# Compliance and Satisfaction With a Protocol for Identifying Novel Targets to Support Postpartum Opioid Use Disorder Recovery: Prospective Cohort Study

## TL;DR

This study tracks individuals with opioid use disorder during pregnancy and postpartum to identify new ways to prevent relapse, and finds that participants were generally satisfied with the study despite challenges.

## Contribution

The study introduces a protocol to identify novel predictors of postpartum opioid misuse through hormones and caregiving approaches.

## Key findings

- Participants showed high completion rates for postpartum clinic visits and follow-up.
- Compliance with study procedures was generally high, though lower among those with opioid use disorder.
- Participants reported high satisfaction with the study procedures.

## Abstract

Although treatment for opioid use disorder (OUD) often yields high adherence during pregnancy, the risk of returning to opioid misuse during postpartum is high. There are currently no relapse prevention programs tailored to this unique time period. Using a prospective cohort study, we seek to preliminarily identify hormones or infant caregiving approaches as novel predictors of postpartum opioid misuse.

As a first step in dissemination of results, this report contains a detailed account of the protocol, as well as recruitment, retention, compliance, and participant satisfaction.

Participants were individuals with OUD (OUD+) and those without (OUD–) who were followed from late pregnancy (≥36 gestational wk) to postpartum month 5. From childbirth to postpartum week 12, participants completed daily surveys (capturing use, craving, interactions with infant) and weekly face-to-face visits (including collection of biological samples for hormone assays). Follow-up visits using the same procedures occurred at postpartum month 4 and 5.

Most participants (50 OUD+, 20 OUD–) notified the study staff of childbirth (n=63, 93%), completed at least 1 postpartum clinic visit (n=62, 87%), and completed follow-up (n=51, 73%). Compliance with procedures ranged from 81% for weekly surveys to 63% for weekly dried blood spots, generally with lower compliance among OUD+ and at later time points. Among a subgroup of participants (n=31), regardless of group and time point, reported high study satisfaction (eg, on a scale where 0 is “not at all” and 3 is “extremely,” on average, participants reported 2.9±0.4 for their willingness to complete this study again at week 12 postpartum).

This prospective cohort study was well tolerated despite the challenging postpartum period. Data collected will provide ample opportunities to identify novel risk or protective factors to inform the development of new relapse prevention intervention programs specific to the needs of those with OUD during early postpartum.