24 results on '"Kimes, Teresa M."'
Search Results
2. Risk factors for breast cancer development by tumor characteristics among women with benign breast disease
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Figueroa, Jonine D., Gierach, Gretchen L., Duggan, Máire A., Fan, Shaoqi, Pfeiffer, Ruth M., Wang, Yihong, Falk, Roni T., Loudig, Olivier, Abubakar, Mustapha, Ginsberg, Mindy, Kimes, Teresa M., Richert-Boe, Kathryn, Glass, Andrew G., and Rohan, Thomas E.
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- 2021
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3. Effect of Combination Cholesterol-Lowering Therapy and Triglyceride-Lowering Therapy on Medical Costs in Patients With Type 2 Diabetes Mellitus
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Nichols, Gregory A., Reynolds, Kristi, Olufade, Temitope, Kimes, Teresa M., O'Keeffe-Rosetti, Maureen, Sapp, Daniel S., Anzalone, Deborah, and Fortmann, Stephen P.
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- 2017
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4. Correction to: Kidney disease progression and all-cause mortality across estimated glomerular filtration rate and albuminuria categories among patients with vs. without type 2 diabetes
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Nichols, Gregory A., Déruaz-Luyet, Anouk, Brodovicz, Kimberly G., Kimes, Teresa M., Rosales, A. Gabriela, and Hauske, Sibylle J.
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- 2020
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5. Kidney disease progression and all-cause mortality across estimated glomerular filtration rate and albuminuria categories among patients with vs. without type 2 diabetes
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Nichols, Gregory A., Déruaz-Luyet, Anouk, Brodovicz, Kimberly G., Kimes, Teresa M., Rosales, A. Gabriela, and Hauske, Sibylle J.
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- 2020
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6. Comparison of Risk of Re-hospitalization, All-Cause Mortality, and Medical Care Resource Utilization in Patients With Heart Failure and Preserved Versus Reduced Ejection Fraction
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Nichols, Gregory A., Reynolds, Kristi, Kimes, Teresa M., Rosales, A. Gabriela, and Chan, Wing W.
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- 2015
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7. Relation of Acute Heart Failure Hospital Length of Stay to Subsequent Readmission and All-Cause Mortality
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Reynolds, Kristi, Butler, Melissa G., Kimes, Teresa M., Rosales, A. Gabriela, Chan, Wing, and Nichols, Gregory A.
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- 2015
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8. The economic burden of progressive chronic kidney disease among patients with type 2 diabetes
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Vupputuri, Suma, Kimes, Teresa M., Calloway, Michael O., Christian, Jennifer B., Bruhn, David, Martin, Alan A., and Nichols, Gregory A.
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- 2014
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9. Incidence and Risk Factors for Venous Thromboembolic Disease in Podiatric Surgery
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Felcher, Andrew H., Mularski, Richard A., Mosen, David M., Kimes, Teresa M., DeLoughery, Thomas G., and Laxson, Steven E.
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- 2009
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10. WED-141 - Treatment eligibility and initiation among chronic hepatitis B patients in a real-world setting in the United States
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Schmidt, Mark A, Daida, Yihe G, Satram, Sacha, Kimes, Teresa M, Rosales, A Gabriela, Nie, Sixiang, Meenan, Richard, Donald, Judy L, Chattergoon, Michael, and Terrault, Norah
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- 2023
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11. Glycemic Response and Attainment of A1C Goals Following Newly Initiated Insulin Therapy for Type 2 Diabetes
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Nichols, Gregory A., Kimes, Teresa M., Harp, Joyce B., Kou, Tzuyung Doug, and Brodovicz, Kimberly G.
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- 2012
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12. Prevalence of Unmet Basic Needs and Association with Diabetes Control and Care Utilization Among Insured Persons with Diabetes.
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Fitzpatrick, Stephanie L., Banegas, Matthew P., Kimes, Teresa M., Papajorgji-Taylor, Dea, and Fuoco, Morgan Justice
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DIABETES prevention ,CONFIDENCE intervals ,MANN Whitney U Test ,MEDICAL care use ,HEALTH insurance ,DESCRIPTIVE statistics ,CHI-squared test ,DATA analysis software ,ODDS ratio ,ELECTRONIC health records ,LOGISTIC regression analysis ,MEDICAL needs assessment ,EVALUATION - Abstract
Unmet basic needs (eg, food insecurity, inadequate housing) are major barriers to diabetes self-management. The purpose of this study was to identify the prevalence of unmet basic needs and examine the association with diabetes control and care utilization among insured persons with diabetes. A total of 4043 adult patients with diabetes were screened for unmet basic needs using Your Current Life Situation, a screener for unmet basic needs, during a clinical encounter or as an online survey, during the study period (January 1, 2016–August 31, 2017). Hemoglobin A1c and care utilization (outpatient, emergency department [ED], hospitalization, diabetes-related prescription refills) were extracted from the electronic health record 12 months prior to screening. The authors compared patients with unmet basic needs to those with no needs on poor diabetes control (ie, A1c ≥8%) and care utilization using multivariable regression models. Of the 4043 patients screened, 25% endorsed ≥1 unmet basic need. In adjusted analyses, the presence of unmet basic needs was associated with an increased likelihood of having an A1c ≥8% (OR = 1.77; 95% CI 1.47, 2.13), more outpatient visits (incidence rate ratio [IRR] = 1.3; 1.2, 1.4), more ED visits (IRR = 2.3; 2.0, 2.6), more hospitalizations (IRR = 1.8; 1.5, 2.2), and more delays in refilling diabetes medication (IRR = 1.21; 1.13, 1.30). Findings indicate that unmet basic needs are highly prevalent, even among an insured patient population, and are associated with poor diabetes-related clinical outcomes and excess utilization. Future studies to determine best strategies to integrate this information into treatment planning are warranted. [ABSTRACT FROM AUTHOR]
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- 2021
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13. Relation of Quantitative Histologic and Radiologic Breast Tissue Composition Metrics With Invasive Breast Cancer Risk.
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Abubakar, Mustapha, Fan, Shaoqi, Bowles, Erin Aiello, Widemann, Lea, Duggan, Máire A, Pfeiffer, Ruth M, Falk, Roni T, Lawrence, Scott, Richert-Boe, Kathryn, Glass, Andrew G, Kimes, Teresa M, Figueroa, Jonine D, Rohan, Thomas E, and Gierach, Gretchen L
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BREAST diseases ,RADIOLOGY ,BIOMARKERS - Abstract
Background Benign breast disease (BBD) is a strong breast cancer risk factor, but identifying patients that might develop invasive breast cancer remains a challenge. Methods By applying machine-learning to digitized hematoxylin and eosin–stained biopsies and computer-assisted thresholding to mammograms obtained circa BBD diagnosis, we generated quantitative tissue composition metrics and determined their association with future invasive breast cancer diagnosis. Archival breast biopsies and mammograms were obtained for women (18-86 years of age) in a case-control study, nested within a cohort of 15 395 BBD patients from Kaiser Permanente Northwest (1970-2012), followed through mid-2015. Patients who developed incident invasive breast cancer (ie, cases; n = 514) and those who did not (ie, controls; n = 514) were matched on BBD diagnosis age and plan membership duration. All statistical tests were 2-sided. Results Increasing epithelial area on the BBD biopsy was associated with increasing breast cancer risk (odds ratio [OR]
Q4 vs Q1 = 1.85, 95% confidence interval [CI] = 1.13 to 3.04; Ptrend =.02). Conversely, increasing stroma was associated with decreased risk in nonproliferative, but not proliferative, BBD (Pheterogeneity =.002). Increasing epithelium-to-stroma proportion (ORQ4 vs Q1 = 2.06, 95% CI =1.28 to 3.33; Ptrend =.002) and percent mammographic density (MBD) (ORQ4 vs Q1 = 2.20, 95% CI = 1.20 to 4.03; Ptrend =.01) were independently and strongly predictive of increased breast cancer risk. In combination, women with high epithelium-to-stroma proportion and high MBD had substantially higher risk than those with low epithelium-to-stroma proportion and low MBD (OR = 2.27, 95% CI = 1.27 to 4.06; Ptrend =.005), particularly among women with nonproliferative (Ptrend =.01) vs proliferative (Ptrend =.33) BBD. Conclusion Among BBD patients, increasing epithelium-to-stroma proportion on BBD biopsies and percent MBD at BBD diagnosis were independently and jointly associated with increasing breast cancer risk. These findings were particularly striking for women with nonproliferative disease (comprising approximately 70% of all BBD patients), for whom relevant predictive biomarkers are lacking. [ABSTRACT FROM AUTHOR]- Published
- 2021
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14. Medication for Opioid Use Disorder During Pregnancy -- Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021.
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Miele, Kathryn, Kim, Shin Y., Jones, Rachelle, Rembert, Juneka H., Wachman, Elisha M., Shrestha, Hira, Henninger, Michelle L., Kimes, Teresa M., Schneider, Patrick D., Sivaloganathan, Vaseekaran, Sward, Katherine A., Deshmukh, Vikrant G., Sanjuan, Pilar M., Maxwell, Jessie R., Seligman, Neil S., Caveglia, Sarah, Louis, Judette M., Wright, Tanner, Bennett, Carolyne Cody, and Green, Caitlin
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METHADONE treatment programs ,NARCOTICS ,PUBLIC health surveillance ,NALTREXONE ,SUBSTANCE abuse ,SUBSTANCE abuse in pregnancy ,BUPRENORPHINE ,AGE distribution ,RACE ,POPULATION geography ,PREGNANCY outcomes ,NALOXONE ,HEALTH insurance ,DESCRIPTIVE statistics ,SOCIODEMOGRAPHIC factors ,PREGNANCY - Abstract
Problem: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care. Period Covered: 2014--2021. Description of the System: Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites in 2019. In 2021, three clinical sites were added to the network (the University of New Mexico, the University of Rochester, and the University of South Florida). Persons receiving care at the seven clinical sites are diverse in terms of geography, urbanicity, race and ethnicity, insurance coverage, and type of MOUD received. The goal of MAT-LINK is to capture demographic and clinical information about persons with OUD during pregnancy to better understand the effect of MOUD on outcomes and, ultimately, provide information for clinical care and public health interventions for this population. MAT-LINK maintains strict confidentiality through robust information technology architecture. MAT-LINK surveillance methods, population characteristics, and evaluation findings are described in this inaugural surveillance report. This report is the first to describe the system, presenting detailed information on funding, structure, data elements, and methods as well as findings from a surveillance evaluation. The findings presented in this report are limited to selected demographic characteristics of pregnant persons overall and by MOUD treatment status. Clinical and outcome data are not included because data collection and cleaning have not been completed; initial analyses of clinical and outcome data will begin in 2023. Results: The MAT-LINK surveillance network gathered data on 5,541 reported pregnancies with a known pregnancy outcome during 2014--2021 among persons with OUD from seven clinical sites. The mean maternal age was 29.7 (SD = ±5.1) years. By race and ethnicity, 86.3% of pregnant persons were identified as White, 25.4% as Hispanic or Latino, and 5.8% as Black or African American. Among pregnant persons, 81.6% had public insurance, and 84.4% lived in urban areas. Compared with persons not receiving MOUD during pregnancy, those receiving MOUD during pregnancy were more likely to be older and White and to have public insurance. The evaluation of the surveillance system found that the initial four clinical sites were not representative of demographics of the South or Southwest regions of the United States and had low representation from certain racial and ethnic groups compared with the overall U.S. population; however, the addition of three clinical sites in 2021 made the surveillance network more representative. Automated extraction and processing improved the speed of data collection and analysis. The ability to add new clinical sites and variables demonstrated the flexibility of MAT-LINK. Interpretation: MAT-LINK is the first surveillance system to collect comprehensive, longitudinal data on pregnant person--infant dyads with perinatal outcomes associated with MOUD during pregnancy from multiple clinical sites. Analyses of clinical site data demonstrated different sociodemographic characteristics between the MOUD and non-MOUD treatment groups. Public Health Actions: MAT-LINK is a timely and flexible surveillance system with data on approximately 5,500 pregnancies. Ongoing data collection and analyses of these data will provide information to support clinical and public health guidance to improve health outcomes among pregnant persons with OUD and their children. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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15. Medical Care Costs Associated With Long-term Weight Maintenance Versus Weight Gain Among Patients With Type 2 Diabetes.
- Author
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Nichols, Gregory A., Bell, Kelly, Kimes, Teresa M., and O'Keeffe-Rosetti, Maureen
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PEOPLE with diabetes ,MEDICAL care costs ,BODY weight ,WEIGHT gain ,GLYCEMIC control ,TYPE 2 diabetes treatment ,TYPE 2 diabetes ,GLYCOSYLATED hemoglobin ,WEIGHT loss ,COST analysis ,SAMPLE size (Statistics) ,ECONOMICS - Abstract
Objective: Weight loss is recommended for overweight patients with diabetes but avoidance of weight gain may be a more realistic goal. We calculated the 4-year economic impact of maintaining body weight versus gaining weight.Research Design and Methods: Among 8,154 patients with type 2 diabetes, we calculated weight change as the difference between the first body weight measure in 2010 and the last measure in 2013 and calculated mean glycated hemoglobin (A1C) from all measurements from 2010 to 2013. We created four analysis groups: weight change <5% and A1C <7%; weight gain ≥5% and A1C <7%; weight change <5% and A1C ≥7%; and weight gain ≥5% and A1C ≥7%. We compared change in medical costs between 2010 and 2013, adjusted for demographic and clinical characteristics.Results: Patients who maintained weight within 5% of baseline experienced a reduction in costs of about $400 regardless of A1C. In contrast, patients who gained ≥5% of baseline weight and had mean A1C ≥7% had an increase in costs of $1,473 (P < 0.001). Those who gained >5% of their baseline weight with mean A1C <7% had a modest increase in costs ($387, NS).Conclusions: Patients who gained at least 5% of their baseline body weight and did not maintain A1C <7% over 4 years experienced a 14% increase in medical costs, whereas those who maintained good glycemic control had a mean cost increase of 3.3%. However, patients who maintained weight within 5% of baseline had costs that were ∼5% lower than baseline. Avoidance of weight gain may reduce costs in the long-term. [ABSTRACT FROM AUTHOR]- Published
- 2016
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16. The Change in HbA1c Associated with Initial Adherence and Subsequent Change in Adherence among Diabetes Patients Newly Initiating Metformin Therapy.
- Author
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Nichols, Gregory A., Rosales, A. Gabriela, Kimes, Teresa M., Tunceli, Kaan, Kurtyka, Karen, and Mavros, Panagiotis
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PEOPLE with diabetes ,TYPE 2 diabetes diagnosis ,METFORMIN ,GLYCEMIC control ,TYPE 2 diabetes treatment - Abstract
Introduction. Whether changes in adherence are associated with changes in HbA1c is assumed but not known. Methods. We conducted a observational study of 2,844 type 2 diabetes patients who initiated metformin as their first antihyperglycemic drug. Using HbA1c measures before, 6–12 months after, and up to 3 years after metformin initiation, we analyzed HbA1c change as a function of initial adherence and change in adherence. Results. Compared with no adherence, initial adherence of 50–79% was associated with an adjusted reduction in HbA1c of 0.45% while adherence ≥80% was associated with HbA1c reduction of 0.73%. Change from some initial adherence (1–79%) to total nonadherence was associated with 0.25% increase in HbA1c. Change from some to full adherence was associated with an HbA1c decrease of 0.15%. Those associations were accentuated among patients not in glycemic control: change from some to no adherence was associated with an HbA1c increase of 0.63% and change from some to full adherence was associated with an HbA1c decrease of 0.40%. Conclusions. Initial adherence to newly prescribed metformin therapy produces substantial HbA1c reduction. Among those with modest adherence but suboptimal glycemic control, the difference between moving to full adherence versus nonadherence results in lower HbA1c of one percentage point. [ABSTRACT FROM AUTHOR]
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- 2016
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17. The economic burden of progressive chronic kidney disease among patients with type 2 diabetes.
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Vuputuri, Suma, Kimes, Teresa M., Calloway, Michael O., Christian, Jennifer B., Bruhn, David, Martin, Alan A., and Nichols, Gregory A.
- Subjects
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KIDNEY diseases , *DISEASE progression , *TYPE 2 diabetes , *MEDICAL care costs , *CREATININE - Abstract
Aims: To estimate the rate of progression of chronic kidney disease (CKD) among patients with type 2 diabetes (T2D) and calculate medical costs associated with progression. Methods: We conducted a retrospective cohort study of 25,576 members at Kaiser Permanente who had T2D and at least one serum creatinine measurement in 2005. Using estimated glomerular filtration rate (eGFR), we assigned patients to baseline stages of kidney function (stage 0-2, >60 ml/min/1.73 m2, n = 21,008; stage 3, 30-59, n = 3,885; stage 4, 15-29, n = 683). We examined all subsequent eGFRs through 2010 to assess progression of kidney disease. Medical costs at baseline and incremental costs during follow-up were assessed. Results: Mean age of patients was 60.6 years, 51% were men, and mean diabetes duration was 5.3 years. At baseline, 17.9% of patients with T2D also had stage 3 or 4 CKD. Incremental adjusted costs that occurred over follow-up (from baseline) was on average $4569, $12,617, and $33,162 per patient per year higher among patients who progressed from baseline stage 0-2, stage 3, and stage 4 CKD, respectively, compared to those who did not progress. Across all stages of CKD, those who progressed to a higher stage of CKD from baseline had follow-up costs that ranged from 2 to 4 times higher than those who did not progress. Conclusions: Progression of CKD in T2D drives substantial medical care costs. Interventions designed to minimize decline in progressive kidney function, particularly among patients with stage 3 or 4 CKD,may reduce the economic burden of CKD in T2D. [ABSTRACT FROM AUTHOR]
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- 2014
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18. 130: A Case-Control Study of Medical Co-Morbidities in Women with Interstitial Cystitis
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Clemens, J. Quentin, Meenan, Richard T., O’Keeffe Rosetti, Maureen C., Kimes, Teresa M., and Calhoun, Elizabeth A.
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- 2007
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19. 85: Prevalence and Risk Factors for Prostatitis in a Managed Care Population
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Clemens, J. Quentin, Meenan, Richard T., O'Keeffe Rosetti, Maureen C., Kimes, Teresa M., and Calhoun, Elizabeth A.
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- 2007
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20. Abstract 14177: The Association Between Heart Failure Hospital and Self-Reported Domains of Health.
- Author
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Nichols, Gregory A, Pesa, Jacqueline, Kimes, Teresa M, Sapp, Daniel S, and Patel, Aarti
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- 2018
21. Prevalence and incidence of urinary tract and genital infections among patients with and without type 2 diabetes.
- Author
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Nichols, Gregory A., Brodovicz, Kimberly G., Kimes, Teresa M., Déruaz-Luyet, Anouk, and Bartels, Dorothee B.
- Abstract
Objective: Epidemiological data on genitourinary infections (GUIs) comparing patients with and without type 2 diabetes (T2DM) is scant. We aimed to estimate the incidence of urinary tract infections (UTIs), genital infections (GIs), or any GUI in total and stratified by history of GUI and sex.Research Design and Methods: We identified 39,295 patients in the Kaiser Permanente Northwest health plan with T2DM and an equal number of age and sex matched patients without diabetes. The cohort was followed for up to 9years (2006-2014). We calculated incidence rates and corresponding 95% confidence intervals (CI) of any GUI, UTIs and GIs adjusting for age, sex, race, BMI, presence of chronic kidney disease, annual number of outpatient visits, and diuretic use.Results: Adjusted incidence of any GUI was 97.2/1000person-years (p-y) (95% CI 95.5-98.8) among the T2DM cohort vs. 79.7/1000 p-y (78.3-81.2) among those without diabetes. T2DM was associated with an adjusted 25% increased risk of UTI (rate ratio 1.25, 95% CI 1.22-1.29), a 26% increased risk of GI (1.26, 1.22-1.31) and a 22% increased risk of any GUI (1.22, 1.19-1.25). Incidence rates were lower among those with no GUI history, but the relative risks were similar. Women in both groups had higher incidence rates of GUIs than men.Conclusions: T2DM was associated with increased risks of any GUI, UTIs and GIs. Incidence rates of UTIs were higher than rates of GIs, but the relative risk of GIs was essentially identical. A similar pattern was observed when stratifying by sex.Significance Of the Study: RESEARCH QUESTIONS. [ABSTRACT FROM AUTHOR]- Published
- 2017
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22. RESOURCE USE ONE YEAR FOLLOWING HOSPITALIZATION FOR ACUTE HEART FAILURE: A COMPARISON OF PATIENTS WITH PRESERVED VERSUS REDUCED EJECTION FRACTION.
- Author
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Nichols, Gregory A., Reynolds, Kristi, Kimes, Teresa M., and Chan, Wing
- Subjects
- *
HEART failure treatment , *HOSPITAL care , *MEDICAL care , *MEDICAL emergencies , *HOSPITAL admission & discharge , *FOLLOW-up studies (Medicine) - Published
- 2015
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23. Screening HMO Women Overdue for both Mammograms and Pap Tests
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Valanis, Barbara G., Glasgow, Russell E., Mullooly, John, Vogt, Thomas M., Whitlock, Evelyn P., Boles, Shawn M., Smith, K. Sabina, and Kimes, Teresa M.
- Subjects
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BREAST cancer , *MAMMOGRAMS - Abstract
Background. Regular screening has the potential to reduce breast and cervical cancer mortality, but despite health plan programs to encourage screening, many women remain unscreened. Tailored communications have been identified as a promising approach to promote mammography and Pap test screening.Methods. The study used a four-group randomized design to compare with Usual Care the separate and combined effects of two tailored, motivational interventions to increase screening—a clinical office In-reach intervention and a sequential letter/telephone Outreach intervention. Subjects were 510 female HMO members ages 52–69 who had had no mammogram in the past 2 years and no Pap smear in the past 3 years. Primary outcomes were the percentage of women in each condition who received a mammogram, a Pap smear, or both screening tests during the 14-month study period.Results. Thirty-two percent of the Combined group, 39% of the Outreach group, and 26% of the In-reach group obtained both services versus 19% of Usual Care participants. Overall, compared with Usual Care, both Outreach (P = 0.006) and Combined (P = 0.05) screened significantly more women. For subjects ages 65–69, Outreach rates were lower than those of Usual Care.Conclusion. A tailored letter-telephone Outreach appears to be more effective at screening women ages 52–64 than a tailored office-based intervention, in large part because most In-reach women did not have clinic visits at which to receive the intervention. [Copyright &y& Elsevier]
- Published
- 2002
- Full Text
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24. Medication for Opioid Use Disorder During Pregnancy - Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021.
- Author
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Miele K, Kim SY, Jones R, Rembert JH, Wachman EM, Shrestha H, Henninger ML, Kimes TM, Schneider PD, Sivaloganathan V, Sward KA, Deshmukh VG, Sanjuan PM, Maxwell JR, Seligman NS, Caveglia S, Louis JM, Wright T, Bennett CC, Green C, George N, Gosdin L, Tran EL, Meaney-Delman D, and Gilboa SM
- Subjects
- Adult, Female, Humans, Infant, Pregnancy, Ethnicity statistics & numerical data, Family, Hispanic or Latino statistics & numerical data, United States epidemiology, Pregnancy Outcome, Young Adult, Black or African American statistics & numerical data, White statistics & numerical data, Opioid-Related Disorders drug therapy, Opioid-Related Disorders epidemiology, Opioid-Related Disorders ethnology, Population Surveillance methods
- Abstract
Problem: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care., Period Covered: 2014-2021., Description of the System: Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites in 2019. In 2021, three clinical sites were added to the network (the University of New Mexico, the University of Rochester, and the University of South Florida). Persons receiving care at the seven clinical sites are diverse in terms of geography, urbanicity, race and ethnicity, insurance coverage, and type of MOUD received. The goal of MAT-LINK is to capture demographic and clinical information about persons with OUD during pregnancy to better understand the effect of MOUD on outcomes and, ultimately, provide information for clinical care and public health interventions for this population. MAT-LINK maintains strict confidentiality through robust information technology architecture. MAT-LINK surveillance methods, population characteristics, and evaluation findings are described in this inaugural surveillance report. This report is the first to describe the system, presenting detailed information on funding, structure, data elements, and methods as well as findings from a surveillance evaluation. The findings presented in this report are limited to selected demographic characteristics of pregnant persons overall and by MOUD treatment status. Clinical and outcome data are not included because data collection and cleaning have not been completed; initial analyses of clinical and outcome data will begin in 2023., Results: The MAT-LINK surveillance network gathered data on 5,541 reported pregnancies with a known pregnancy outcome during 2014-2021 among persons with OUD from seven clinical sites. The mean maternal age was 29.7 (SD = ±5.1) years. By race and ethnicity, 86.3% of pregnant persons were identified as White, 25.4% as Hispanic or Latino, and 5.8% as Black or African American. Among pregnant persons, 81.6% had public insurance, and 84.4% lived in urban areas. Compared with persons not receiving MOUD during pregnancy, those receiving MOUD during pregnancy were more likely to be older and White and to have public insurance. The evaluation of the surveillance system found that the initial four clinical sites were not representative of demographics of the South or Southwest regions of the United States and had low representation from certain racial and ethnic groups compared with the overall U.S. population; however, the addition of three clinical sites in 2021 made the surveillance network more representative. Automated extraction and processing improved the speed of data collection and analysis. The ability to add new clinical sites and variables demonstrated the flexibility of MAT-LINK., Interpretation: MAT-LINK is the first surveillance system to collect comprehensive, longitudinal data on pregnant person-infant dyads with perinatal outcomes associated with MOUD during pregnancy from multiple clinical sites. Analyses of clinical site data demonstrated different sociodemographic characteristics between the MOUD and non-MOUD treatment groups., Public Health Actions: MAT-LINK is a timely and flexible surveillance system with data on approximately 5,500 pregnancies. Ongoing data collection and analyses of these data will provide information to support clinical and public health guidance to improve health outcomes among pregnant persons with OUD and their children., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. The Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is funded by the Assistant Secretary for Planning and Evaluation’s Office of the Secretary Patient-Centered Outcomes Research Trust Fund. All clinical site coauthors report funding for MAT-LINK. Katherine A. Sward reports funding from the National Institutes of Health for work with the Helping to End Addiction Long-Term (HEAL) Pain Management Effectiveness Research Network as a Data Coordinating Center. Vikrant G. Deshmukh reports a National Cancer Institute/University of Wisconsin subaward for investigating COVID-19 complications among smokers. Pilar M. Sanjuan reports funding as a principal investigator from the National Institute on Alcohol Abuse and Alcoholism for Project REACT (neural underpinnings of emotional regulation and drinking to cope); the National Institute on Drug Abuse for Project Vida (prenatal opioid use disorder and posttraumatic stress disorder); and the National Institute of Mental Health for Project Raptor (attention and post-traumatic stress disorder) and as a coinvestigator from the National Institute on Alcohol Abuse and Alcoholism on Project AsCENd (neuroimaging of child attention development); the National Institute on Drug Abuse Helping to End Addiction Long-Term initiative for Integrative Management of chronic Pain and OUD for Whole Recovery (pain and prenatal opioid use) and for the HEALthy Brain and Child Development study; and relationships with New Mexico Postpartum Support International as a board chair and the New Mexico Perinatal Collaborative as a board member. Jessie R. Maxwell reports funding from the National Institute on Drug Abuse for work as a coinvestigator on the HEALthy Brain and Childhood Development studies; the National Institutes of Health for work as a Helping to End Addiction Long-Term initiative alternate principal investigator; the National Institute on Alcohol Abuse and Alcoholism for work as a principal investigator on a project; the National Institute on Alcohol Abuse and Alcoholism for work as a coinvestigator on a local project; and the IDeA States Pediatric Clinical Trials Network for work as site principal investigator, work as a junior investigator, and meeting attendance as a member of the leadership committee. Neil S. Seligman reports funding from PreTel Inc. and Mae Stone Goode for work not related to this report; Natera for consulting fees; UpToDate for writing; and various legal reviews. Judette Louis reports funding from TD Bank for an institutional grant; Wolters Kluwer for an UpToDate piece on sleep apnea during pregnancy; Hologic for a one-time fee; Elsevier for serving as a textbook editor; Goldasich, Vick & Fulk for a fee; Sleep Disorder Research Advisory Board for being a member; the National Institutes of Health for work on a personalized integrated chronotherapy for perinatal depression; March of Dimes for travel expenses related to being a board member; Society for Maternal-Fetal Medicine for travel expenses related to being a board member; American Board of Obstetrics and Gynecology for travel expenses related to being a board member; and Preeclampsia Foundation for blood pressure cuffs for her institution. Tanner Wright reports funding from Duke University for a National Institutes of Health–funded project on Eating, Sleeping, Consoling for Neonatal Opioid Withdrawal Syndrome (ESC-NOW): a Function-Based Assessment and Management Approach; the National Institute on Drug Abuse for CADENCE (Continuous and Data-driven Care); the American Academy of Pediatrics for work as a subject matter expert on maternal–infant health and opioid use; and the National Advanced Practice and Low Risk Neonatal Nurses Conferences for presentations on neonatal opioid withdrawal syndrome. No other potential conflicts of interest were disclosed.
- Published
- 2023
- Full Text
- View/download PDF
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