits

Headlines from MedPage Today® - Tue, 08/16/2016 - 7:01pm
(MedPage Today) -- But panelists question value of OTC flu testing

FDA Advisors: Over-the-Counter Tests for STIs Offer Benefits

Headlines from MedPage Today® - Tue, 08/16/2016 - 7:01pm
(MedPage Today) -- But panelists question value of OTC flu testing

Improving Medication Adherence: ConsultantLive & Rheumatology Network

Headlines from MedPage Today® - Tue, 08/16/2016 - 6:30pm
(MedPage Today) -- Also, how important are hypertension goals?

Improving Medication Adherence: ConsultantLive & Rheumatology Network

Headlines from MedPage Today® - Tue, 08/16/2016 - 6:30pm
(MedPage Today) -- Also, how important are hypertension goals?

Guideline Supports 2-mm Margins for DCIS (CME/CE)

Headlines from MedPage Today® - Tue, 08/16/2016 - 5:54pm
(MedPage Today) -- Wider not better at reducing recurrence risk

Guideline Supports 2-mm Margins for DCIS (CME/CE)

Headlines from MedPage Today® - Tue, 08/16/2016 - 5:54pm
(MedPage Today) -- Wider not better at reducing recurrence risk

PDUFA Again: Still Trying to Get It Right

Headlines from MedPage Today® - Tue, 08/16/2016 - 5:35pm
(MedPage Today) -- FDA juggles staffing problems with public concerns

PDUFA Again: Still Trying to Get It Right

Headlines from MedPage Today® - Tue, 08/16/2016 - 5:35pm
(MedPage Today) -- FDA juggles staffing problems with public concerns

The Plight of the Emergency Physician

Headlines from MedPage Today® - Tue, 08/16/2016 - 5:00pm
(MedPage Today) -- Remember that you are not alone, says Edwin Leap, MD

The Plight of the Emergency Physician

Headlines from MedPage Today® - Tue, 08/16/2016 - 5:00pm
(MedPage Today) -- Remember that you are not alone, says Edwin Leap, MD

Plavix Smoker's Paradox Debunked? (CME/CE)

Headlines from MedPage Today® - Tue, 08/16/2016 - 4:30pm
(MedPage Today) -- Hemoglobin confounds platelet level readings, study suggests

Plavix Smoker's Paradox Debunked? (CME/CE)

Headlines from MedPage Today® - Tue, 08/16/2016 - 4:30pm
(MedPage Today) -- Hemoglobin confounds platelet level readings, study suggests

Angina Often Under-Recognized in Stable CAD

Headlines from MedPage Today® - Tue, 08/16/2016 - 4:00pm
(MedPage Today) -- Clinicians' lower ratings of frequency could spell undertreatment

Angina Often Under-Recognized in Stable CAD

Headlines from MedPage Today® - Tue, 08/16/2016 - 4:00pm
(MedPage Today) -- Clinicians' lower ratings of frequency could spell undertreatment

Pelzman's Picks: India's Cutthroat Drug Market

Headlines from MedPage Today® - Tue, 08/16/2016 - 3:00pm
(MedPage Today) -- Also: costs of health insurance, assigning sex, fetal pain and more
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